Biologic Markers of Antibiotic-Refractory Lyme Arthritis in Human: A Systematic Review

Abstract Introduction Lyme disease—also known as Lyme borreliosis (LB)—is the most common vector-borne disease in North America and Europe. It may result in substantial morbidity, primarily from persistent Lyme arthritis (LA) that—although treatable—can develop into antibiotic-refractory LA (A-RLA)....

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Main Authors: Alaa Badawi, Paul Arora, Darren Brenner
Format: Article
Language:English
Published: Adis, Springer Healthcare 2018-11-01
Series:Infectious Diseases and Therapy
Subjects:
Online Access:http://link.springer.com/article/10.1007/s40121-018-0223-0
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author Alaa Badawi
Paul Arora
Darren Brenner
author_facet Alaa Badawi
Paul Arora
Darren Brenner
author_sort Alaa Badawi
collection DOAJ
description Abstract Introduction Lyme disease—also known as Lyme borreliosis (LB)—is the most common vector-borne disease in North America and Europe. It may result in substantial morbidity, primarily from persistent Lyme arthritis (LA) that—although treatable—can develop into antibiotic-refractory LA (A-RLA). The aim of this study is to systematically review and evaluate a range of biomarkers for their potential predictive value in the development of A-RLA. Methods We conducted a systematic review of studies examining biomarkers among patients with A-RLA from MEDLINE via OVID, EMBASE and Web of Science databases and identified a total of 26 studies for qualitative analysis. Results All studies were of patient populations from the USA, with the exception of one from Europe. We identified an array of biomarkers that are commonly modulated in the A-RLA compared with subjects with antibiotic-responsive LA. These included a range of inflammatory markers (IL-6, IL-8, IL-10, IL-1β, IL-23, IL-17F, TNFα, IFNγ, CXCL9, CXCL10, CCL2, CCL3 and CCL4, CRP), factors along the innate and adaptive immune response pathways (e.g., CD4+ T cells, GITR receptors, OX40 receptors, IL-4+CD4+Th2 cells, IL-17+CD4+ T cells) and an array of miRNA species (e.g., miR-142, miR-17, miR-20a, let-7c and miR-30fam). Conclusion The evidence base of biologic markers for A-RLA is limited. However, a range of promising biomarkers have been identified. Cytokines and chemokines related to Th17 pathway together with a number of miRNAs species (miR-146a, miR-155 and let-7a) may be promising candidates in the prediction of A-RLA. A panel of multiple biomarkers may yield clinically relevant prediction of the possible resistance at the time of LA first diagnosis. Funding Public Health Agency of Canada.
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spelling doaj.art-6841d68a9aeb44c8845af06f211c4c0f2022-12-22T00:05:11ZengAdis, Springer HealthcareInfectious Diseases and Therapy2193-82292193-63822018-11-018152210.1007/s40121-018-0223-0Biologic Markers of Antibiotic-Refractory Lyme Arthritis in Human: A Systematic ReviewAlaa Badawi0Paul Arora1Darren Brenner2Public Health Risk Sciences Division, Public Health Agency of CanadaDalla Lana School of Public Health, University of TorontoCumming School of Medicine, University of CalgaryAbstract Introduction Lyme disease—also known as Lyme borreliosis (LB)—is the most common vector-borne disease in North America and Europe. It may result in substantial morbidity, primarily from persistent Lyme arthritis (LA) that—although treatable—can develop into antibiotic-refractory LA (A-RLA). The aim of this study is to systematically review and evaluate a range of biomarkers for their potential predictive value in the development of A-RLA. Methods We conducted a systematic review of studies examining biomarkers among patients with A-RLA from MEDLINE via OVID, EMBASE and Web of Science databases and identified a total of 26 studies for qualitative analysis. Results All studies were of patient populations from the USA, with the exception of one from Europe. We identified an array of biomarkers that are commonly modulated in the A-RLA compared with subjects with antibiotic-responsive LA. These included a range of inflammatory markers (IL-6, IL-8, IL-10, IL-1β, IL-23, IL-17F, TNFα, IFNγ, CXCL9, CXCL10, CCL2, CCL3 and CCL4, CRP), factors along the innate and adaptive immune response pathways (e.g., CD4+ T cells, GITR receptors, OX40 receptors, IL-4+CD4+Th2 cells, IL-17+CD4+ T cells) and an array of miRNA species (e.g., miR-142, miR-17, miR-20a, let-7c and miR-30fam). Conclusion The evidence base of biologic markers for A-RLA is limited. However, a range of promising biomarkers have been identified. Cytokines and chemokines related to Th17 pathway together with a number of miRNAs species (miR-146a, miR-155 and let-7a) may be promising candidates in the prediction of A-RLA. A panel of multiple biomarkers may yield clinically relevant prediction of the possible resistance at the time of LA first diagnosis. Funding Public Health Agency of Canada.http://link.springer.com/article/10.1007/s40121-018-0223-0Antibiotic-refractory Lyme arthritisBiomarkersHumanInflammationSystematic review
spellingShingle Alaa Badawi
Paul Arora
Darren Brenner
Biologic Markers of Antibiotic-Refractory Lyme Arthritis in Human: A Systematic Review
Infectious Diseases and Therapy
Antibiotic-refractory Lyme arthritis
Biomarkers
Human
Inflammation
Systematic review
title Biologic Markers of Antibiotic-Refractory Lyme Arthritis in Human: A Systematic Review
title_full Biologic Markers of Antibiotic-Refractory Lyme Arthritis in Human: A Systematic Review
title_fullStr Biologic Markers of Antibiotic-Refractory Lyme Arthritis in Human: A Systematic Review
title_full_unstemmed Biologic Markers of Antibiotic-Refractory Lyme Arthritis in Human: A Systematic Review
title_short Biologic Markers of Antibiotic-Refractory Lyme Arthritis in Human: A Systematic Review
title_sort biologic markers of antibiotic refractory lyme arthritis in human a systematic review
topic Antibiotic-refractory Lyme arthritis
Biomarkers
Human
Inflammation
Systematic review
url http://link.springer.com/article/10.1007/s40121-018-0223-0
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AT paularora biologicmarkersofantibioticrefractorylymearthritisinhumanasystematicreview
AT darrenbrenner biologicmarkersofantibioticrefractorylymearthritisinhumanasystematicreview