title: Autoantibodies from synovial lesions in chronic, antibiotic treatment-resistant Lyme arthritis bind cytokeratin-10.
abstract: Although the causative agent of Lyme disease is definitively known to be the tick-borne spirochete, Borrelia burgdorferi, the etiology of chronic joint inflammation that ensues in a subset of patients remains less well understood. Persistence of arthritis after apparent eradication of the spirochete suggests an autoimmune reaction downstream of the original bacterial infection. We have generated recombinant Ab probes from synovial lesions within affected arthritic joints in an attempt to recapitulate disease-relevant Ag-binding specificities at the site of injury. Using this panel of intra-articular probes, as well as Ab fragments derived from patient peripheral blood, we have identified cytokeratin 10, present in synovial microvascular endothelium, as a target ligand and a putative autoantigen in chronic, antibiotic treatment-resistant Lyme arthritis. Furthermore, there is cross-reactivity between cytokeratin 10 and a prominent B. burgdorferi Ag, outer surface protein A. Release of the self protein in the context of inflammation-induced tissue injury and the resulting in situ response to it could set in motion a feed-forward loop, which amplifies the inflammatory process, thereby rendering it chronic and self-perpetuating, even in the absence of the inciting pathogen.
authors.affiliation: Department of Pathology, Tufts University School of Medicine, 150 Harrison Avenue, Boston, MA 02111, USA.
authors.forename: Srimoyee
authors.initials: S
authors.lastname: Ghosh
authors.forename: Robert
authors.initials: R
authors.lastname: Seward
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Costello
authors.forename: B David
authors.initials: BD
authors.lastname: Stollar
authors.forename: Brigitte T
authors.initials: BT
authors.lastname: Huber
mesh_terms: D001323:Autoantibodies / Q000378:metabolism*; D001324:Autoantigens / Q000276:immunology* / Q000378:metabolism; D001666:Binding Sites, Antibody; D002908:Chronic Disease; D024881:Drug Resistance, Bacterial; D004730:Endothelium, Vascular / Q000276:immunology / Q000378:metabolism; D006801:Humans; D053550:Keratin-10; D007633:Keratins / Q000276:immunology* / Q000378:metabolism; D008193:Lyme Disease / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D013583:Synovial Membrane / Q000276:immunology* / Q000473:pathology
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; C507493:KRT10 protein, human; D053550:Keratin-10; D007633:Keratins