Anti-tumor necrosis factor-alpha treatment activates Borrelia burgdorferi spirochetes 4 weeks after ceftriaxone 69treatment in C3H/He mice.

 J Infect Dis. 2007 May 15;195,10:1489-96. Epub 2007 Apr 6.Anti-tumor necrosis 
factor-alpha treatment activates Borrelia burgdorferi spirochetes 4 weeks after ceftriaxone
69treatment in C3H/He mice. Yrjänäinen H, Hytönen J, Song XY, Oksi J, Hartiala K, Viljanen MK. 
Department of Medical Microbiology, University of Turku, Turku, 20520, Finland. 
heta.yrjanainen@utu.fi
BACKGROUND: The effect of anti-tumor necrosis factor, TNF,-alpha treatment in Borrelia
burgdorferi-infected and ceftriaxone-treated C3H/He mice was evaluated. METHODS: Mice 
were infected with B. garinii A218 or B. burgdorferi sensu stricto N40. At 2 weeks of infection, 
one group was treated simultaneously with ceftriaxone and anti-TNF-alpha, whereas another 
received ceftriaxone at 2 weeks and anti-TNF-alpha 4 weeks later. One group received ceftri
axone treatment only. Infected and noninfected control groups were sham treated. RESULTS: At 
14 weeks of infection, B. burgdorferi could not be detected by cultivation or by polymerase chain 
reaction in tissue samples of any mouse treated with ceftriaxone only. However, spirochetes grew 
from the tissue samples of one-third of the mice treated with anti-TNF-alpha simultaneously 
or 4 weeks after ceftriaxone. These activated spirochetes showed ceftriaxone sensitivity rates, 
plasmid profiles, and virulence rates similar to those of bacteria used to infect the mice. All 
infected control mice and mice given anti-TNF-alpha only were culture positive. 
CONCLUSIONS: This report shows that, after ceftriaxone treatment for 5 days, a portion of B. 
burgdorferi-infected mice still have live spirochetes in their body, which are activated by 
anti-TNF-alpha treatment




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