Borrelia burgdorferi and the macrophage: routine annihilation but occasional haven?
Borrelia burgdorferi, the agent for Lyme disease, has a typical pattern of bacterial interaction with phagocytes: attachment, stimulation o f release o f inflammatory mediators and, in most cases, ingestion and killing. Spirochetes are killed extracellulorly by antibody plus complement via the classical pathway, as well as by phagocytes through apparently nonoxidative means. Yet rare persistent spirochetes (mutants?) have been identified both in patients' tissues and in cells grown in vitro. Ruth Montgomery and Stephen Malawista here ask: are some Borrelia wolves in sheeps' clothing, evading macrophage anti-microbial action?
Department of Internal Medicine, Section of Rheumatology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA.
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