Genotyping of Borrelia from formalin‐fixed paraffin‐embedded skin biopsies of cutaneous borreliosis and tick bite reactions by assays targeting the intergenic spacer region, ospA and ospC genes. (27th August 2014)

• Record Type: Journal Article
• Authors: Brandt, F.C.; Ertas, B.; Falk, T.M.; Metze, D.; Böer‐Auer, A.
• Is Part Of: British journal of dermatology. Volume 171:Number 3(2014:Sep.)
• Page Start: 528
• Page End: 543
• Publication Date: 2014-08-27
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.12855
• Languages: English
• ISSNs: 0007-0963

Abstract

<abstract abstract-type="main" id="bjd12855-abs-0001"> <title>Summary</title> <sec id="bjd12855-sec-0001" sec-type="section"> <title>Background</title> <p>Lyme borreliosis has a broad spectrum of clinical presentations involving the skin, joints and nervous system. The variable manifestations have been attributed to different <italic>Borrelia</italic> genospecies but genotyping required culture or fresh tissue. However, in dermatology practice, formalin‐fixed paraffin‐embedded biopsies are used for dermatopathological examination. Polymerase chain reaction (PCR) for <italic>Borrelia burgdorferi sensu latu</italic> has been established on such specimens, but studies attempting genotyping of subspecies or strains are lacking.</p> </sec> <sec id="bjd12855-sec-0002" sec-type="section"> <title>Objectives</title> <p>To adapt PCR assays for genotyping of <italic>Borrelia</italic> using paraffin‐embedded biopsies, to identify <italic>Borrelia</italic> genospecies and to compare clinicopathological features of different genospecies.</p> </sec> <sec id="bjd12855-sec-0003" sec-type="section"> <title>Methods</title> <p>Eighty‐two paraffin‐embedded biopsies from 68 patients, with erythema migrans, acrodermatitis chronica atrophicans, lymphocytoma cutis or tick bite reactions, were studied with assays targeting the intergenic spacer (IGS), <italic>ospA</italic> and <italic>ospC</italic>, followed by sequencing and phylogenetic analysis. Clinicopathological data were analysed comparing different <italic>Borrelia</italic> genospecies.</p> </sec> <sec id="bjd12855-sec-0004" sec-type="section"> <title>Results</title> <p>Genotyping by IGS, <italic> ospA</italic> and <italic>ospC</italic> was successful in 85% of patients (91% <italic>B. afzelii</italic>, 7% <italic>B. garinii</italic>, 2% <italic>B. bavariensis</italic>). <italic>ospA</italic> serotyping identified type 2 (90%), type 3 (8%) and type 4 (2%). <italic>ospC</italic>‐PCR was positive in 40% of the patients revealing 12 different groups, noninvasive forms being seen only in tick bite reactions and erythema migrans. No major clinicopathological differences could be identified between the genospecies, but neural inflammation and arthralgia were seen more often in lesions caused by invasive <italic>ospC</italic> strains.</p> </sec> <sec id="bjd12855-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Genotyping of <italic>Borrelia</italic> can be easily implemented in a routine dermatopathology setting, especially as a fast method to confirm early cutaneous borreliosis. Genotyping could also enable earlier treatment of patients infected with invasive strains.</p> </sec> </abstract>