Etiological differences in Lyme borreliosis patients with and without localized scleroderma based on serological examination in the western Ukraine : Etiological differences in Lyme borreliosis patients with and without localized scleroderma based on serological examination in the western Ukraine

Mykhaylo Andreychyn; Mykhaylo Korda; Maria Shkilna; Oleksandr Tokarskyy; Kateryna Shtokailo; Tetiana Yuzkiv

Authors

Mykhaylo Andreychyn Department of Infectious Diseases with Epidemiology, Dermatology and Venereology, I. Horbachevskyy Ternopil National Medical University
Mykhaylo Korda Department of Medical Biochemistry, I. Horbachevskyy Ternopil National Medical University
Maria Shkilna Department of Infectious Diseases with Epidemiology, Dermatology and Venereology, I. Horbachevskyy Ternopil National Medical University
Oleksandr Tokarskyy Department of Medical Biochemistry, I. Horbachevsky Ternopil National Medical University
Kateryna Shtokailo Department of Infectious Diseases with Epidemiology, Dermatology and Venereology, I. Horbachevskyy Ternopil National Medical University
Tetiana Yuzkiv Department of Infectious Diseases with Epidemiology, Dermatology and Venereology, I. Horbachevskyy Ternopil National Medical University

Abstract

Background Possible associations of localized scleroderma (LS) with Lyme borreliosis (LB) were reported in certain countries, though denied in others. Therefore, it is still under investigation, whether the association is real or fictional. Objective The aims of the current study was to determine percentage of serologically positive patients among suspected LB patients, as well as to investigate etiological differences between confirmed LB patients with and without LS in Ternopil region. Methods An observational study of 196 patients with complaints related to LB treated at Ternopil healthcare institutions (2017-2022) was conducted. LB serological confirmation was done using using two-stage procedure (ELISA and immunoblotting). The confirmed LB patients were split into two groups, with or without localized scleroderma (LS), and a wide spectra of specific IgG were analyzed to check for significant differences between the two groups. Results We confirmed the necessity of the two-stage procedure, as some ELISA screening results, 11.4% (95% CI 3.1âˆ’29.3) for IgM and 11.5% (95% CI 4.6âˆ’23.6) for IgG, appeared to be false positives during stage two immunoblotting tests. VlsE antigens of B. afzelii and p83 were significantly more often detected in the LB patients with LS compared to LB patients without LS, p < 0.05. VlsE antigens of B. burgdorferi s. s. and p39 were diagnosed more often in LB alone patients compared to LB with LS patients, p <0.05. Conclusion We can speculate, that failures to detect borreliosis-associated morphea in some countries may be related to the absence of B. afzelii in those areas.

References

Nii-Trebi N. Emerging and Neglected Infectious Diseases: Insights, Advances, and Challenges. Biomed Res Int. 2017;2017:1-15.

Shah J, Liu S, Du Cruz I, et al. Line Immunoblot Assay for Tick-Borne Relapsing Fever and Findings in Patient Sera from Australia, Ukraine and the USA. Healthcare. 2019;7(4):121

Woudenberg T, Bohm S, Bohmer M, et al. Dynamics of Borrelia burgdorferi-Specific Antibodies: Seroconversion and Seroreversion between Two Population-Based, Cross-Sectional Surveys among Adults in Germany. Microorganisms. 2020;8(12):1859.

Vandekerckhove O, De Buck E, Van Wijngaerden E. Lyme disease in Western Europe: an emerging problem? A systematic review. Acta Clin Belg. 2021;76(3):244-52.

Schwartz A, Shankar M, Kugeler K, et al. Epidemiology and cost of Lyme disease-related hospitalizations among patients with employer-sponsored health insurance-United States, 2005-2014. Zoonoses Public Health. 2020;67(4):407-15.

Andreichyn M, Huk M, Shkilna M, Shtokailo K, Korda M. Detection of serum antibodies to tick-borne and other infections in patients with lymphadenopathy. Zaporozhye Med J. 2022;24(1):38-43.

Shkilna M, Andreychyn M, Korda M, et al. Serological Surveillance of Hospitalized Patients for Lyme Borreliosis in Ukraine. Vector Borne Zoonotic Dis. 2021;21(4):301-3.

Weiner M, Zukiewicz-Sobczak W, Tokarska-Rodak M, et al. Prevalence of Borrelia burgdorferi sensu lato in ticks from the Ternopil region in Ukraine. J Vet Res. 2018;62(3):275-80.

Andreychyn M, Panczuk A, Shkilna M, et al. Epidemiological situation of Lyme borreliosis and diagnosis standards in Poland and Ukraine. Health Probl Civiliz. 2017;11(3):190-4.

Tokarska-Rodak M, Shkilna M, Krajewska M, et al. The evaluation of hunters and foresters' knowledge of the possible ways of preventing Borrelia burgdorferi infections. Med Pr. 2020;71(1):59-68.

Trevisan G, Rees D, Stinco G. Borrelia-burgdorferi and localized scleroderma. Clin Dermatol. 1994;12(3):475-79.

Careta M, Romiti R. Localized scleroderma: clinical spectrum and therapeutic update. An Bras Dermatol. 2015;90(1):62-73.

Choi M, Seong G, Park M, et al. Rapidly Progressing Generalized Morphea with High Lyme Disease Titer. Indian J Dermatol. 2020;65(5):432.

Sandru F, Popa A, Petca A, et al. Etiologic role of Borrelia burgdorferi in morphea: A case report. Exp Ther Med. 2020;20(3):2373-6.

Buechner S, Winkelmann R, Lautenschlager S, Gilli L, Rufli T. Localized scleroderma associated with Borrelia-burgdorferi infection - clinical, histologic, and immunohistochemical observations. J Am Acad Dermatol. 1993;29(2):190-6.

Aberer E, Klade H, Stanek G, Gebhart W. Borrelia-burgdorferi and different types of morphea. Dermatologica. 1991;182(3):145-54.

Alonso-Llamazares J, Persing DH, Anda P, Gibson LE, Rutledge BJ, Iglesias L. No evidence for Borrelia burgdorferi infection in lesions of morphea and lichen sclerosus et atrophicus in Spain. A prospective study and literature review. Acta Derm Venereol. 1997;77(4):299-304.

Meis J, Koopman R, Vanbergen B, Pool G, Melchers W. No evidence for a relation between Borrelia-burgdorferi infection and old lesions of localized scleroderma (morphea). Arch Dermatol. 1993;129(3):386-7.

Vaillant L, Goudeau A. Localized scleroderma is not a Borrelia-burgdorferi infection in France. Letter Dermato. 1992;184(4):286.

Pritt B, Mead P, Johnson D, et al. Identification of a novel pathogenic Borrelia species causing Lyme borreliosis with unusually high spirochaetaemia: a descriptive study. Lancet Infectious Dis. 2016;16(5):556-64.

Shapiro E. Lyme Disease. N Engl J Med. 2014;370(18):1724-31.

Stanek G, Wormser G, Gray J, Strle F. Lyme borreliosis. Lancet. 2012;379(9814):461-73.

Shkilna M, Andreychyn M, Klishch I, Korda M, Rogalskyy I. Risk of tick-borne bacterial diseases in forestry workers of Ternopil region (western Ukraine). Health Probl Civiliz. 2017;11(2):93-8.

Pavlyshyn H, Haliyash N, Shkilna M, Horishna I, Furdela V. Epidemiology of Lyme Borreliosis among Risk-Group Children of Western Ukraine. Eur J Pediatr. 2017;176(11):1505-1505.

Nykytyuk S, Panczuk A, Shkilna M, et al. Awareness of tick-borne bacterial infection in the students of non-medical universities in Ternopil region (western Ukraine). Health Probl Civiliz. 2017;11(2):99-102.

Aberer E, Wutte N. Atrophosclerotic manifestations of Lyme Borreliosis. Open Dermatol J. 2016;10:27-43.

Zollinger T, Mertz K, Schmid M, Schmitt A, Pfaltz M, Kempf W. Borrelia in granuloma annulare, morphea and lichen sclerosus: a PCR-based study and review of the literature. J Cutan Pathol. 2010;37(5):571-7.

Weide B, Walz T, Garbe C. Is morphoea caused by Borrelia burgdorferi? A review. Br J Dermatol. 2000;142(4):636-44.

Zinchuk A, Kalyuzhna L, Pasichna I. Is Localized Scleroderma Caused by Borrelia burgdorferi? Vector Borne Zoonotic Dis. 2016;16(9):577-80.

Jovanovic D, Atanasievska S, Protic-Djokic V, Rakic U, Lukac-Radoncic E, Ristanovic E. Seroprevalence of Borrelia burgdorferi in occupationally exposed persons in the Belgrade area, Serbia. Braz J Microbiol. 2015;46(3):807-14.

Etiological differences in Lyme borreliosis patients with and without localized scleroderma based on serological examination in the western Ukraine