Serum Inflammatory Mediators as Markers of Human Lyme Disease Activity

• Published in: PloS one Vol. 9; no. 4; p. e93243
• Main Authors: Soloski, Mark J., Crowder, Lauren A., Lahey, Lauren J., Wagner, Catriona A., Robinson, William H., Aucott, John N.
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.04.2014; Public Library of Science (PLoS)
• Subjects: Acute phase proteins; Acute phase substances; Acute-Phase Proteins - metabolism; Amyloid; Antibiotics; Biology and Life Sciences; Biomarkers; Biomarkers - blood; Borrelia burgdorferi; Care and treatment; CCL19 protein; CD4 antigen; Cell activation; Chemokine receptors; Chemokines; Chemokines - blood; CXCL10 protein; CXCR3 protein; Cytokines; Cytokines - blood; Diagnosis; Disease control; Humans; Immune system; Immunology; Infections; Inflammation; IP-10 protein; Lesions; Liver; Lyme disease; Lyme Disease - blood; Lyme Disease - immunology; Lymphocytes; Lymphocytes T; Medicine; Medicine and Health Sciences; Multiplexing; Patients; Proteins; Receptors; Rheumatoid arthritis; Rheumatology; Risk factors; Seroconversion; Serum Amyloid A Protein - metabolism; Signal Transduction; Signaling; Skin; Skin diseases; Up-Regulation; Vector-borne diseases; Veterans; United States; Maryland; Palo Alto California; California; United States > US; Baltimore Maryland
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0093243

Chemokines and cytokines are key signaling molecules that orchestrate the trafficking of immune cells, direct them to sites of tissue injury and inflammation and modulate their states of activation and effector cell function. We have measured, using a multiplex-based approach, the levels of 58 immune mediators and 7 acute phase markers in sera derived from of a cohort of patients diagnosed with acute Lyme disease and matched controls. This analysis identified a cytokine signature associated with the early stages of infection and allowed us to identify two subsets (mediator-high and mediator-low) of acute Lyme patients with distinct cytokine signatures that also differed significantly (p<0.0005) in symptom presentation. In particular, the T cell chemokines CXCL9 (MIG), CXCL10 (IP-10) and CCL19 (MIP3B) were coordinately increased in the mediator-high group and levels of these chemokines could be associated with seroconversion status and elevated liver function tests (p = 0.027 and p = 0.021 respectively). There was also upregulation of acute phase proteins including CRP and serum amyloid A. Consistent with the role of CXCL9/CXCL10 in attracting immune cells to the site of infection, CXCR3+ CD4 T cells are reduced in the blood of early acute Lyme disease (p = 0.01) and the decrease correlates with chemokine levels (p = 0.0375). The levels of CXCL9/10 did not relate to the size or number of skin lesions but elevated levels of serum CXCL9/CXCL10 were associated with elevated liver enzymes levels. Collectively these results indicate that the levels of serum chemokines and the levels of expression of their respective chemokine receptors on T cell subsets may prove to be informative biomarkers for Lyme disease and related to specific disease manifestations.