Decreased XXXX -type inflammatory cytokine expression in the skin is associated with persisting symptoms after treatment of @entity8831 .

@entity1 @entity3001 @entity21786 @entity2069 @entity1198 @entity8831 @entity25974
BACKGROUND: Despite the good prognosis of @entity8831 ( @entity8831 ), some @entity1 have persisting symptoms of various character and duration post-treatment. Several factors may affect the clinical outcome of @entity8831 , e.g. the early interaction between Borrelia ( @entity2069 and the host immune response, the B. burgdorferi genotype, antibiotic treatment as well as other clinical circumstances. Our study was designed to determine whether early cytokine expression in the skin and in peripheral blood in @entity1 with @entity8831 is associated with the clinical outcome. METHODS: A prospective follow-up study of 109 @entity1 with @entity8831 was conducted at the   land Islands, Finland. Symptoms were evaluated at 3, 6, 12 and 24 months post-treatment. Skin biopsies from the @entity8831 and healthy skin were immunohistochemically analysed for expression of interleukin (IL)-4, IL-10, IL-12p70 and interferon (IFN)-y, as well as for @entity2069 DNA. Blood samples were analysed for B. burgdorferi antibodies, allergic predisposition and levels of systemic cytokines. FINDINGS: None of the @entity1 developed late manifestations of @entity3001 . However, at the 6-month follow-up, 7 of 88 @entity1 reported persisting symptoms of diverse character. Compared to asymptomatic @entity1 , these 7 @entity1 showed decreased expression of the @entity1198 -associated cytokine IFN-y in the @entity8831 biopsies (p=0.003). @entity21786 DNA was found in 48%, @entity25974 in 15% and @entity2069 in 1% of the @entity8831 biopsies, and species distribution was the same in @entity1 with and without post-treatment symptoms. The two groups did not differ regarding baseline @entity1 characteristics, B. burgdorferi antibodies, allergic predisposition or systemic cytokine levels. CONCLUSION: @entity1 with persisting symptoms following an @entity8831 show a decreased @entity1198 -type inflammatory response in infected skin early during the infection, which might reflect a dysregulation of the early immune response. This finding supports the importance of an early, local @entity1198 -type response for optimal resolution of LB.
