title: Borrelia burgdorferi genetic markers and disseminated disease in patients with early Lyme disease.
abstract: Three genetic markers of Borrelia burgdorferi have been associated with disseminated disease: the OspC type, the 16S-23S rRNA intergenic spacer type (RST), and vlsE. Here, we modified previous methods so as to identify the three markers by PCR and restriction fragment length polymorphism in parallel, analyzed B. burgdorferi isolates from erythema migrans (EM) skin lesions in 91 patients, and correlated the results with evidence of dissemination. OspC type A was found approximately twice as frequently in patients with disseminated disease, whereas type K was identified approximately twice as often in those without evidence of dissemination, but these trends were not statistically significant. The remaining seven types identified were found nearly equally in patients with or without evidence of dissemination. RST 1 strains were significantly associated with dissemination (P=0.03), whereas RST 2 and RST 3 strains tended to have an inverse association with this outcome. The vlsE gene was identified in all 91 cases, using primer sets specific for an N-terminal sequence of B. burgdorferi strain B31 (vlsEB31) or strain 297 (vlsE297), but neither marker was associated with dissemination. Specific combinations of the three genetic markers usually occurred together. OspC type A was always found with RST 1 and vlsEB31, type K was always identified with RST 2 and more often with vlsE297, and types E and I were almost always found with RST 3 and equally often with vlsEB31 and vlsE297. We conclude that B. burgdorferi strains vary in their capacity to disseminate, but almost all strains isolated from EM lesions sometimes caused disseminated disease.
authors.affiliation: Division of Rheumatology, Allergy, and Immunology, Center for Immunology and Inflammatory Disease, Harvard Medical School, Massachusetts General Hospital, 55 Fruit St., CNY 149/8301, Boston, MA 02114, USA. KLJones@partners.org
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Jones
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Glickstein
authors.forename: Nitin
authors.initials: N
authors.lastname: Damle
authors.forename: Vijay K
authors.initials: VK
authors.lastname: Sikand
authors.forename: Gail
authors.initials: G
authors.lastname: McHugh
authors.forename: Allen C
authors.initials: AC
authors.lastname: Steere
mesh_terms: D000942:Antigens, Bacterial / Q000235:genetics; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics; D001426:Bacterial Proteins / Q000235:genetics; D015415:Biomarkers; D025065:Borrelia burgdorferi / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification / Q000472:pathogenicity; D004269:DNA, Bacterial / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000235:genetics; D005787:Gene Frequency; D005798:Genes, Bacterial; D005838:Genotype; D006801:Humans; D008074:Lipoproteins / Q000235:genetics; D008193:Lyme Disease / Q000175:diagnosis* / Q000382:microbiology*; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D012867:Skin / Q000382:microbiology; D013223:Statistics as Topic; D014774:Virulence / Q000235:genetics
chemical_list: D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D001426:Bacterial Proteins; D015415:Biomarkers; D004269:DNA, Bacterial; D021903:DNA, Ribosomal Spacer; D008074:Lipoproteins; C079616:OspC protein; C105546:VlsE protein, Borrelia burgdorferi