CLINICAL AND IMMUNOLOGICAL CHARACTERISTICS OF ERYTHEMA AND NON-ERYTHEMA FORMS OF IXODIC TICK-BORNE BORRELIOSIS

Abstract

2 clinical forms of ixodic tick-borne borreliosis are recorded occurring with and without erythema in which difficulties arise in the diagnosis, assessment of the severity and prognosis of the disease.The purpose of the work is to study the clinical features and pathogenetic significance of pro-inflammatory and anti-inflammatory cytokines in the development of erythemal and non-erythemal forms of ixodic tick-borne borreliosis.Results. In contrast to erythema, the syndrome of intoxication and involvement of joints, respiratory organs, cardiovascular and nervous systems in the pathological process are most characteristic for the non-erythema variant of ixodic tick-borne borreliosis. In the compared groups, unidirectional changes in the blood cytokine profile were revealed: reliably high levels of proinflammatory cytokines during the peak period and a significant decrease in their level to normalization during the recovery period, and the peak in the production of antiinflammatory and proinflammatory (IFN-γ) cytokines occurs at the stage of reducing of the disease the manifestations and recovery to normal values by 3-6 months of dispensary observation. The revealed relationships between the values of inflammatory mediators and clinical symptoms indicate the dependence of the nature of the disease course on the intensity of the systemic inflammatory syndrome.Conclusions. The dynamics of cytokine production in ixodic tick-borne borreliosis indicates the early formation of Th1 and gradual Th2 types of immune response. In the non-erythema variant of the disease, the level of the studied cytokines is significantly higher which is manifested by a more severe course of the disease and multiple organ lesions.