Chapter 14 : Lyme Borreliosis

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in

Lyme Borreliosis, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555818104/9781555811594_Chap14-1.gif /docserver/preview/fulltext/10.1128/9781555818104/9781555811594_Chap14-2.gif


Lyme borreliosis (Lyme disease) is unequivocally a persistent infectious disease. , the agent of Lyme disease, persists in both humans and animals, despite a vigorous and effective immune response by the infected host. The agent of Lyme disease also owes its survival to its propensity to infect a wide variety of mammalian and avian hosts, thereby allowing geographic spread and adaptation to new niches. The majority (60 to 80%) of patients with Lyme disease develop an expanding annular skin lesion (erythema migrans) at the site of the tick bite. Borrelia plasmids are fundamentally different from plasmids of other bacteria in that they contain essential, rather than nonessential, extrachromosomal elements of the genome. The phenomenon of lateral gene transfer and recombination may have selective advantages in mixed populations of spirochetes but does not provide an explanation for the immune evasion of clonal populations of spirochetes during persistent infection. The proof of the pudding for antigenic variation is whether antigenic changes in spirochetes provide selective advantages for the variant subpopulation in evading immune clearance. No evidence for this phenomenon has been observed with . Analysis of the outer and inner membranes of spirochetes indicates that the majority of protein is associated with the inner membrane and that proteins associated with the outer membrane, including OspC, may have only limited surface exposure.

Citation: Barthold S. 2000. Lyme Borreliosis, p 281-304. In Nataro J, Blaser M, Cunningham-Rundles S (ed), Persistent Bacterial Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818104.ch14
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


Image of FIGURE 1

Indirect immunohistochemistry of joint tissue from an infected SCID mouse probed with immune serum from a i-infected immunocompetent mouse. Immune serum contains antibodies that are reactive to spirochetes in joint tissue, but the target antigen(s) has not been implicated.

Citation: Barthold S. 2000. Lyme Borreliosis, p 281-304. In Nataro J, Blaser M, Cunningham-Rundles S (ed), Persistent Bacterial Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818104.ch14
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 2

Indirect immunofluorescence of the midgut of a flat (resting) tick labeled with antiserum to OspA. Spirochetes within the midgut of the tick are strongly reactive with OspA antibody. (Reprinted from reference .)

Citation: Barthold S. 2000. Lyme Borreliosis, p 281-304. In Nataro J, Blaser M, Cunningham-Rundles S (ed), Persistent Bacterial Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818104.ch14
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 3

Indirect immunofluorescence of the midgut of a tick that has fed upon a mouse immunized with OspA. Ingestion of OspA antibody has killed organisms, with no viable spirochetes remaining in the midgut. (Reprinted from reference .)

Citation: Barthold S. 2000. Lyme Borreliosis, p 281-304. In Nataro J, Blaser M, Cunningham-Rundles S (ed), Persistent Bacterial Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818104.ch14
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 4

Indirect immunofluorescence and confocal microscopy of a tick salivary gland following onset of feeding, demonstrating loss of OspA following migration to salivary glands during feeding. Spirochetes are labeled with antiserum to (A) but are not labeled with antiserum to OspA (B). (With permission from E. Fikrig.)

Citation: Barthold S. 2000. Lyme Borreliosis, p 281-304. In Nataro J, Blaser M, Cunningham-Rundles S (ed), Persistent Bacterial Infections. ASM Press, Washington, DC. doi: 10.1128/9781555818104.ch14
Permissions and Reprints Request Permissions
Download as Powerpoint


1. Aguero-Rosenfeld , M. E.,, J. Nowakowski,, D. F. McKenna,, C. A. Carbonaro,, and G. P. Wormser. 1993. Serodiagnosis in early Lyme disease. J. Clin. Microbiol. 31: 3090 3095.
2. Akins, D. R.,, S. F. Porcella,, T. G. Popova,, D. Shevchenko,, S. I. Baker,, M. Li,, M. V. Norgard,, and J. D. Radolf. 1995. Evidence for in vivo but not in vitro expression of a Borrelia burgdorferi outer surface protein F (OspF) homologue. Mol. Microbiol. 18: 507 520.
3. Anderson, J. F.,, and L. A. Magnarelli. 1993. Epizootiology of Lyme disease-causing borreliae. Clin. Dermatol. 11: 339 351.
4. Armstrong, A. L.,, S. W. Barthold,, D. H. Persing,, and D. S. Beck. 1992. Carditis in Lyme disease susceptible and resistant strains o f laboratory mice infected with Borrelia burgdorferi. Am. J. Trop. Med. Hyg. 47: 249 258.
5. Aron, L.,, M. Alekshun,, L. Perlee,, I. Schwartz,, H. Godfrey,, and F. Cabello. 1994. Cloning and DNA sequence analysis of bmpC, a gene encoding a potential membrane lipoprotein of Borrelia burgdorferi. FEMS Microbiol. Lett. 123: 75 82.
6. Asbrink, E.,, and A. Hovmark. 1985. Successful cultivation of spirochetes from skin lesions of patients with erythema chronica migrans afzelius and acrodermatitis chonica atrophicans. Acta Pathol. Microbiol. Immunol. Scand. 93: 161 163.
7. Backenson, P. B.,, J. L. Coleman ,, and J. L. Benach. 1995. Borrelia burgdorferi shows specificity of binding to glycosphingolipids. Infect. Immun. 63: 2811 2817.
8. Balmelli, T.,, and J. C. Piffaretti. 1995. Association between different clinical manifestations of Lyme disease and different species of Borrelia burgdorferi sensu lato. Res. Microbiol. 146: 329 340.
9. Barbour, A. G.,, S. L. Tessier,, and W. J. T odd. 1983. Lyme disease spirochetes and Ixodid tick spirochetes share a common surface antigenic determinant defined by monoclonal antibody. Infect. Immun. 41: 795 804.
10. Barthold, S. W. 1993. Antigenic stability of Borrelia burgdorferi during chronic infections of immunocompetent mice. Infect. Immun. 61: 4955 4961.
11. Barthold, S. W. 1996. The globilisation of Lyme borreliosis. Lancet 348: 1603 1604.
12. Barthold, S. W. 1991. Infectivity of Borrelia burgdorferi relative to route of inoculation and genotype in laboratory mice. J. Infect. Dis. 163: 419 420.
13. Barthold, S. W. 1999. Specificity of infectioninduced immunity among Borrelia burgdorferi sensu lato species. Infect. Immun. 67: 36 42.
14. Barthold, S. W. 1998. Spirochetes, ticks, and DNA. Parasitol. Today 14: 444.
15. Barthold, S. W.,, and L. K. Bockenstedt. 1993. Passive immunizing activity of sera from mice infected with Borrelia burgdorferi. Infect. Immun. 61: 4696 4702.
16. Barthold, S. W.,, M. de Souza ,, and S. Feng. 1996. Serum-mediated resolution of Lyme arthritis in mice. Lab. Investig. 74: 57 67.
17. Barthold, S. W.,, M. S. deSouza,, J. L. Janotka,, A. L. Smith,, and D. H. Persing. 1993. Chronic Lyme borreliosis in the laboratory mouse. Am. J. Pathol. 143: 951 971.
18. Barthold, S. W.,, S. Feng ,, L. K. Bockenstedt,, E. Fikrig,, and K. Feen. 1997. Protective and arthritis-resolving activity in serum from mice infected with Borrelia burgdorferi. Clin. Infect. Dis. 25: S9 S17.
19. Barthold, S. W.,, E. Fikrig,, L. K. Bockenstedt,, and D. H. Persing. 1995. Circumvention of outer surface protein A immunity by host-adapted Borrelia burgdorferi. Infect. Immun. 63: 2255 2261.
20. Barthold, S. W.,, S. A. Levy,, E. Fikrig,, L. K. Bockenstedt ,, and A. L. Smith. 1995. Serologic response of naturally exposed or vaccinated dogs to Borrelia burgdorferi, the agent o f Lyme borreliosis. J. Am. Vet. Med. Assoc. 207: 1435 1440.
21. Barthold, S. W.,, D. H. Persing,, A. L. Armstrong,, and R. A. Peeples. 1991. Kinetics of Borrelia burgdorferi dissemination and evolution of disease following intradermal inoculation of mice. Am. J. Pathol. 139: 263 273.
22. Barthold, S. W.,, C. L. Sidman,, and A. L. Smith. 1992. Lyme borreliosis in genetically resistant and susceptible mice with severe combined immunodeficiency. Am. J. Trop. Med. Hyg. 47: 605 613.
23. Bergstrom, S.,, C. F. Garon,, and A. G. Barbour. 1992. Extrachromosomal elements of spirochetes. Res. Microbiol. 143: 623 628.
24. Bledsoe, H. A.,, J. A. Carroll,, T. R. Whelchel,, M. A. Farmer,, D. W. Dorward,, and F. C. Gherardini. 1994. Isolation and partial characterization of Borrelia burgdorferi inner and outer membranes by using isopycnic centrifugation. J. Bacteriol. 176: 7447 7455.
25. Bockenstedt, L. K.,, E. Hodzic ,, S. Feng,, K. W. Bourell,, A. deSilva,, R. Montgomery ,, J. D. Radolf,, and S. W. Barthold. 1997. Borrelia burgdorferi strain-specific OspC-mediated immunity in mice. Infect. Immun. 65: 4661 4667.
26. Brorson, O.,, and S. H. Brorson. 1998. In vitro conversion of Borrelia burgdorferi to cystic forms in spinal fluid, and transformation to mobile spirochetes by incubation in BSK-H medium. Infection 26: 144 150.
27. Brorson, O.,, and S. H. Brorson. 1997. Transformation of cystic forms of Borrelia burgdorferi to normal, mobile spirochetes. Infection 25: 240 246.
28. Brouqui, P.,, S. Badiaga,, and D. Raoult. 1996. Eukaryotic cells protect Borrelia burgdorferi from the action of penicillin and ceftriaxone but not from the action of doxycline and erythromycin. Antimicrob. Agents Chemother. 40: 1552 1554.
29. Bruck, D. K.,, M. L. Talbor,, R. G. Cluss,, and J. T. Booth by. 1995. Ultrastructural characterization of the stages of spheroplast preparation of Borrelia burgdorferi. J. Microbiol. Methods 23: 219.
30. Brunet, L. R.,, A. Spielman,, E. Fikrig,, and S. R. Telford III. 1997. Heterogeneity of Lyme disease spirochaetes within individual vector ticks. Res. Microbiol. 148: 437 445.
31. Burgdorfer, W.,, S. Hayes,, and J. Benach. 1988. Development of Borrelia burgdorferi in ixodid tick vectors. Ann. N. Y. Acad. Sci. 539: 172 179.
32. Burgdorfer, W.,, and S. F. Hayes. 1989. Vector- spirochete relationships in louse-borne and tick-borne borreliosis with emphasis on Lyme disease. Adv. Dis. Vector Res. 6: 127 150.
33. Burgdorfer, W.,, S. F. Hayes,, and D. Corwin. 1989. The pathophysiology of the Lyme disease spirochete, Borrelia burgdorferi, in ixodid ticks. Rev. Infect. Dis. 110: S1442 S1450.
34. Burkot, T. R.,, J. Piesman,, and R. A. Wirtz,. 1994. Kinetics of the Borrelia burgdorferi outer surface protein A (OspA) in the tick, Ixodes scapularis, p. 224 227. In R. Cevinini,, V. Sambri,, and M. LaPlaca (ed.), Advances in Lyme Borreliosis Research. Proceedings of the Vlth International Conference on Lyme Borreliosis. University of Bologna, Bologna, Italy.
35. Carter, C. J.,, S. Bergstrom,, S.J. Norris,, and A. G. Barbour. 1994. A family of surface-exposed proteins of 20 kilodaltons in the genus Borrelia. Infect. Immun. 62: 2792 2799.
36. Casjens, S.,, G. Hatfull,, and R. Hendrix. 1992. Evolution of dsDNA tailed-bacteriophage genomes. Semin. Virol. 3: 383 397.
37. Casjens, S.,, R. van Vugt,, K. Tilly,, P. A. Rosa,, and B. Stevenson. 1997. Homology throughout the multiple 32-kilobase circular plasmids present in Lyme disease spirochetes. J. Bacteriol. 179: 217 227.
38. Champion, C. I.,, D. R. Blanco,, J. T. Skare,, D. A. Haake,, M. Giladi,, D. Foley,, J. N. Miller,, and M. A. Lovett. 1994. A 9.0 kilobasepair circular plasmid of Borrelia burgdorferi encodes an exported protein: evidence for expression only during infection. Infect. Immun. 62: 2653 2661.
39. Chang, Y. F.,, M. J. G. Appel,, R. H. Jacobson,, S. J. Shin,, P. Harpending,, R. Straubinger,, L. A. Patrician,, H. Mohammed ,, and B. A. Summers. 1995. Recombinant OspA protects dogs against infection and disease caused by Borrelia burgdorferi. Infect. Immun. 63: 3543 3549.
40. Cheetham, B.,, and M. Katz. 1995. A role for bacteriophages in the evolution and transfer of bacterial virulence determinants. Mol. Microbiol. 18: 201 208.
41. Cinco, M.,, E. Banfi,, D. Balanzin,, C. Godeas,, and E. Panfili. 1991. Evidence for (Hpo) oligosaccharides in Borrelia burgdorferi and their surrounding serological specificity. FEMS Microbiol. Lett. 76: 33 38.
42. Coburn, J.,, L. Magoun,, S. C. Bodary,, and J. M. Leong. 1998. Integrins alpha(v)beta and alpha5betal mediate attachment of Lyme disease spirochetes to human cells. Infect. Immun. 66: 1946 1952.
43. Coleman, J. L.,, and J. L. Benach. 1987. Isolation of antigenic components from the Lyme disease spirochete: their role in early diagnosis. J. Infect. Dis. 155: 756 765.
44. Coleman, J. L.,, J. A. Gebbia,, J. Piesman,, J. L. Degen,, T. H. Bugge,, and J. L. Benach. 1997. Plasminogen is required for efficient dissemination of Borrelia burgdorferi in ticks and for enhancement of spirochetemia in mice. Cell 89: 1111 1119.
45. Comstock, L. E.,, and D. D. Thomas. 1991. Characterization of Borrelia burgdorferi invasion of cultured endothelial cells. Microb. Pathog. 10: 137 148.
46. Coughlin, R. T.,, D. Fish,, T. N. Mather,, J. N. Ma,, C. Pavia,, and P. Bulger. 1995. Protection of dogs from Lyme disease with a vaccine containing outer surface protein (Osp) A, OspB and the saponin adjuvant QS21. J. Infect. Dis. 171: 1049 1052.
47. Cox, C. L.,, D. R. Akins,, K. W. Bourell,, P. Lahdenne,, M. V. Norgard,, and J. D. Radolf. 1996. Limited surface exposure of Borrelia burgdorferi outer surface lipoproteins. Proc. Natl. Acad. Sci. USA 93: 7973 7978.
48. Das, S.,, S. W. Barthold,, S. S. Giles,, R. R. Montgomery ,, S. R. Telford III,, and E. Fikrig. 1997. Temporal pattern of Borrelia burgdorferi p21 gene expression in ticks and the mammalian host. J. Clin. Investig. 99: 987 995.
49. Defosse, D. L.,, P. H. Duray,, and R. C. Johnson. 1992. The N I H-3 immunodeficient mouse is a model for Lyme borreliosis myositis and carditis. Am. J. Pathol. 141: 3 10.
50. Demaerschalck, I.,, A. BenMessaoud,, M. DeKesel,, B. Hyois,, Y. Lobet,, P. Hoet,, G. Bigaignon,, A. Bollen,, and E. Godfroid. 1995. Simultaneous presence of different Borrelia burgdorferi genospecies in biological fluids o f Lyme disease patients. J. Clin. Microbiol. 33: 602 608.
51. deSilva, A.,, and E. Fikrig. 1995. Growth and migration of Borrelia burgdorferi in Ixodes ticks during blood feeding. Am. J. Trop. Med. Hyg. 53: 397 404.
52. deSilva, A.,, E. Fikrig,, E. Hodzic,, S. R. Telford III,, and S. W. Barthold. 1998. Immune evasion by tick-borne and host-adapted Borrelia burgdorferi. J. Infect. Dis. 177: 395 400.
53. deSilva, A.,, S. R. Telford,, L. R. Brunet,, S. W. Barthold,, and E. Fikrig. 1996. Borrelia burgdorferi OspA arthropod-specific transmission-blocking Lyme disease vaccine. J. Exp. Med. 183: 271 275.
54. deSilva, A. M.,, and E. Fikrig. 1997. Arthropod- and host-specific gene expression by Borrelia burgdorferi. J. Clin. Investig. 99: 377 379.
55. deSilva, A. M.,, D. Fish,, T. R. Burkot,, Y. Zhang,, and E. Fikrig. 1997. OspA antibodies inhibit the acquisition of Borrelia burgdorferi by Ixodes ticks. Infect. Immun. 65: 3146 3150.
56. deSouza, M. S.,, E. Fikrig,, A. L. Smith,, R. A. Flavell,, and S. W. Barthold. 1992. Nonspecific proliferative responses of murine lymphocytes to Borrelia burgdorferi antigens. J. Infect. Dis. 165: 471 478.
57. deSouza, M. S.,, A. L. Smith ,, D. S. Beck,, G. A. Terwilliger,, E. Fikrig,, and S. W. Barthold. 1993. Long-term study of cell-mediated responses to Borrelia burgdorferi in the laboratory mouse. Infect. Immun. 61: 1814 1822.
58. Dorward, D. W. 1998. Immune ultrastructural evidence of lymphocytic antigen binding by Lyme disease spirochetes. Scanning 20: 197 199.
59. Dorward, D. W.,, E. R. Fischer,, and D. M. Brooks. 1997. Invasion and cytopathic killing of human lymphocytes by spirochetes causing Lyme disease. Clin. Infect. Dis. 25: S22 S8.
60. Dorward, D. W.,, E. D. Huegenel,, G. Davis,, and C. F. Garon. 1992. Interactions between extracellular Borrelia burgdorferi proteins and non- Borrelia-directed immunoglobulin M antibodies. Infect. Immun. 60: 838 844.
61. Dressier, F.,, J. A. Whalen,, B. N. Reinhardt,, and A. C. Steere. 1993. Western blotting in the serodiagnosis of Lyme disease. J. Infect. Dis. 167: 392 400.
62. Ebnet, K.,, K. D. Brown,, U. K. Siebenlist,, M. M. Simon,, and S. Shaw. 1997. Borrelia burgdorferi activates nuclear factor-KB and is a potent inducer of chemokine and adhesion molecule gene expression in endothelial cells and fibroblasts. J. Immunol. 158: 3285 3292.
63. Erdile, L. F.,, M. A. Brandt,, D. J. Warakomski,, G. J. Westrack,, A. Sadziene,, A. G. Barbour,, and J. P. Mays. 1993. Role of attached lipid in immunogenicity of Borrelia burgdorferi OspA. Infect. Immun. 61: 81 90.
64. Feng, S.,, E. Hodzic,, B. Stevenson,, and S. W. Barthold. 1998. Humoral Immunity to Borrelia burgdorferi N 4 0 decorin binding proteins during infection of laboratory mice. Infect. Immun. s 66: 2827 2835.
65. Fikrig, E.,, S. W. Barthold,, F. S. Kantor,, and R. A. Flavell. 1990. Protection of mice against the Lyme disease agent by immunizing with recombinant OspA. Science 250: 553 556.
66. Fikrig, E.,, S. W. Barthold,, W. Sun,, W. Feng,, S.R.I. Telford ,, and R. A. Flavell. 1997. Borrelia burgdorferi P35 and P37 proteins, expressed in vivo, elicit protective immunity. Immunity 6: 531 539.
67. Fikrig, E.,, L. K. Bockenstedt ,, S. W. Barthold ,, M. Chen,, H. Tao,, P. Ali-Salaam,, S. R. Telford,, and R. A. Flavell. 1994. Sera from patients with chronic Lyme disease protect mice from Lyme borreliosis. J. Infect. Dis. 169: 568 574.
68. Fikrig, E.,, M. Chen,, S. W. Barthold,, J. Anguita,, W. Feng,, S. R. Telford III,, and R. A. Flavell. 1999. Borrelia burgdorferi erpT expression in the arthropod vector and murine host. Mol. Microbiol. 31: 281 290.
69. Fikrig, E.,, S. R. Telford III,, S. W. Barthold,, F. S. Kantor,, A. Spielman,, and R. A. Flavell. 1992. Elimination of Borrelia burgdorferi from vector ticks feeding on OspA-immunized mice. Proc. Natl. Acad. Sci. USA 89: 5418 5421.
70. Fikrig, E.,, S. R. Telford in,, R. Wallich,, M. Chen,, Y. Lobet,, F. R. Matuschka,, R. B. Kimsey,, F. S. Kantor,, S. W. Barthold,, A. Spielman,, and R. A. Flavell. 1995. Vaccination against Lyme disease caused by diverse Borrelia burgdorferi. J. Exp. Med. 181: 215 221.
71. Fingerle, V.,, U. Hauser,, G. Liegl,, B. Petko,, V. Preac-Mursic,, and B. Wilske. 1995. Expression of outer surface proteins A and C of Borrelia burgdorferi in Ixodes ricinus. J. Clin. Microbiol. 33: 1867 1869.
72. Fraser, C. M.,, S. Casjens,, W. M. Huang ,, G. G. Sutton,, R. Clayton,, R. Lathigra,, O. White,, K. A. Ketchum,, R. Dodson ,, E. K. Hickey ,, M. Gwinn,, B. Dougherty,, J. F. Tomb,, R. D. Fleischmann,, D. Richardson,, J. Peterson,, A. R. Kerlavage,, J. Quackenbush,, S. Salzberg,, M. Hanson ,, R. van Vugt,, N. Palmer,, M. D. Adams,, J. Gocayne,, J. Weidman,, T. Utterback,, L. Watthey,, L. Mc Donald,, P. Artiach,, C. Bowman,, S. Garland,, C. Fujii,, M. D. Cotton,, K. Horst,, K. Roberts,, B. Hatch,, H. O. Smith,, and J. C. Venter. 1997. Genomic sequence of a Lyme disease spirochaete, Borrelia burgdorferi. Nature 390: 580 586.
73. Garon, C. F.,, D. W. Dorward,, and M. D. Corwin. 1989. Structural features of Borrelia burgdorferi—the Lyme disease spirochete: silver staining for nucleic acids. Scanning Microsc. 3: 109 115.
74. Gern, L.,, O. Rais,, C. Capiau,, P. Hauser,, Y. Lobet,, E. Simoen,, P. Voet,, and J. Petre. 1994. Immunization of mice by recombinant OspA preparations and protection against Borrelia burgdorferi infection induced by Ixodes ricinus ticks. Immunol. Lett. 39: 249 258.
75. Gern, L.,, U. E. Schaible,, and M. M. Simon. 1993. Mode of inoculation of the Lyme disease agent Borrelia burgdorferi influences infection and immune responses in inbred strains of mice. J. Infect. Dis. 167: 971 975.
76. Giambartolomei, G. H.,, V. A. Dennis,, B. L. Lasater,, and M. T. Philipp. 1999. Induction of pro- and anti-inflammatory cytokines by Borrelia burgdorferi lipoproteins in monocytes is mediated by CD14. Infect. Immun. 67: 140 147.
77. Gilmore, R. D., Jr.,, and M. L. Mbow. 1998. A monoclonal antibody generated by antigen inoculation via tick bite is reactive to Borrelia burgdorferi Rev protein, a member of the 2.9 gene family locus. Infect. Immun. 66: 980 986.
78. Girschick, H. J.,, H. I. Huppertz,, H. Russmann,, V. Krenn,, and H. Karch. 1996. Intracellular persistence of Borrelia burgdorferi in human synovial cells. Rheumatol. Int. 16: 125 132.
79. Golde, W. T.,, K. J. Kappel,, G. Dequesne,, C. Feron,, D. Plainchamp,, C. Capiau,, and Y. Lobet. 1994. Tick transmission of Borrelia burgdorferi to inbred strains o f mice induces an antibody response to P39 but not to outer surface protein A. Infect. Immun. 62: 2625 2627.
80. Goldstein, S. F.,, N. W. Charon,, and J. A. Kreiling. 1994. Borrelia burgdorferi swims with a planar waveform similar to that of eukaryotic flagella. Proc. Natl. Acad. Sci. USA 91: 3433 3437.
81. Goodman, J. L.,, P. Jurkovich,, C. Kodner,, and R. C. Johnson. 1991. Persistent cardiac and urinary tract infections with Borrelia burgdorferi in experimentally infected Syrian hamsters. J. Clin. Microbiol. 29: 894 896.
82. Grab, D. J.,, C. Givens,, and R. Kennedy. 1998. Fibronectin-binding activity in Borrelia burgdorferi. Biochim. Biophys. Acta 1407: 135 145.
83. Guttman, D. S.,, P. W. Wang,, I. N. Wang,, E. M. Bosler,, B. J. Luft,, and D. E. Dykhuizen. 1996. Multiple infections of Ixodes scapularis ticks by Borrelia burgdorferi as revealed by singlestrand conformation polymorphism analysis. J. Clin. Microbiol. 34: 652 656.
84. Hanson, M. S.,, D. R. Cassatt,, B. P. Guo,, N. K. Patel,, M. P. McCarthy,, D. W. Dorward,, and M. Hook. 1998. Active and passive immunity against Borrelia burgdorferi decorin binding protein A (DbpA) protects against infection. Infect. Immun. 66: 2143 2153.
85. Hofmeister, E. K.,, and J. E. Childs. 1995. Analysis of Borrelia burgdorferi sequentially isolated from Peromyscus leucopus captured at a Lyme disease enzootic site. J. Infect. Dis. 172: 462 469.
86. Hu, L. T.,, S. D. Pratt,, G. Perides,, L. Katz,, R. A. Rogers,, and M. S. Klempner. 1997. Isolation, cloning, and expression of a 70-kilodalton plasminogen binding protein of Borrelia burgdorferi. Infect. Immun. 65: 4989 4995.
87. Hulinska, D.,, P. Bartak,, J. Hercogova ,, J. Hancil,, J. Basta,, and J. Schramlova. 1994. Electron microscopy of Langerhans cells and Borrelia burgdorferi in Lyme disease patients. Zentbl. Bakteriol. 280: 348 359.
88. Indest, K. J.,, R. Ramamoorthy,, M. Sole,, R. D. Gilmore ,, B. J. B. Johnson ,, and M. T. Philip p. 1997. Cell-density-dependent expression of Borrelia burgdorferi lipoproteins in vitro. Infect. Immun. 65: 1165 1171.
89. Jauris-Heipke, S.,, G. Liegl,, V. Preac-Mursic,, D. Rossler,, E. Schwab,, E. Spitscjel,, G. Will,, and B. Wilske. 1995. Molecular analysis of genes encoding outer surface protein C (OspC) of Borrelia burgdorferi sensu lato: relationship to OspA genotype and evidence of lateral gene exchange of OspC. J. Clin. Microbiol. 33: 1860 1866.
90. Johnson, B. J. B.,, S. L. Sviat,, C. M. Happ,, J. J. Dunn,, J. C. Frantz,, L. W. Mayer,, and J. Piesman. 1995. Incomplete protection of hamsters vaccinated with unlipidated OspA from Borrelia burgdorferi infection is associated with low levels o f antibody to an epitope defined by mAb La- 2. Vaccine 13: 1086 1094.
91. Kalish, R. A.,, J. M. Leong,, and A. C. Steere. 1995. Early and late antibody responses to full length and truncated constructs of outer surface protein A of Borrelia burgdorferi in Lyme disease. Infect. Immun. 63: 2228 2235.
92. Kaneda, K.,, T. Masuzawa,, M. M. Simon,, E. Isogai,, H. Isogai,, K. Yasugarni,, T. Suzuki,, Y. Suzuki,, and Y. Yanagihara. 1998. Infectivity and arthritis induction of Borrelia japonica on SCID mice and immune competent mice: possible role of galactosylceramide binding activity on initiation of infection. Microbiol. Immunol. 42: 171 175.
93. Kersten, A.,, C. Poitschek,, S. Rauch ,, and E. Aberer. 1995. Effects of penicillin, ceftriaxone, and doxycycline on morphology of Borrelia burgdorferi. Antimicrob. Agents Chemother. 39: 1127 1133.
94. Kimsey, R. B.,, and A. Spielman. 1990. M o tility of Lyme disease spirochetes in fluid as viscous as the extracellular matrix. J. Infect. Dis. 162: 1205 1208.
95. Kitten, T.,, and A. Barbour. 1990. Juxtaposition of expressed variable antigen genes with a conserved telomere in the bacterium Borrelia hermsii. Proc. Natl. Acad. Sci. USA 87: 6077 6081.
96. Klempner, M. S.,, R. Noring,, M. P. Epstein,, B. Mc Cloud,, and R. A. Rogers. 1996. Binding of human urokinase type plasminogen activator and plasminogen to Borrelia species. J. Infect. Dis. 174: 97104.
97. Klempner, M. S.,, R. Noring,, and R. A. Rogers. 1993. Invasion of human skin fibroblasts by the Lyme disease spirochete, Borrelia burgdorferi. J. Infect. Dis. 167: 1074 1081.
98. Kuiper, H.,, A. P. van Dam,, L. Spanjaard,, B. M. de Jongh,, A. Widjojokusumo,, T. C. P. Ramselaar,, I. Cairo,, K. Vos,, and J. Dankert. 1994. Isolation of Borrelia burgdorferi from biopsy specimens taken from healthy-looking skin of patients with Lyme borreliosis. J. Clin. Microbiol. 32: 715 720.
99. Lahdenne, P.,, S. F. Porcella,, K. E. Hagman,, D. R. Akins,, T. G. Popova,, D. D. Cox,, L. I. Katona,, J. D. Radolf,, and M. V. Norgard. 1997. Molecular characterization of 6.6-kilodalton Borrelia burgdorferi outer membrane-associated lipoprotein (lp6.6) which appears to be downregulated during mammalian infection. Infect. Immun. 65: 412 421.
100. Lam, T. T.,, T. K. Nguyen,, R. R. Montgomery,, F. S. Kantor,, E. Fikrig,, and R. A. Flavell. 1994. Outer surface proteins E and F of Borrelia burgdorferi, the agent of Lyme disease. Infect. Immun. 62: 290 298.
101. LeFleche, A.,, D. Postic,, K. Girardet,, O. Peter,, and G. Baranton. 1997. Characterization of Borrelia lusitaniae sp. nov. by 16S ribosomal DNA sequence analysis. Int. J. Syst. Bacteriol. 47: 921 925.
102. Leong, J. M.,, H. Wang,, L. Magoun,, J. A. Field,, P. E. Morrissey,, D. Robbins,, J. B. Tatro J. Coburn, and N. Parveen. 1998. Different classes of proteoglycan contribute to the attachment of Borrelia burgdorferi to cultured endothelial and brain cells. Infect. Immun. 66: 994 999.
103. Liveris, D.,, G. P. Wormser,, J. Nowakowski,, R. Nadelman,, S. Bittker,, D. Cooper,, S. Varde,, F. H. Moy,, G. Forsetter,, C. S. Pavia,, and I. Schwartz. 1996. Molecular typing of Borrelia burgdorferi from Lyme disease patients by PCR-restriction fragment length polymorphism analysis. J. Clin. Microbiol. 34: 1306 1309.
104. Livey, I.,, C. P. Gibbs,, R. Schuster,, and F. Dormer. 1995. The role of lateral transfer and recombination in OspC variation in Lyme disease Borrelia. Mol. Microbiol. 18: 257 269.
105. Lovrich, S. D.,, S. M. Callister,, B. K. Du-Chateau,, L. C. L. Lim,, J. Winfrey,, S. P. Day,, and R. F. Schell. 1995. Abilities of OspA proteins from different seroprotective groups of Borrelia burgdorferi to protect hamsters from infection. Infect. Immun. 63: 2113 2119.
106. Ma, Y.,, K. P. Seiler,, K.-F. Tai,, L. Yang,, M. Woods,, and J. J. Weis. 1994. Outer surface lipoproteins of Borrelia burgdorferi stimulate nitric oxide production by the cytokine-inducible pathway. Infect. Immun. 62: 3663 3671.
107. MacDonald, A. B. 1998. Concurrent neocortical borreliosis and Alzheimer's disease. Ann. N. Y. Acad. Sci. 539: 468 470.
108. Malawista, S. M.,, S. W. Barthold,, and D. H. Persing. 1994. Fate of Borrelia burgdorferi DNA in tissues of infected mice after antibiotic treatment. J. Infect. Dis. 170: 1312 1316.
109. Marconi, R. T.,, D. S. Samuels,, R. K. Landry,, and C. F. Garon. 1994. Analysis of the distribution and molecular heterogeneity of the ospD gene among the Lyme disease spirochetes: evidence for lateral gene exchange. J. Bacteriol. 176: 4572 4582.
110. Marti Ras, N.,, D. Postic,, M. Foretz,, and G. Baranton. 1997. Borrelia burgdorferi sensu stricto, a bacterial species "made in the U.S.A."? Int. J. Syst. Bacteriol. 47: 1112 1117.
111. Mitchell, P. D.,, K. D. Reed,, and J. M. Hofkes. 1996. Immunoserologic evidence of coinfection with Borrelia burgdorferi, Babesia microti, and human granulocytic Ehrlichia species in residents of Wisconsin and Minnesota. J. Clin. Microbiol. 34: 724 727.
112. Modolell, M.,, U. E. Schaible,, M. Rittig,, and M. M. Simon. 1994. Killing of Borrelia burgdorferi by macrophages is dependent on oxygen radicals and nitric oxide and can be enhanced by antibodies to outer surface proteins of the spirochete. Immunol. Lett. 40: 139 146.
113. Montgomery, R. R.,, and S. E. Malawista. 1996. Entry of Borrelia burgdorferi into macrophages is end-on and leads to degradation in lysosomes. Infect. Immun. 64: 2867 2872.
114. Montgomery, R. R.,, M. H. Nathanson,, and S. E. Malawista. 1993. The fate of Borrelia burgdorferi, the agent for Lyme disease, in mouse macrophages: destruction, survival, recovery. J. Immunol. 150: 909 915.
115. Moody, K. D.,, S. W. Barthold,, G. A. Terwilliger,, D. S. Beck,, G. M. Hansen,, and R. O. Jacoby. 1990. Experimental chronic Lyme borreliosis in Lewis rats. Am. J. Trop. Med. Hyg. 4 2: 65 74.
116. Morrison, T. B.,, J. H. Weis,, and J. J. Weis. 1997. Borrelia burgdorferi outer surface protein A (OspA) activates and primes human neutrophils. J. Immunol. 158: 4838 4845.
117. Nakao, M.,, and K. Miyamoto. 1995. Mixed infection of different Borrelia species among Apodemus speciosus mice in Hokkaido, Japan. J. Clin. Microbiol. 33: 490 492.
118. Nguyen, T. K.,, T. T. Lam,, S. W. Barthold,, S. R. Telford III,, R. A. Flavell,, and E. Fikrig. 1994. Partial destruction of Borrelia burgdorferi within ticks engorged on OspE- or OspF-immunized mice. Infect. Immun. 62: 2079 2084.
119. Nocton, J. J.,, F. Dressier,, R. J. Rutledge,, P. N. Rys,, D. H. Persing,, and A. C. Steere. 1994. Detection of Borrelia burgdorferi DNA by polymerase chain reaction in synovial fluid from patients with Lyme arthritis. N. Engl. J. Med. 330: 229 234.
120. Norgard, M.,, B. Riley,, J. Richardson,, and J. Radolf. 1995. Dermal inflammation elicited by synthetic analogs of Treponema pallidum and Borrelia burgdorferi lipoproteins. Infect. Immun. 63: 1507 1515.
121. Norgard, M. V.,, L. L. Arndt,, D. R. Akins,, L. L. Curetty,, D. A. Harrich,, and J. D. Radolf. 1996. Activation of human monocytic cells by Treponema pallidum and Borrelia burgdorferi lipoproteins and synthetic lipopeptides via a pathway distinct from that of lipopolysaccharide involves the transcriptional activator of N F-K B. Infect. Immun. 64: 3845 3852.
122. Norris, S. J.,, C.J. Carter,, J. K. Howell,, and A. G. Barbour. 1992. Low-passage associated proteins of Borrelia burgdorferi B31: characterization and molecular cloning of OspD, a surface exposed, plasmid-encoded lipoprotein. Infect. Immun. 60: 4662 4672.
123. Oksi, J.,, M. Marjamaki,, K. Koski,, J. Ni-koskelainen,, and M. Viljanen. 1995. Bilateral facial palsy and meningitis caused by borrelia double infection. Lancet 345: 1583 1584.
124. Pachner, A. R.,, J. Basta,, E. Delaney,, and D. Hulinska. 1995. Localization of Borrelia burgdorferi in murine Lyme borreliosis by electron microscopy. Am. J. Trop. Med. Hyg. 52: 128 133.
125. Pachner, A. R.,, E. Delaney,, and T. O Neill. 1995. Neuroborreliosis in the nonhuman primate: Borrelia burgdorferi persists in the central nervous system. Ann. Neurol. 38: 667 669.
126. Padula, S. J.,, F. Dias,, A. Sampieri,, R. B. Craven,, and R. W. Ryan. 1994. Use of recombinant OspC from Borrelia burgdorferi for serodiagnosis of early Lyme disease. J. Clin. Microbiol. 32: 1733 1738.
127. Persing, D. H.,, D. Mathiesen,, D. Podzorski,, and S. W. Barthold. 1994. Genetic stability of Borrelia burgdorferi recovered from chronically infected immunocompetent mice. Infect. Immun. 62: 3521 3527.
128. Persing, D. H.,, B. J. Rutledge,, P. N. Rys,, D. S. Podzorski,, P. D. Mitchell,, K. D. Reed,, B. Liu,, E. Fikrig,, and S. E. Malawista. 1994. Target imbalance: disparity of Borrelia burgdorferi genetic material in synovial fluid from Lyme arthritis patients. J. Infect. Dis. 169: 668 672.
129. Philipp, M. T.,, M. K. Aydintug,, R. P. Bohm, Jr.,, F. B. Cogswell,, V. A. Dennis,, H. N. Lanners,, R. C. Lowrie, Jr.,, E. D. Roberts,, M. D. Conway,, M. Karacorlu,, G. A. Peyman,, D. J. Gubler,, B. J. B. Johnson,, J. Piesman,, and Y. Gu. 1993. Early and early disseminated phases o f Lyme disease in the rhesus monkey: a model for infection in humans. Infect. Immun. 61: 3047 3059.
130. Philipp, M. T.,, Y. Lobet,, R. P. Bohm, Jr.,, E. D. Roberts,, V. A. Dennis,, Y. Gu,, R. C. Lowrie, Jr.,, P. Desmons,, P. H. Duray,, J. D. Englands,, P. Hauser,, J. Piesman,, and K. Xu. 1997. The outer surface protein A (OspA) vaccine against Lyme disease: efficacy in the rhesus monkey. Vaccine 15: 1872 1887.
131. Phillips, S. E.,, L. H. Mattman,, D. Hulinska,, and H. Moayad. 1998. A proposal for the reliable culture of Borrelia burgdorferi from patients with chronic Lyme disease, even from those previously aggressively treated. Infection 26: 364 367.
132. Piesman, J.,, M. C. Dolan,, C. M. Happ,, B. J. Luft,, S. E. Rooney,, T. N. Mather,, and W. T. Golde. 1997. Duration of immunity to reinfection with tick-transmitted Borrelia burgdorferi in naturally infected mice. Infect. Immun. 65: 4043 4047.
133. Porcella, S. F.,, T. G. Popova,, D. R. Akins,, M. Y. Li,, J. D. Radolf,, and M. V. Norgard. 1996. Borrelia burgdorferi supercoiled plasmids encode multicopy tandem open reading frames and a lipoprotein gene family. J. Bacteriol. 178: 3293 3307.
134. Preac-Mursic, V.,, H. W. Pfister,, B. Wilske,, B. Gross,, A. Baumann,, and J. Prokop. 1989. Survival of Borrelia burgdorferi in antibiotically treated patients with Lyme borreliosis. Infection 17: 355 359.
135. Preac-Mursic, V.,, G. Wanner,, S. Reinhardt,, B. Wilske,, U. Busch,, and W. Marget. 1996. Formation and cultivation of Borrelia burgdorferi spheroplast-L-form variants. Infection 24: 218 226.
136. Probert, W. S.,, M. Crawford,, R. B. Cadiz,, and R. B. LeFebvre. 1997. Immunization with outer surface protein (Osp) A, but not OspC, provides cross-protection of mice challenged with North American isolates of Borrelia burgdorferi. J Infect. Dis. 175: 400 405.
137. Radolf, J. D.,, L. L. Arndt,, D. R. Akins,, L. L. Curetty,, M. E. Levi,, Y. N. Shen,, L. S. Davis,, and M. V. Norgard. 1995. Treponema pallidum and Borrelia burgdorferi lipoproteins and synthetic lipopeptides activate monocytes/macrophages. J. Immunol. 154: 2866 2877.
138. Ramamoorthy , R.,, and M. T. Philipp. 1998. Differential expression of Borrelia burgdorferi proteins during growth in vitro. Infect. Immun. 66: 5119 5124.
139. Ramamoorthy, R.,, L. Povinelli,, and M. T. Philipp. 1996. Molecular characterization, genomic arrangement, and expression of bmpD, a new member of the bmp class of genes encoding membrane proteins of Borrelia burgdorferi. Infect. Immun. 64: 1259 1264.
140. Ribeiro, J. M. C.,, T. N. Mather,, J. Piesman,, and A. Spielman. 1987. Dissemination and salivary delivery of Lyme disease spirochetes in vector ticks (Acari: Ixodidae). J. Med. Entomol. 24: 201 205.
141. Rijpkema, S. G. T.,, M. J. C. H. Molkenboer,, L. M. Schouls,, F. Jongejan,, and J. F. P. Schellekens. 1995. Simultaneous detection and genotyping of three genomic groups of Borrelia burgdorferi sensu lato in Dutch Ixodes ricinus ticks by characterization of the amplified intergenic spacer region between 5S and 23S rRNA genes. J. Clin. Microbiol. 33: 3091 3095.
142. Roberts, E. D.,, R. F. Bohm,, F. B. Cogswell,, H. Norbert-Lanners,, R. C. Lowrie,, L. Povinelli,, J. Piesman,, and M. T. Philipp. 1995. Chronic Lyme disease in the rhesus monkey. Lab. Investig. 72: 146 160.
143. Roberts, W. C.,, B. A. Mullikin,, R. Lathigra,, and M. S. Hanson. 1998. Molecular analysis of sequence heterogeneity among genes encoding decorin binding proteins A and B of Borrelia burgdorferi sensu lato. Infect. Immun. 66: 5275 5285.
144. Roehrig, J. T.,, J. Piesman,, A. R. Hunt,, M. G. Keen,, C. M. Happ,, and B. J. B. Johnson. dorferi in murine Lyme borreliosis by electron microscopy. Am. J. Trop. Med. Hyg. 52: 128 133.
145. Rosa, P. A.,, T. Schwan,, and D. Hogan. 1992. Recombination between genes encoding major outer surface proteins A and B of Borrelia burgdorferi. Mol. Microbiol 6: 3031 3040.
146. Sadziene, A.,, P. Rosa,, D. Hogan,, and A. Barbour. 1992. Antibody-resistant mutants of Borrelia burgdorferi: in vitro selection and characterization. J. Exp. Med. 176: 799 809.
147. Schaible, U. E.,, M. D. Kramer,, K. Eichmann,, M. Modolell,, C. Museteanu,, and M. M. Simon. 1990. Monoclonal antibodies specific for the outer surface protein A (OspA) of Borrelia burgdorferi prevent Lyme borreliosis in severe combined immunodeficiency (scid) mice. Proc. Natl. Acad. Sci. USA 87: 3768 3772.
148. Schaible, U. E.,, M. D. Kramer,, C. Museteanu,, G. Zimmer,, H. Mossmann,, and M. Simon. 1990. Lyme borreliosis in the severe combined immunodeficiency (scid) mouse manifests predominantly in the joints, heart and liver. Am. J. Pathol 137: 811 820.
149. Schaible, U. E.,, R. Wallich,, M. D. Kramer,, G. Nerz,, T. Stehle,, C. Museteanu,, and M. M. Simon. 1994. Protection against Borrelia burgdorferi infection in SCID mice is conferred by presensitized spleen cells and partially by B- but not T-cells alone. Intern. Immun. 6: 671 681.
150. Schaller, M.,, and U. Neubert. 1994. Ultrastructure of Borrelia burgdorferi after exposure to benzylpenicillin. Infection 22: 401 406.
151. Schmidli, J.,, T. Hunziker,, P. Moesli,, and U. B. Schaad. 1988. Cultivation of Borrelia burgdorferi from joint fluid three months after treatment of facial palsy due to Lyme borreliosis. J. Infect. Dis. 158: 905 906.
152. Schwan, T. G. 1996. Ticks and Borrelia: Model systems for investigating pathogen-arthropod interactions. Infect. Agents Dis. 5: 167 181.
153. Schwan, T. G.,, W. Burgdorfer,, and C. F. Garon. 1988. Changes in infectivity and plasmid profile of the Lyme disease spirochete, Borrelia burgdorferi, as a result of in vitro cultivation. Infect. Immun. 56: 1831 1836.
154. Schwan, T. G.,, and B. J. Hinnebusch. 1998. Bloodstream-versus tick-associated variants of a relapsing fever bacterium. Science 280: 1938 1940.
155. Schwan, T. G.,, J. Piesman,, W. T. Golde,, M. C. Dolan,, and P. A. Rosa. 1995. Induction of outer surface protein on Borrelia burgdorferi during tick-feeding. Proc. Natl. Acad. Sci. USA 92: 2909 2913.
156. Seifert, H. S.,, and M. So. 1988. Genetic mechanisms of bacterial antigenic variation. Microbiol Rev. 52: 327 336.
157. Shih, C.-M.,, L.-P. Liu,, and A. Spielman. 1995. Differential spirochetal infectivities to vector ticks of mice chronically infected by the agent of Lyme disease. J. Clin. Microbiol. 33: 3164 3168.
158. Shoberg, R. J.,, and D. D. Thomas. 1995. Borrelia burgdorferi vesicle production occurs via a mechanism independent of immunoglobulin M. Infect. Immun. 63: 4857 4861.
159. Simpson, W. J.,, W. Cieplak,, M. E. Schrumpf,, A. G. Barbour,, and T. G. Schwan. 1994. Nucleotide sequence and analysis of the gene in Borrelia burgdorferi encoding the immunogenic P39 antigen. FEMS Microbiol Lett. 119: 381 388.
160. Simpson, W. J.,, C. R. Garon,, and T. G. Schwan. 1990. Borrelia burgdorferi contains repeated DNA sequences that are species specific and plasmid associated. Infect. Immun. 58: 847 853.
161. Steere, A. C. 1989. Lyme disease. N. Engl J. Med. 321: 586 596.
162. Stevenson, B.,, L. K. Bockenstedt,, and S. W. Barthold. 1994. Expression and gene sequence of outer surface protein C of Borrelia burgdorferi reisolated from chronically infected mice. Infect. Immun. 62: 3568 3571.
163. Stevenson, B.,, J. L. Bono ,, A. Elias,, K. Tilly,, and P. Rosa. 1998. Transformation of the Lyme disease spirochete Borrelia burgdorferi with heterologous DNA. J. Bacteriol 180: 4850 4855.
164. Stevenson, B.,, J. L. Bono,, T. G. Schwan,, and P. Rosa. 1998. Borrelia burgdorferi Erp proteins are immunogenic in mammals infected by tick bite, and their synthesis is inducible in cultured bacteria. Infect. Immun. 66: 2648 2654.
165. Stevenson, B.,, S. Casjens,, and P. Rosa. 1998. Evidence of past recombination events among the genes encoding the Erp antigens of Borrelia burgdorferi. Microbiology 144: 1869 1879.
166. Stevenson, B.,, T. G. Schwan,, and P. A. Rosa. 1995. Temperature-related differential expression of antigens in the Lyme disease spirochete, Borrelia burgdorferi. Infect. Immun. 63: 4535 4539.
167. Stevenson, B.,, K. Tilly,, and P. A. Rosa. 1996. A family of genes located on four separate 32-kilobase circular plasmids in Borrelia burgdorferi B31. J. Bacteriol 178: 3508 3516.
168. Straubinger, R. K.,, B. A. Summers,, Y. F. Chang,, and M. J. G. Appel. 1997. Persistence of Borrelia burgdorferi in experimentally infected dogs after antibiotic treatment. J. Clin. Microbiol. 35: 111 116.
169. Suk, K.,, S. Das,, W. Sun,, B. Jwang,, S. W. Barthold,, R. A. Flavell,, and E. Fikrig. 1995. Borrelia burgdorferi genes selectively expressed in the infected host. Proc. Natl. Acad. Sci. USA 92: 4269 4273.
170. Sung, S.-Y.,, C. L. Lavoie,, J. A. Carlyon,, and R. T. Marconi. 1998. Genetic divergence and evolutionary instability of ospE-related members of the upstream homology box gene family in Borrelia burgdorferi sensu lato complex isolates. Infect. Immun. 66: 4656 4668.
171. Tai, K. F.,, Y. Ma,, and J. J. Weis. 1994. Normal human B lymphocytes and mononuclear cells respond to the mitogenic and cytokinestimulatory activities of Borrelia burgdorferi and its lipoprotein OspA. Infect. Immun. 62: 520 528.
172. Telford, S. R., III,, P. M. Armstrong,, P. Katavolos,, I. Foppa,, A. S. Olmeda-Garcia,, M. L. Wilson,, and A. Spielman. 1997. A new tick-borne encephalitis-like virus infecting New England deer ticks, Ixodes dammini. Emerg. Infect. Dis. 3: 165 170.
173. Theisen, M.,, B. Frederiksen,, A.-M. Lebech,, J. Vuust,, and K. Hansen. 1993. Polymorphism in the ospC gene of Borrelia burgdorferi and immunoreactivity of OspC protein: implications for taxonomy and for use o f OspC protein as a diagnostic antigen. J. Clin. Microbiol. 31: 2570 2576.
174. Theisen, M.,, M. Borre,, M. J. Mathiesen,, B. Mikkelsen,, A. M. Lebech,, and K. Hansen. 1995. Evolution of the Borrelia burgdorferi outer surface protein C. J. Bacteriol. 177: 3036 3044.
175. van Dam, A. P.,, H. Kuiper,, K. Vos,, A. Widojojokusumo,, L. Spanjaard,, B. M. de Jongh,, A. C. P. Bamselaar,, M. D. Kramer,, and J. Dankert. 1993. Different genospecies of Borrelia burgdorferi are associated with distinct clinical manifestations of Lyme borreliosis. Clin. Infect. Dis. 17: 708 717.
176. Wallich, R.,, C. Brenner,, M. D. Kramer,, and M. M. Simon. 1995. Molecular cloning and immunological characterization of a novel linear-plasmid-encoded gene, pG, of Borrelia burgdorferi expressed only in vivo. Infect. Immun. 63: 3327 3335.
177. Wang, G.,, A. P. vandam,, A. LeFleche,, D . Postic,, O. Peter,, G. Baranton,, R. deBoer,, L. Spanjaard,, and J. Dankert. 1997. Genetic and phenotypic analysis of Borrelia valaisiana sp. nov. (Borrelia genomic groups VS116 and M l 9 J. Int. J. Syst. Bacteriol 47: 926 932.
178. Weis, J. J.,, Y. Ma,, and L. F. Erdile. 1994. Biological activities of native and recombinant Borrelia burgdorferi outer surface protein A: dependence on lipid modification. Infect. Immun. 62: 4632 4636.
179. Wheeler, C. M.,, J. C. Garcia-Monco,, M. G. Golightly,, G. S. Habicht,, and A. C. Steere. 1993. Nonprotein antigens of Borrelia burgdorferi. J. Infect. Dis. 167: 665 674.
180. Wilske, B.,, A. G. Barbour,, S. Bergstrom,, N. Burman,, B. I. Restrepo,, P. A. Rosa,, T. Schwan,, E. Soutschek,, and R. Wallich. 1992. Antigenic variation and strain heterogeneity in Borrelia spp. Res. Microbiol 143: 583 596.
181. Wilske, B.,, V. Preac-Mursic,, S. Jauris,, A. Hofman,, I. Pradel,, E. Soutschek,, E. Schwab,, E. Will,, and G. Wanner. 1993. Immunological and molecular polymorphisms of OspC, an immunodominant major outer surface protein of Borrelia burgdorferi. Infect. Immun. 61: 2182 2191.
182. Wooten, R. M.,, V. R. Modur,, T. M. Mclntyre,, and J. J. Weis. 1996. Borrelia burgdorferi outer membrane protein A induces nuclear translocation of nuclear factor-KB and inflammatory activation in human endothelial cells. J. Bacteriol. 178: 4584 4590.
183. Zhang, J.-R.,, J. M. Hardham,, A. G. Barbour,, and S.J. Norris. 1997. Antigenic variation in Lyme disease borreliae by promiscuous recombination of VMP-like sequence cassettes. Cell 89: 1 20.
184. Zhang, J. R.,, and S.J. Norris. 1998. Kinetics and in vivo induction of genetic variation of vlsE in Borrelia burgdorferi. Infect. Immun. 66: 3689 3697.
185. Zhong, W.,, T. Stehle,, C. Museteanu,, A. Siebers,, L. Gern,, M. Kramer,, R. Wallich,, and M. M. Simon. 1997. Therapeutic passive vaccination against chronic Lyme disease in mice. Proc. Natl Acad. Sci. USA 94: 12533 12538.
186. Zung, J.,, S. Lewengrub,, M. Rudzinska,, A. Spielman,, S. Telford,, and J. Piesman. 1989. Fine structural evidence for the penetration of the Lyme disease spirochete Borrelia burgdorferi through the gut and salivary tissues o f Ixodes dammini. Can. J. Zool 67: 1717 1748.

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error