Persistence of Borrelia garinii and Borrelia afzelii in patients with Lyme arthritis.

 Zentralbl Bakteriol. 1999 Jul;289,3:301-18. Persistence of Borrelia garinii and Borrelia
afzelii in patients with Lyme arthritis. Hulínská D, Votýpka J, Valeso vá M.
55National Institute of Public Health, Prague, Czech Republic.
We repeatedly detected DNA of Borrelia garinii or B. afzelii and Borrelia-like structures in 
the blood, joint fluid or in the synovium of 10 patients with Lyme arthritis by means of the 
polymerase chain reaction and immunoelectron microscopy at 2-4-month intervals in the 
course of two years. All samples were analyzed using primers which amplified the 16S rRNA
gene sequence of Borrelia burgdorferi sensu lato and nucleotide sequences for the OspA gene. No 
cross hybridization occurred with DNA from human cells and with DNA from other bacteria. 
Capture and labelling with monoclonal antibodies of aggregated antigens, membranes and 
flagellae were evident in the blood of 7 patients, in 4 synovial membranes and 2 synovial
fluids. Borreliae were found in blood capillaries, in collagen and in clusters surrounding 
inflammatory cells in the synovium of patients with recurrent infections who carried IgM and 
IgG antibodies to OspA and to 83 kDa core protein. After significant improvement for several 
weeks after treatment, arthritis recurred in six patients. Synoviocyte hyperplasia, inflammatory 
infiltration and concentric adventitial fibroplasia were seen in the synovium of the patients with 
persisting borreliae. Only two patients were infected with B. afzelii, the others with B. garinii




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