ArticleArthritis and rheumatism2011
Burden and viability of Borrelia burgdorferi in skin and joints of patients with erythema migrans or lyme arthritis.
Article in Arthritis and rheumatism, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
78 citing papers in PubMed, 149 citations in OpenAlex.
- Xenodiagnosis to detect Borrelia burgdorferi infection: a first-in-human study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2014Trial
- Lyme borreliosis.Nature reviews. Disease primers · 2026Review
- Aspects of the Immunopathogenesis of Lyme Arthritis.Microorganisms · 2025Review
- Bacterial and host enzymes modulate the pro-inflammatory response elicited by the peptidoglycan of Lyme disease agent Borrelia burgdorferi.PLoS pathogens · 2025Article
- Investigation of erythema migrans patients identifies Borrelia species and Neoehrlichia mikurensis with implications for clinical assessment.Scientific reports · 2025Observational
- Toll-like receptor 1 polymorphism is associated with impaired immune tolerance, dysregulated inflammatory responses toFrontiers in immunology · 2025Article
- Wider recognition and greater understanding of postinfectious, antibiotic-refractory Lyme arthritis.The Journal of clinical investigation · 2024Article
- Evidence for the Presence ofMicroorganisms · 2024Article
- Variants in the Late Cornified Envelope Gene Locus Are Associated With Elevated T-helper 17 Responses in Patients With Postinfectious Lyme Arthritis.The Journal of infectious diseases · 2024Article
- Synthesis of aMolecules (Basel, Switzerland) · 2024Article
- Article
- Tick-Borne Co-Infections: Challenges in Molecular and Serologic Diagnoses.Pathogens (Basel, Switzerland) · 2023Review
- Direct Detection of Lyme Borrelia: Recent Advancement and Use of Aptamer Technology.Biomedicines · 2023Review
- Autoimmunity to synovial extracellular matrix proteins in patients with postinfectious Lyme arthritis.The Journal of clinical investigation · 2023Article
- Analysis of macerated ticks using Boolean logic gating colorimetric isothermal nucleic acid assays for Lyme Borrelia and Ixodes scapularis ticks.Scientific reports · 2023Article
- Association of Persistent Symptoms after Lyme Neuroborreliosis and Increased Levels of Interferon-α in Blood.Emerging infectious diseases · 2023Review
- A portable immunosensor provides sensitive and rapid detection of Borrelia burgdorferi antigen in spiked blood.Scientific reports · 2023Article
- Cell-Mediated Cytotoxicity in Lyme Arthritis.Arthritis & rheumatology (Hoboken, N.J.) · 2023Article
- Persistent Borrelia burgdorferiClinical microbiology reviews · 2022Review
- Lyme Arthritis.Infectious disease clinics of North America · 2022Review
18 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveTo determine the burden and viability of Borrelia burgdorferi in the skin and joints of patients with Lyme disease.
methodsStandard and quantitative polymerase chain reaction (PCR) techniques were used to detect B burgdorferi DNA in skin samples from 90 patients with erythema migrans (EM) and in synovial fluid (SF) from 63 patients with Lyme arthritis (LA) and in synovial tissue from 9 patients. Quantitative PCR determinations of B burgdorferi DNA, messenger RNA (mRNA), and ribosomal RNA (rRNA) were made in 10 skin samples from EM patients and 11 SF samples from LA patients.
resultsSkin lesions in most patients with EM had positive PCR results for B burgdorferi DNA. In the majority of patients with LA, a late disease manifestation, PCR results in pretreatment SF samples were positive. In patients with antibiotic-refractory arthritis, positive PCR results persisted for as long as 11 months, but positive results in samples taken during the postantibiotic period did not correlate with relapse or with the subsequent duration of arthritis, and at synovectomy, all results of PCR of synovial tissue were negative. B burgdorferi mRNA, a marker of spirochetal viability, was detected in 8 of 10 skin samples from EM patients, but in none of 11 SF samples from LA patients, even when obtained prior to antibiotic administration. Moreover, the median ratio of spirochetal rRNA to DNA, a measure of ribosomal activity, was 160 in the 10 EM skin samples, but only 0.15 in the 3 LA SF samples with positive results.
conclusionB burgdorferi in the skin lesions of EM patients were active and viable, whereas those in the SF of LA patients were moribund or dead at any time point. Thus, detection of B burgdorferi DNA in SF is not a reliable test of active joint infection in Lyme disease.
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Registered trials
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