Target Imbalance: Disparity of Borrelia burgdorferi Genetic Material in Synovial Fluid from Lyme Arthritis Patients

Authors:
  • BRBarbara J. Rutledge
    Barbara J. Rutledge
  • PRPaul N. Rys
    Paul N. Rys
  • DPDiane S. Podzorski
    Diane S. Podzorski
  • PMPaul D. Mitchell
    Paul D. Mitchell
  • KRK. D. R.
    K. D. R.
  • BLBing Liu
    Bing Liu
  • EFErol Fikrig
    Erol Fikrig
  • SMStephen E. Malawista
    Stephen E. Malawista
Publisher website
Google Scholar
Abstract
Lyme arthritis is a late manifestation of Lyme disease that results in episodic synovial inflammation and swelling. Although this process is thought to be driven directly by the spirochetal etiologic agent, Borrelia burgdorferi, the organism itself has been recovered by culture only twice. In contrast, polymerase chain reaction (peR) studies are usually positive. This apparent discrepancy in 19 culture-negative synovial fluid specimens from 18 patients with Lyme arthritis was investigated. In all 19,DNA sequences characteristic of plasmid-encoded genes OspA and OspB were easily detected. However, despite equivalent or even superior analytic sensitivity for detection of cultured organisms, the reactivity of two genomic DNA targets was often weak or absent altogether in the clinical specimens. This apparent overrepresentation of B. burgdorferi plasmid sequences wasfound exclusively in clinical specimensand not in cultured organisms. The physiologic imbalance of genomic and plasmid DNA reactivityin B. burgdorferi infection may signal an underlying pathogenetic mechanism.