Borreliagruppen

Borreliagruppen på Åland

En forskargrupp på Åland som har varit verksam sedan 90-talet. Borreliagruppen har sin specialitet och expertis inom fästingar och fästingburna infektioner. Borreliagruppen har medlemmar av olika professioner inom medicin och bioteknik. Borreliagruppen på Åland har goda samarbeten med Linköpings Universitet men även med andra samarbetsgrupper och universitet.

Pågående forskning:

AxBioTick

Insamling av fästingar som bitit människa. Målet är att studera immunförsvarets reaktioner på ett fästingbett och fästingens patogener. Studien har för tillfället paus i insamlandet

TBE-kartläggning – En tillbakablick, hur har TBE fallen sett ut sedan det allmänna TBE-vaccinet infördes på Åland?

Fältinsamling på Åland- Fästingar och dess patogeninnehåll

Nyheter

Borreliagruppen har under 2023 publicerat två artiklar.

The AxBioTick-study

Ny diagnostisk markör för borreliainfektion, C6IgG1

Uppdaterad 12.03.2024

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Fältinsamlingen av fästingar har påbörjats. Vi från Borreliagruppen hade den 27.4.23 en Workshop tillsammans med Södertörns Högskola för att grundligt gå igenom principerna för insamlingen.

Metoden som används är en moppnings metod där man drar ett tygstycke över marken för att samla in fästingar.

Vi kommer under vår-sommar-höst att samla in på ett 50-tal ställen på Åland.

På bilderna ses Nellie Carlströmer Berthén och Susanne Olausson tillsammans med Patrick Dinnétz och Hanna Lindell från Södertörns Högskola.

Malin Ringbom moppar fältet.

Uppdaterat 16.05.2023

Publikationer

Borreliagruppen har genom åren publicerat många artiklar i olika tidskrifter.

Här nedan visas några tidigare publicerade artiklar.

Hela publikationslistan hittar ni här: Borreliagruppens publikationslista

Nyman D, Nordberg M, Nyberg C, Olausson S, Carlströmer Berthen N and Carlsson S-A. Diagnostic probability classification in suspected borreliosis by a novel Borrelia C6-peptide IgG1- subclass antibody test. Front. Cell. Infect. Microbiol. 13:1108115. doi: 10.3389/fcimb.2023.1108115

The tick-borne multisystemic infection caused by Borrelia burgdorferi sensu lato,
Lyme borreliosis, or Lyme disease, occurring in temperate regions of the
northern hemisphere, continues to spread geographically with the expanding
tick population. Despite the rising perceived risk of infection in the population,
the clinical diagnosis of Borrelia infection is not always obvious and the most
important laboratory test, antibody detection, has limited accuracy in diagnosing
active disease. According to international guidelines, the primary serology test,
which has a high sensitivity-low specificity, should, be verified using a high
specificity confirmation test to improve the specificity. However, this
enhancement in specificity comes at the cost of lower sensitivity. This twostep
procedure is often omitted in everyday clinical practice. An optimal primary
test would be one where no secondary tests for confirmation would be
necessary. In the present study, the performance of a novel assay for
quantitating IgG1-subclass antibodies to Borrelia C6-peptide was compared to
a commercial reference assay of total IgG and IgM antibodies to Borrelia C6-
peptide in the setting of a high endemic area for borreliosis. A derivation study on
a retrospective clinical material was performed to compare the performance
parameters and assess the discriminatory properties of the assays, followed by a
prospective validation study. The IgG1-antibody assay achieved comparable
summary performance parameters to those of the reference assay. The
sensitivity was almost 100% while the specificity was about 50%. In a highendemic
setting, characterized by high background seropositivity of about 50%
and disease prevalence of approximately 10%, antibody tests are unable to rulein
active Borrelia infection. The rule-out assessment of the methods revealed
that of 1000 patients, 7 – 54 with negative results based on the reference method
could have an active Borrelia infection. Such uncertainty was not found for the
index test and may help improve the risk classification of patients.
Carlströmer Berthén N, Tompa E, Olausson S, Nyberg C, Nyman D, Ringbom M, Perander L, Svärd J, Lindgren P-E, Forsberg P, Wilhelmsson P, Sjöwall J and Nordberg M. The AxBioTick Study: Borrelia Species and Tick-Borne Encephalitis Virus in Ticks, and Clinical Responses in Tick-BittenIndividuals on the Aland Islands, Finland. Microorganisms 2023, 11, 1100. https://doi.org/10.3390/microorganisms11051100

The AxBioTick study was initiated to investigate the prevalence of ticks and tick-borne
pathogens and their impact on antibody and clinical responses in tick-bitten individuals on the Aland Islands. This geographical area is hyperendemic for both Lyme borreliosis (LB) and Tick-borne encephalitis (TBE). Blood samples and ticks were collected from 100 tick-bitten volunteers. A total of 425 ticks was collected, all determined to Ixodes ricinus using molecular tools. Of them 20% contained
Borrelia species, of which B. garinii and B. afzelii were most common. None contained the TBE virus (TBEV). Blood samples were drawn in conjunction with the tick bite, and eight weeks later. Sera were analyzed for Borrelia- and TBEV-specific antibodies using an ELISA and a semiquantitative antibody assay. In total 14% seroconverted in Borrelia C6IgG1, 3% in TBEV IgG, and 2% in TBEV IgM. Five participants developed clinical manifestations of LB. The high seroprevalence of both Borrelia (57%) and TBEV (52%) antibodies are likely attributed to the endemic status of the orresponding infections as well as the TBE vaccination program. Despite the similar prevalence of Borrelia spp. detected in ticks in other parts of Europe, the infection rate in this population is high. The AxBioTick study is continuing to investigate more participants and ticks for co-infections, and to characterize the dermal immune response following a tick bite.
Peter Wahlberg, Sten-Anders Carlsson, Hans Granlund, Christian Jansson, Mogens Lindén, Clara Nyberg & Dag Nyman: TBE in Åland Islands 1959-2005: Kumlinge Disease. Scand J Inf Dis 2006; 38: 1057-62

Abstract

Tick-borne encephalitis, TBE, has been observed in Aland Islands (population 26,500) for more than 60 years. Because of the small population, the relative incidence is high. Antibodies to TBE virus have been found in ca. 5% of healthy blood donors, indicating that subclinical infection must be common. This study is a review of the symptoms and signs of all the 301 serologically verified cases of TBE seen in Aland during 1959-2005. It also aims at analysing any possible changes in the symptoms and signs of TBE over time. The annual number of patients has been from 1 to 26, and has increased over time. The clinical picture has not undergone any conspicuous changes during these years. A few patients have had permanent neurological damage. There were no certain deaths from TBE. Simple practical measures may be taken to diminish, but not to eliminate, the risk of tick bites. Vaccination of exposed people is recommended, and general vaccination against TBE has commenced in Aland, beginning 2006. This is expected to reduce the incidence of TBE among the population to almost nil, provided that new inhabitants are vaccinated and that booster vaccinations are carried out as required.
Nyman D, Willén L, Jansson C, Carlsson S-A, Granlund H, Wahlberg P: VlsE C6 peptide and IgG ELISA antibody analysis for clinical diagnosis of Lyme borreliosis in an endemic area. Clin Microbiol Infect 2006: 12: 496
Carlsson S-A, Granlund H, Jansson C, Nyman D, Wahlberg P. Characteristics of Erythema migrans in Borrelia afzelii and Borrelia garinii infections. Scand J Infect Dis
2003;35(1):31-3.

Abstract

Erythema migrans is the most common manifestation of stage I Lyme borreliosis. This study investigated the relation between the subspecies of Borrelia burgdorferi involved, the time of development and the appearance of the manifestation. The study comprised 33 cases of erythema migrans yielding B. burgdorferi sensu lato by culture of skin biopsy. The species was determined by polymerase chain reaction analysis of the cultivated spirochaetes. In 22 of the cases, B. afzelii was demonstrated, whereas 11 yielded growth of B. garinii. All 11 erythemas associated with B. garinii were homogeneous, whereas 20 of the 22 associated with B. afzelii were annular. The garinii erythemas developed more rapidly, and were generally larger than the afzelii erythemas. The observations call for comparison with other geographical areas with similar, and with different, borrelial infection spectra.
C. Jansson, S.-A. Carlsson, H. Granlund, P. Wahlberg and D. Nyman: Analysis of Borrelia burgdorferi IgG antibodies with a combination of IgG ELISA and VlsE C6 peptide ELISA. Clin Microbiol Inf 2005;11:147

Abstract

Enzyme-linked immunosorbent assays (ELISAs) were used to detect antibodies to the C6 peptide of the Borrelia burgdorferi VlsE protein and a selection of B. burgdorferi IgG antigens, separately and as a combination, in 355 serum specimens from blood donors and patients. Western immunoblotting was used as the reference method. The sensitivity of the combined analysis of IgG antigen and C6 peptide analysis was markedly superior to those of the separate analyses. When the C6 peptide and IgG results were concordant, the customary confirmatory Western immunoblotting assay could be omitted, thus reducing the time and cost of analysis.
Sten-Anders Carlsson, Hans Granlund, Dag Nyman and Peter Wahlberg: IgG
Seroprevalence of Lyme borreliosis in the Population of the Åland Islands in Finland.
Scand J Infect Dis 1998, 30, 501-503

Abstract

This is a study of people living in Aland, a group of islands in the Baltic Sea between Finland and Sweden. 500 blood donors and 3,248 health service clients who did not have Lyme borreliosis were examined for Borrelia burgdorferi IgG antibodies. The method used was an ELISA containing a selection of diagnostic antigens to a Borrelia burgdorferi PKo strain. It was found that the distribution according to sex, age and titre values was identical in the 2 groups, which were therefore treated as one. 19.7% of all the sera was positive. The prevalence in men was 23.6%, and in women 16.7%. The prevalence rises with age, the highest prevalence being seen in men (44.7%) and women (37.0%) over 70 y of age. The data show that the Aland islands are strongly endemic for Lyme borreliosis compared with international levels of infection.
Wahlberg P. Vaccination against Lyme borreliosis. Ann Med 1999;31:233-5

Abstract

Lyme borreliosis is a worldwide family of tick-borne infections caused by the spirochete Borrelia burgdorferi sensu lato. It is the most common tick-borne human infection in the Western world. There are several subgroups of the spirochete. Two monovalent vaccines against this infection have been presented in the USA, both of which use the borrelial outer surface protein A (OspA) as antigen. The first of these vaccines has been released for general use. A European polyvalent vaccine using the antigen OspC is undergoing clinical trial in the Aland Islands in Finland. Lately, another antigen group, decorin-binding proteins (Dbp), has been considered for immunization purposes. A European vaccine must be effective against several subgroups of the borrelia spirochete, and this complicates the situation compared with that in the USA, where one spirochete subspecies dominates the scene.