Open AccessLack of Borrelia burgdorferi DNA in synovial samples from patients with antibiotic treatment–resistant lyme arthritis
Author(s) -
Carlson David,
Hernandez Jesus,
Bloom Bradley J.,
Coburn Jenifer,
Aversa John M.,
Steere Allen C.
Publication year - 1999
Publication title -
arthritis & rheumatism
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/1529-0131(199912)42:12<2705::aid-anr29>3.0.co;2-h
Subject(s) - borrelia burgdorferi , arthritis , lyme disease , synovial fluid , synovectomy , medicine , antibiotics , lyme , polymerase chain reaction , spirochaetaceae , immunology , microbiology and biotechnology , pathology , biology , antibody , rheumatoid arthritis , osteoarthritis , gene , biochemistry , alternative medicine
Objective To determine whether Borrelia burgdorferi DNA may be detected in synovial tissue from patients with Lyme arthritis who have persistent synovial inflammation after antibiotic treatment. Methods Synovial specimens obtained at synovectomy from 26 patients with antibiotic treatment–resistant Lyme arthritis and from 10 control subjects were tested for B burgdorferi DNA using 3 primer‐probe sets that target genes encoding outer surface proteins A or B or a flagellar protein (P41) of the spirochete. Results The 26 patients with Lyme arthritis, who had received antibiotic therapy for a mean total duration of 8 weeks prior to synovectomy, and the 10 control subjects each had negative polymerase chain reaction (PCR) results in synovial samples. When the samples were spiked with ∼1–10 B burgdorferi, all but 1 had positive PCR results, suggesting that spirochetal DNA could have been detected in most of the unspiked samples if it had been present. Conclusion These results indicate that synovial inflammation may persist in some patients with Lyme arthritis after the apparent eradication of the spirochete from the joint with antibiotic therapy.