LYMPHOPROLIFERATIVE RESPONSES TO BORRELIA-BURGDORFERI IN PATIENTS WITH ERYTHEMA MIGRANS, ACRODERMATITIS CHRONICA ATROPHICANS, LYMPHADENOSISBENIGNA CUTIS, AND MORPHEA
Sa. Buechner et al., LYMPHOPROLIFERATIVE RESPONSES TO BORRELIA-BURGDORFERI IN PATIENTS WITH ERYTHEMA MIGRANS, ACRODERMATITIS CHRONICA ATROPHICANS, LYMPHADENOSISBENIGNA CUTIS, AND MORPHEA, Archives of dermatology, 131(6), 1995, pp. 673-677
Background and Design: Specific humoral and cell-mediated immune respo
nses play an important role in the pathogenesis of Lyme borreliosis. S
everal previous studies demonstrated that a specific cellular immune r
esponse to Borrelia burgdorferi can occur independently of a diagnosti
c humoral response. Little is known about T-cell reactivities against
B burgdorferi in early and late cutaneous manifestations of Lyme borre
liosis. We studied the lymphoproliferative response of peripheral bloo
d mononuclear cells to B burgdorferi antigen from 99 patients (25 with
erythema migrans, 16 with acrodermatitis chronica atrophicans, 13 wit
h lymphadenosis benigna cutis, and 45 with localized scleroderma) and
21 control subjects. The results are expressed as a stimulation index
(SI) (mean count per minute of triplicate cultures with stimulant divi
ded by mean count per minute without stimulant). The serum samples fro
m all patients and control subjects were tested for antibodies to B bu
rgdorferi by indirect immunofluorescence assay. Results: The 21 health
y seronegative controls had an SI of 3.3 +/- 2.0 (mean +/- SD). Compar
ed with that of control subjects, the SIs were significantly elevated
in patients with erythema migrans (9.8 +/- 9.1), acrodermatitis chroni
ca atrophicans (11.8 +/- 8.2), and lymphadenosis benigna cutis (7.2 +/
- 6.2). The 45 patients with localized scleroderma had elevated prolif
erative responses, with an SI of 6.5 +/- 7.3, but these responses did
not significantly differ from those of controls. Elevated titers of an
tibodies to B burgdorferi were present in six (24%) of 25 patients wit
h erythema migrans, five (38%) of 13 patients with lymphadenosis benig
na cutis, and 13 (29%) of 45 patients with localized scleroderma. All
16 patients with acrodermatitis chronica atrophicans had markedly elev
ated antibody titers.