title: Complement split products C3a and C4a are early markers of acute lyme disease in tick bite patients in the United States.
abstract: BACKGROUND
  Current laboratory markers do not readily detect acute Lyme disease. We assessed the utility of complement and its split products as markers of Lyme disease in patients shortly after a tick bite.
  
  
  METHODS
  Thirty-one consecutive acute Lyme disease patients, 14 with and 17 without erythema migrans (EM) skin rash, seen by a physician within 96 h of a tick bite were matched with 24 consecutive tick bite patients without Lyme disease symptoms and 46 healthy control subjects. Complement and split products measured included factor B, Bb, C4, C3c, C3a(des Arg), C4a(des Arg), C1q- and C3d-containing immune complexes, and C2.
  
  
  RESULTS
  C2, C4, C3 and factor B levels were within normal ranges in all groups. C3a and C4a levels were significantly higher in acute Lyme disease patients than in tick bite and healthy control groups (both p < 0.001). All acute Lyme disease patients, regardless of EM, had elevated levels of C3a or C4a. Few tick bite controls had elevated levels of C3a (2/20) or C4a (5/24) and only 1 of the healthy control subjects had elevated C3a (0/46) or C4a (1/32).
  
  
  CONCLUSIONS
  These findings suggest that C3a and C4a may be useful markers of Lyme disease in patients seen shortly after tick bite, even in those without EM.
authors.affiliation: Center for Research on Biotoxin Associated Illnesses, Pocomoke, Md., USA.
authors.forename: Ritchie C
authors.initials: RC
authors.lastname: Shoemaker
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Giclas
authors.forename: Chris
authors.initials: C
authors.lastname: Crowder
authors.forename: Dennis
authors.initials: D
authors.lastname: House
authors.forename: M Michael
authors.initials: MM
authors.lastname: Glovsky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D025065:Borrelia burgdorferi / Q000276:immunology*; D003167:Complement Activation / Q000276:immunology; D015926:Complement C3a / Q000032:analysis / Q000276:immunology*; D015934:Complement C4a / Q000032:analysis / Q000276:immunology*; D015787:Erythema Chronicum Migrans / Q000276:immunology; D005260:Female; D006801:Humans; D007299:Insect Bites and Stings / Q000276:immunology; D008193:Lyme Disease / Q000175:diagnosis / Q000276:immunology* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric
chemical_list: D015926:Complement C3a; D015934:Complement C4a