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Background  Based on their essential role in concerting immunological and inflammatory responses we hypothesized that the homeostatic chemokines CCL19 and CCL21 may play a pathogenic role in rickettsiae infection.    Methods  Serum levels of CCL19 and CCL21 in patients with  R. africae  and  R. conorii  infection were analyzed by enzyme immunoassays. Lungs from  R. conorii  infected mice were examined for CCL19, CCL21 and CCR7 expression by immunohistochemistry.    Results  We found that patients with  R. africae  infection (n = 15) and in particular those with  R. conorii  infection (n = 16) had elevated serum levels of CCL19 on admission, with a decline during follow-up. While a similar pattern was seen for CCL21 in  R. africae  infection, patients with  R. conorii  infection showed persistently increased CCL21 levels during follow-up. In experimental  R. conorii  infection, we found strong immunostaining of CCL19 and CCL21 in the lungs, particularly in individuals that had received lethal doses. Immunofluorescence showed co-localization of CCR7 to endothelial cells, macrophages and fibroblasts within the lung tissue of  R. conorii  infected mice.    Conclusions  Our findings suggest that the CCL19/CCL21/CCR7 axis is up-regulated during  R. africae  and in particular during  R. conorii  infection, which may potentially contribute to the pathogenesis of these disorders.

Increased expression of the homeostatic chemokines CCL19 and CCL21 in clinical and experimental Rickettsia conoriiinfection