FOLIA PARASITOLOGICA 52: 279–294, 2005
REVIEW ARTICLE
Lyme borreliosis: insights into tick- / host-borrelia relations
Libor Grubhoffer1, Maryna Golovchenko1, Marie Vancová1, Klára Zacharovová-Slavíčková1, Nataliia
Rudenko1 and James H. Oliver, Jr.2
1
Institute of Parasitology, Academy of Sciences of the Czech Republic and Faculty of Biological Sciences, University of South
Bohemia, Branišovská 31, 370 05 České Budějovice, Czech Republic;
2
Institute of Arthropodology and Parasitology, Georgia Southern University, Statesboro, Georgia 30460-8056, USA
Key words: borrelia spirochete, Lyme borreliosis, ticks, vectors, interactions, glycoproteins
Abstract. Lyme borreliosis (LB) is a serious infectious disease of humans and some domestic animals in temperate regions of the
Northern Hemisphere. It is caused by certain spirochetes in the Borrelia burgdorferi sensu lato (s.l.) species complex. The complex consists of 11 species (genospecies). Borrelia burgdorferi sensu stricto (s.s.), Borrelia garinii and Borrelia afzelii are the
major agents of human disease. Borrelia burgdorferi s.l. species are transmitted mainly by ticks belonging to the Ixodes ricinus
species complex plus a few additional species not currently assigned to the complex. B. burgdorferi infections may produce an
acute or chronic disease with a wide array of clinical symptoms such as erythema migrans (EM), carditis, arthritis, neuroborreliosis, and acrodermatitis chronica atrophicans (ACA). Differences in LB spirochetes ‘genospecies’ and strains/isolates determine
the occurrence and severity of this multi-system disease. Accurate and reliable identification of the LB spirochetes in ticks as
well as knowledge of their prevalence are essential for prevention against the disease and development of an effective vaccine.
An overview of the knowledge of molecular factors with emphasis on potential protein-carbohydrate interactions in the tickborrelia system is the main focus of this review.
1. BORRELIA BURGDORFERI SENSU LATO AS
THE CAUSATIVE AGENT OF LYME
BORRELIOSIS
Lyme borreliosis (LB) is a disease of epidemiological, clinical and social importance, especially in Europe,
USA and Asia (Stanek 1997, Burgdorfer 2001, Takada
et al. 2001, Weber 2001, Dennis and Hayes 2002, Kamradt 2002, Hengge et al. 2003).
1.1. Genospecies of Borrelia burgdorferi sensu lato
LB is caused by infection with certain spirochetes assigned to the Borrelia burgdorferi sensu lato (s.l.) species complex. Much attention has been paid to the basic
biological and ecological aspects of the LB causative
agent including the molecular mechanisms of pathogenesis with the aim to understand the mechanism of
interaction between borrelia spirochetes, their arthropod
vectors (ticks) and their vertebrate hosts. In the autumn
of 1981, a new species of the genus Borrelia, a spirochete described as Borrelia burgdorferi, was first identified by W. Burgdorfer from the hard tick Ixodes scapularis (formerly called Ixodes dammini) (Burgdorfer et
al. 1982, Oliver et al. 1993). Borrelia burgdorferi was
originally characterized as a single species (Johnson et
al. 1984). However, in recent years it has become clear
that B. burgdorferi is composed of a number of distinct
species and genomic groups. Thus the term “Borrelia
burgdorferi sensu lato” is now used to collectively refer
to all Borrelia isolates within this species complex. To
date, a lot is known about the species composition of the
whole complex of which three (perhaps four) species
cause the disease with clinical symptoms typical of LB
in different parts of the world. Based on gene sequence
variation of a limited numbers of loci, the following 11
genospecies of B. burgdorferi sensu lato have so far
been discriminated from each other and named: B.
burgdorferi sensu stricto, B. garinii and B. afzelii
(Baranton et al. 1992, Canica et al. 1993), B. japonica
(Kawabata et al. 1993), B. andersonii (Marconi et al.
1995), B. tanukii, B. turdi (Fukunaga et al. 1996), B.
lusitaniae (LeFleche et al. 1997), Borrelia bissettii
(formerly genomic group DN127) (Postic et al. 1998),
B. valaisiana (Wang et al. 1999), and the recently described B. sinica (Masuzawa et al. 2001). Borrelia bissettii has been cultured from patients as an undocumented strain that is genetically similar to Borrelia japonica, but appears only occasionally in humans. The
differences between species are observed in the different antigen composition and in the substitution of the
structural components and their functional activities.
There are differences in the antigen profile between
various species of LB spirochetes that are specifically
revealed in the molecular interactions of pathogen with
molecular factors (receptors) of tick or host inner environment. Due to the above-mentioned molecular differences significant diversities exist in the LB clinical picture (Assous et al. 1993, van Dam et al. 1993). Prevalence rates of B. burgdorferi sensu lato in host-seeking
Address for correspondence: L. Grubhoffer, Institute of Parasitology, Academy of Sciences of the Czech Republic, Branišovská 31, 370 05 České
Budějovice, Czech Republic. Phone: ++420 387 775 456; Fax: ++420 385 310 388; E-mail:
[email protected]
279
Ixodes ricinus ticks in Europe were estimated by
Hubálek and Halouzka (1998). The results obtained
with adult ticks varied according to the method used
(cultivation on BSK medium: 11%; PCR: 29%; microscopic techniques: 17–20%).
1.2. Biogeography of LB spirochetes
In Eurasia, seven genospecies of B. burgdorferi s.l.
have been recorded, three of which, i.e. B. burgdorferi
s.s., B. garinii, and B. afzelii, have been cultured from
patients and traditionally are thought to be responsible
for human Lyme borreliosis (Van Dam et al. 1993).
However, an additional genospecies, B. bissettii was
also reported from patients in Slovenia. The nine isolates were closely related to the North American isolate
25015, a member of the B. bissettii group. Thus, strains
belonging to B. bissettii may also cause human disease
(Picken et al. 1996, Strle et al. 1997). In 1992, one more
isolate, A14S, was cultured from a skin biopsy specimen of a Dutch patient with erythema migrans who had
contracted the disease in the Netherlands. That isolate
could not be determined using various monoclonal antibodies (MAbs) against B. burgdorferi s.l. Moreover, it
showed a unique pattern upon ribotyping analysis that
differentiated it from B. burgdorferi s.s., B. garinii and
B. afzelii. In addition, a striking genetic difference between this isolate and 135 other LB-related Borrelia
isolates was noted in the randomly amplified polymorphic DNA (RAPD) fingerprinting analysis (van Dam et
al. 1993). Isolate A14S also clearly differs from B. bissettii, the fourth genomic group reported to be able to
cause human LB. Therefore, this isolate (A14S) most
likely represents a new Borrelia genomic group, recently named B. spielmani (Richter et al. 2004), which
is the fifth group with culture-confirmed pathogenic
potential for causing human LB besides B. burgdorferi
s.s., B. garinii, B. afzelii and B. bissettii (Wang et al.
1999). However, it also appeared that B. valaisiana may
be pathogenic for humans, since one serum sample from
a patient with Lyme arthritis was more reactive by immunoblotting to this species (Ryffel et al. 1999). Moreover, DNA specific for this species was detected by
PCR in skin biopsies of patients with erythema migrans
and acrodermatitis chronica atrophicans (Rijpkema et al.
1997). Seven other B. burgdorferi sensu lato species —
B. japonica, B. andersonii, B. turdi, B. tanukii, B. bissettii, B. sinica, and B. lusitaniae— were isolated from tick
species in the United States (B. andersonii and B. bissettii); Japan (B. japonica, B. turdi and B. tanukii); China
(B. sinica); and Portugal, Czech Republic, Slovakia,
Byelorussia, and North Africa (B. lusitaniae). They are
considered nonpathogenic for humans (Kawabata et al.
1993, Fukunaga et al. 1995, Marconi et al. 1995, LeFleche et al. 1997, Postic et al. 1998, Gern et al. 1999,
Masuzawa 2004). Nevertheless, a recent study has
pointed out that a low passage of B. lusitaniae (strain
PotiB2) is able to induce disease in susceptible mice
280
(Zeidner et al. 2001). B. lusitaniae has been isolated
from a patient in Portugal (Collares-Pereira et al. 2004).
Recently, an unknown Borrelia species from South
Bohemia in the Czech Republic was detected in Ixodes
ricinus ticks in the area around České Budějovice. Using the techniques of spacer and nested PCR followed
by RFLP analysis (with MseI restriction endonuclease),
its similarity to Borrelia japonica was proved (Rudenko
and Obbels, unpublished). Subsequently, Derdáková et
al. (2003) confirmed this borrelia as identical with A14S
(van Dam et al. 1993) as well as with that Borrelia
which they isolated from Ixodes ricinus in East Slovakia
and labeled as I-77.
Qiu et al. (2004) carried out a comparative genomic
analysis of closely related borrelia isolates and concluded that B. burgdorferi undergoes genome-wide genetic exchanges including plasmid transfers. Frequent
recombination implies a potential for rapid adaptive
evolution and a possible polygenic basis of B. burgdorferi pathogenicity.
1.3. Clinical manifestations of LB and differences in
borrelia pathogenicity
Different Borrelia species have been associated with
distinct clinical manifestations of LB. Erythema migrans is one of symptoms that is common for LB patients infected by different species. Retrospective analysis revealed that many clinical symptoms of LB had
been separately recorded by European clinicians since
the end of the 19th century (Weber and Pfister 1993). It
appears that there is an association of B. garinii with
neurological symptoms, an association of B. burgdorferi
s.s. with arthritis, and an association of B. afzelii with
acrodermatitis chronica atrophicans (Demaerschalck et
al. 1995). Nevertheless, although each of the genospecies may cause the symptoms associated with them
above, a particular genospecies may cause any of the
symptoms listed plus others. As a result of its clinical
manifestations, LB was described as the new “great
imitator” of various human diseases (Pachner 1989).
LB spirochetes are highly heterogeneous, as is readily apparent upon analysis of their antigenic composition, plasmid content or genomic restriction pattern
(Livey et al. 1995). The revealed structural and functional diversity has required classification of these spirochetes into species (genospecies) and genomic groups.
However, even within these taxonomic groupings there
may be extensive strain differences and different antigenic or plasmid profiles even from single isolates.
Those isolates may alter during in vitro (Livey et al.
1995) and in vivo (Persing et al. 1994) passaging and
this may be accompanied by the loss of virulence (Livey
et al. 1995).
In the past several years, various molecular approaches have been developed and successfully used for
the identification and typing of the LB-related spirochetes (Tenover et al. 1995). Application of molecular
typing methods to the classification of B. burgdorferi s.l.
Grubhoffer et al.: Lyme borreliosis
provides the framework for the systematic approach to
characterisation of differences in infectivity as well as in
pathogenicity between strains. Sensitive molecular typing techniques do not require large amounts of material
or cultivation of spirochetes and thus will play an increasingly important role in elucidation of the pathogenic potential of different B. burgdorferi genotypes
(Elias et al. 2002, Qiu et al. 2002, Schwan and Piesman
2002). Ultimately, the development of suitable animal
models for the investigation of tissue tropisms of different B. burgdorferi s.l. species will provide a more direct
evidence for the correlation between Borrelia species
and clinical symptoms of LB (Ružić-Sabljić et al. 2001).
1.4. Structure and genome of Borrelia burgdorferi
sensu lato
Analysis of genetic diversity among individual Borrelia isolates has defined a closely related cluster containing at least 11 tick-borne species of LB agents,
called Borrelia burgdorferi s.l. They resemble most
other spirochetes in that they are highly specialised,
motile, two-membrane, spiral-shaped gram-negative
bacteria that live as extracellular pathogens. Like other
spirochetes, B. burgdorferi has periplasmic flagella (7 to
11 in number) that are inserted at each end of the cell
and extend towards the middle of the cell body. The
unique flagella allow the organism to move through
viscous solutions, an ability that is presumed to be important in its migration to distant tissues following
deposition in the skin layer. The length of spirochete
varies between 10 and 30 µm and the width from 0.2 to
0.5 µm. Borrelia spirochetes are fastidious and difficult
to culture in vitro, requiring a specially enriched medium and low oxygen tension (Barbour and Hayes
1986).
One of the most striking features of B. burgdorferi is
its unusual genome consisting of a linear chromosome
of 910,724 bp and 21–27 linear (lp) and circular (cp)
plasmids containing over 610,694 bp and also known as
micro-chromosomes. The linear chromosome contains
853 predicted genes, of which 500 (59%) have predicted
functions based on amino acid sequence similarity with
orthologous gene products. Twelve percent of the open
reading frames (ORFs) matched hypothetical coding
sequences of unknown functions from other organisms,
and 29% were unknown genes. An average G+C content of the chromosome is 28.6%, predicted coding regions have an average size of 992 bp (similar to that
observed in other prokaryotic genomes), and an average
relative molecular mass of the chromosome-encoded
proteins is 37,529 Da (ranging from 3,369 to 254,242
Da). The median isoelectric point (pI) for all predicted
proteins is 9.7 (Fraser et al. 1997).
Comparison of the plasmid profiles of LB spirochetes
demonstrates that a high degree of heterogeneity and
plasticity exists in terms of plasmid contents. Analysis
of the nucleotide sequences (Southern analysis) indicates that the spirochete contains the following linear
plasmids: lp56, lp54, lp38, lp36, lp28-1, lp28-2, lp28-3,
lp28-4, lp25, lp21, lp17, lp5 and the following circular
plasmids: cp32-1, cp32-3, cp32-4, cp32-6, cp32-7,
cp32-8, cp32-9, cp26 and cp9 (Fraser et al. 1997, Purser
and Norris 2000). Considerable evidence indicates that
B. burgdorferi plasmids are important in pathogenesis
and that there is a relationship between plasmid content
and infectivity of spirochetes. In vitro passage of B.
burgdorferi is associated with the loss of plasmids
(Barbour 1988). Plasmid loss after 10–17 passages is
also coupled with decreased infectivity in mice and
changes in spirochete protein expression. The results of
the first step of identification of infectivity-associated
plasmids indicate that lp25 and lp28-1 appear to be important in the spirochete pathogenesis (Purser and Norris 2000, for review see Qiu et al. 2004). At the same
time, some studies indicate that genetic changes other
than plasmid loss may contribute to loss of infectivity.
Recent improvements in the methods for genetic manipulation should facilitate the identification of potential
virulence factors and understanding the molecular basis
of pathogenicity. The genes encoding virulence factors
have been identified in several bacterial pathogens.
These include toxins (Guignot et al. 1997, Oyston et al.
1998), capsule components (Welkos 1991, Friedlander
et al. 1995), adhesins (Guo et al. 1995, Rudel et al.
1995) and invasion factors (Coleman et al. 1999, Seinost et al. 1999). Several genes potentially important
during host adaptation, dissemination, infection and
persistence of spirochetes are localised on plasmids. An
increased understanding of the putative virulence factors
and identification of new virulence-associated genes are
necessary to elucidate the mechanism of pathogenesis of
infection by LB spirochetes.
1.5. Antigens of LB spirochetes
Currently, much data are available about antigenic
structures of LB spirochetes, in particular about the
outer membrane surface proteins (Osp) or about the
components of flagella (for review see Bergström et al.
2002). The majority of these data contains the basic
structural features such as their molecular weights, antigenicity, etc. After the entire genomic sequence of the
LB spirochete was published (Fraser et al. 1997), localisation of genes encoding some of the given proteins
was determined. Based on interaction with the antibodies of specific patient sera, expression of antigenic determinants of LB spirochetes during the infection process was determined. Little is known, however, about the
functional activities of the structural units on the borrelia surface. The genome of LB spirochetes codes for a
large number of lipoproteins, many of which are localised on the outer membrane and likely play a role in
transmission. They are obviously expressed only at certain stages of the spirochete life cycle (de Silva and Fikrig 1997). The most studied are the outer membrane
surface lipoproteins characterized as OspA (31 kDa)
and OspC (21–25 kDa) (for review see Stanek 1997 and
281
Bergström et al. 2002). Even their crystal structures
with respect to epitopes involved in an immune response of the vertebrate host were published (Li et al.
1997, Kumaran et al. 2001). The genes encoding OspA
and OspB are located on the linear plasmid lp54,
whereas the gene encoding OspC is located on the circular plasmid cp26. The ospC gene is highly variable
within each species of the LB spirochetes and can be
used to define groups of related clones (Baranton et al.
2001, Lin et al. 2002). The expression pattern of OspA
and OspC is suggestive of their roles in the infection
cycle of the spirochetes (Schwan et al. 1995, Pal et al.
2000, 2004a, Baranton et al. 2001, Grimm et al. 2004).
In unfed ticks, spirochetes express OspA, but not
OspC. However, when the tick starts feeding on mammals, OspC synthesis is induced and OspA is repressed.
Other surface antigens of B. burgdorferi are lipoprotein
OspD (28 kDa, the encoding gene localised on the linear
plasmid lp38), lipoproteins OspE and OspF (19 kDa and
26 kDa, the encoding genes localised on the circular
plasmid cp32, and linear plasmid lp36, respectively) and
protein p27 (linear plasmid lp54). These proteins were
identified as structural units of the borrelia outer membrane with the different level of expression in the separate isolates that also depend upon the phase of the life
cycle of the LB spirochetes (Fig. 1). Currently, there are
more structural proteins of the LB spirochetes which are
under investigation. Erp (OspEF-related) proteins are
surface exposed lipoproteins that are also synthesized
during the initial stages of mammalian infection (Babb
et al. 2001). At least some Erp proteins can bind anticomplement factor H (Hellwage et al. 2001). Kurtenbach et al. (2002) have shown a key role of the host
complement to the LB spirochete diversity (see 11
genospecies of the LB spirochetes). The ability of the
LB spirochetes to maintain chronic infection indicates
that they are capable of immune response escape. OspE
and VlsE (relapsing fever spirochete “Variable major
protein” [Vmp]-like sequence E) are two outer membrane proteins highly polymorphic which might be responsible for immune evasion (McDowell et al. 2001).
Two other surface lipoproteins, DbpA/DbpB (decorinbinding proteins) with molecular sizes of 20 and 22
kDa, were identified as receptors for decorin. Decorin is
a proteoglycan from the flagella surface of intestinal
collagen (Feng et al. 1998,
Hagman et al. 1998). These proteins facilitate the adherence of B. burgdorferi to extracellular matrix when
the spirochete invades mammalian tissue (Ulbrandt et
al. 2001). Probert et al. (2001) described the fibronectinbinding protein BBK32 (47 kDa), which is localised on
the outer surface of the LB spirochetes. The outer membrane protein P66 was suggested as a candidate ligand
for recognition of the integrin alpha(IIb)beta(3) which
takes place in attachment of the spirochetes to the host
cells (Baranton et al. 1998, Defoe and Coburn 2001). In
addition, membrane-associated protein P66 contains a
282
domain homologous to the L-sialyl motif which is a
highly conservative region of the sequence in (poly)
sialyltransferases (www.ncbi.blm.nih.gov/blast/). Sialyltransferases made a large family of proteins which are
diverse in their functional activities; some are even lacking the enzyme activity, and therefore they can retain
the carbohydrate-binding (lectin or lectin-like) activity.
The role of certain proteases during LB spirochete
invasion and pathogenesis is essential. Discovery of the
LB spirochete receptor for plasminogen was of particular interest. After activation in plasmin, the receptor
facilitates dissemination of the spirochetes inside the
tick as well as strengthens the spirochetaemia in the host
organism (Fuchs et al. 1994, Coleman et al. 1997).
Based on results of the receptor analysis, Fuchs et al.
(1994) concluded that the above-mentioned receptor is
the surface lipoprotein OspA. Recently discovered sialoglycoprotease (gcp, BB0769) might be involved in
borrelia invasion (Fraser et al. 1997). Till now there is
nothing known about the function of this protease. It can
be suggested that sialylated glycoproteins in host tissues
might be target receptors for the LB spirochetes.
It has been known for several years that B. burgdorferi binds to many types of mammalian cells and to extracellular matrix (Szczepanski et al. 1990). GarciaMonco et al. (1992) reported that host cell galactosylcerebroside is recognized by B. burgdorferi, and Isaacs
(1994) proved that borrelia spirochetes are bound to the
host cell proteoglycans. However, OspA and OspB were
removed from the group of expected antigenic structures that could be directly responsible for the adhesion
of borrelia (Garcia-Monco et al. 1992, Isaacs 1994).
According to Leong et al. (1995), haemagglutination
activity of the LB spirochetes is not mediated by any of
the above-mentioned molecules. They presented evidence that the LB spirochetes provide a lectin activity
that promotes agglutination of erythrocytes and bacteria
attachment to the target glycosaminoglycans.
Regarding membrane systems of the LB spirochetes,
B. burgdorferi s.l. spirochetes contain both an outer
membrane with most of above-mentioned molecules/
antigens, and a cytoplasmic membrane analogous to the
surface of enteric gram-negative bacteria. In contrast to
an extraordinary abundance of lipoproteins in the outer
membrane, there are just a few transmembranespanning proteins known in the cytoplasmic membrane
of the LB spirochetes. An integral peptide P13 is one of
those (Noppa et al. 2001).
1.6. Glycoproteins and other glycoconjugates in LB
spirochetes
Bacterial lipopolysaccharides and peptidoglycans
used to be the only molecules considered as bacterial
glycoconjugates. Recently, structural analyses of glycolipids of B. burgdorferi have identified two surface-exposed glycolipids BbGL-II (α-galactosyl-diacyl-glycerolipid) and BbGL-I (cholesteryl 6-O-acyl-β-D-galactopyranoside). It was demonstrated that B. burgdorferi
Grubhoffer et al.: Lyme borreliosis
Figs. 1–5. Transmission electron micrographs of cultured Lyme borreliosis spirochetes. Fig. 1. A cryosection of Borrelia
burgdorferi B31 labeled with anti-OspA antibodies followed by Protein A-gold detection. Fig. 2. Cryosectioned outer membrane
vesicles of B. burgdorferi B31 labeled with lectin DBA directly conjugated with gold particles. Fig. 3. Negatively stained Borrelia afzelii and their outer membrane vesicles (arrow) double labeled with both WGA (10 nm gold particles) and ConA (20 nm
gold particles). Fig. 4. Spirochetes B. afzelii with released flagella (arrow) labeled as described in Fig. 3 and negatively stained.
Fig. 5. Longitudinal cryosection of B. burgdorferi B31 with gold-marked WGA-binding sites. Scale bars: Fig. 1, 3 = 200 nm;
Fig. 2 = 50 nm; Figs. 4, 5 = 100 nm.
glycolipids are highly antigenic and might be considered as promising candidates for diagnosis or vaccination (Hossain et al. 2001, Ben-Menachem et al. 2003,
Schröder et al. 2003). However, during the last two decades a significant change of perception has taken place
regarding prokaryotic glycoproteins. Glycosylation of
proteins is no longer considered a specific feature of
eukaryotic organisms but has been demonstrated in
many archea and bacteria. Besides the occurrence of
glycosylated bacterial enzymes and antigens, surface
layer glycoproteins represent the best-studied examples
of glycosylated prokaryotic proteins (Schäffer et al.
2001).
Sambri et al. (1992, 1993) showed that even the outer
surface proteins/lipoproteins OspA and OspB of several
isolates of the LB spirochetes are major glycosylated
proteins. These results are consistent with data published by Dorward and Garon (1990). However, since
that time, reliable evidence on glycosylation of the major outer surface proteins has not been published. The
LB spirochete glycoconjugates with different oligosaccharide structures were distinguished with labeled lectin
probes in lectin affinity blotting or electron microscopy
(Hulínská et al. 1992, Stoitsova et al. 2003). Figs. 2–5
show borrelia spirochetes labeled with lectin probes. A
high-mannose glycan structure was detected in an 83kDa glycoprotein (major extracellular protein, predominantly present in the membrane vesicles) (Fig. 6); at
least four carbohydrates (glucose or mannose, galactose,
N-acetylgalactosamine, and N-acetylglucosamine) were
present in other borrelia glycoconjugates. N-acetylneuraminic (sialic) acid was detected on the borrelia
surface as well (Hulínská et al. 1991, 1992). Currently
performed research on the occurrence of sialic acid in
borrelia spirochetes has not proved spirochetal origin of
the sialic acid. It seems that most of the detected sialic
acid molecules come along with serum glycoproteins in
the cultivation media (Vancová et al. 2005). The occurrence of polysialic acid in the bacterial capsules is always a very important indication of bacterial pathogenicity. The different polysialic acids expressed by
Neisseria meningitidis are major virulence factors and
are used as epidemiological markers and vaccine targets
(Swartley et al. 1997). Also, polysialic acid and poly-
283
Fig. 6. Negative staining of cultured Borrelia burgdorferi
spirochetes and their membrane vesicles (arrow). Scale bar = 2
µm.
sialyltransferase were found in Escherichia coli K92
(McGowen et al. 2001).
At least one additional borrelia glycosylated protein,
FlaA (P37), is known. FlaA is an outer sheath protein of
the periplasmic flagella and is glycosylated in contrast
to the major protein FlaB of the periplasmic flagella (Ge
et al. 1998, Gilmore et al. 1999). The protein FlaA elicits an early IgM antibody response in LB patients.
1.7. Lectins/agglutinins of LB spirochetes
The first findings of borrelia in the linkage to the
haemagglutination activity of the lysate of B. burgdorferi and B. recurrentis spirochetes were reported by
Grubhoffer et al. (1992, 1993). Unlike results of Leong
et al. (1995), the binding specificity of the borrelia
(B31) lectin/agglutinin toward D-galactosamine, Dmannosamine and fetuin were recorded. The full gene
that codes borrelia lectin was isolated from the genome
of the spirochete using degenerated primers designed
from sequences of already known lectin genes (about
100 genes were compared). The study of the 825-bp
lectin gene from B. burgdorferi B31 showed the possibility of the existence of two forms of predicted protein
LEC1/2. Further analysis of the obtained sequences and
their comparison with the molecular databases enabled
the authors to determine the proper ORF of 274 amino
acids, which should represent the functional region of
the lectin molecule from B. burgdorferi B31. It corresponds to the BB0725 region of the borrelia genome
(Fraser et al. 1997). The predicted amino acid sequence
showed that this fragment contains the conservative
domain typical of the lectins from seeds of Phaseolus
vulgaris PHA-E a PHA-L. Of importance also is the fact
that according to GenBank data the fragment of 274
amino acids revealed a high homology (94% identity)
284
with the conserved hypothetical protein that is mentioned the first time by Fraser et al. (1997). The borrelia
lectin gene was designated as lecB31 for further use
(Rudenko et al. 1999), and its sequence was registered
in the GenBank by number AF028001 NCBI
(giI3138928). The entire sequence now is completed
and codes for both forms of LEC molecules (LEC1/2,
short/long form). This enables researchers to clone it
and obtain the recombinant LEC protein (Rudenko et al.
2001).
Unlike the LEC31 borrelia lectin, the other haemagglutinin described by Leong et al. (1995) and Parveen
and Leong (2000) is a protein of molecular size of 26
kDa with the binding affinity for glycosaminoglycans
(GAGs). The latter authors have called it the Borrelia
GAG-binding protein (Bgp). GAG as heparin or
heparan sulfate, dermatan sulfate and chondroitin sulfate were found the most efficient inhibitors of red
blood cell agglutination by Bgp (Parveen and Leong
2000). The gene encoding Bgp is located on spirochetal
chromosome at BB0375 site (Parveen and Leong 2000,
Frazer et al. 1997). The GAG-binding preference of a
borrelia spirochete strain reflects in its cell-type-specific
binding (Parveen et al. 1999). Borrelia strains that recognized predominantly heparan sulfate bound efficiently to endothelial cells, whereas strains with binding
affinity to dermatan sulfate bound very well only epithelial cells. Host cell attachment may be critical for tissue
colonisation. Besides Bgp there are two other GAGbinding proteins, which are called decorin-binding proteins A and B (DbpA, DbpB) after human proteoglycan
decorin (Guo et al., 1995, 1998). Parveen et al. (2003)
have shown that three LB spirochetes surface proteins,
Bgp, DbpA and DbpB bind to GAGs or GAG-containing molecules, and they might be considered as molecular factors of borrelia spirochetes invasion in the
mammalian host organism. Till now there are no data
about GAGs in ticks as well as a role of Bgp and
DbpA/B inside of tick vectors of LB.
2. TRANSMISSION OF LB SPIROCHETES AND
PARTICIPATION OF LECTINS IN THE
PATHOGEN-VECTOR INTERACTION
Ticks as haematophagous parasites represent an important group of the vectors of viral, bacterial and protozoan causative agents of diseases. With respect to
public health, the sheep tick Ixodes ricinus is the principal vector of tick borne encephalitis (TBE) virus and
Borrelia burgdorferi s.l. spirochetes in western and central Europe, while Ixodes persulcatus is most important
in Eurasia. Ixodes scapularis and Ixodes pacificus are
the main vectors of B. burgdorferi in eastern and western North America, respectively.
2.1. Ticks as the vectors of LB spirochetes
Ixodes ricinus is a competent vector of B. burgdorferi
s.l. spirochetes. Unlike TBE virus, borrelia spirochetes
Grubhoffer et al.: Lyme borreliosis
are extracellular parasites with significantly different
pathophysiology of systemic infection of the vector.
Spirochetes, conspicuously aggregated (by a lectin?) are
localised between epithelial cells of the gut and attached
to basal membrane in the early phase of infection
(Burgdorfer et al. 1989). Other authors (Benach et al.
1987, Ribeiro et al. 1987) observed penetration of spirochetes from the gut to the haemocoel only in the early
phase (3–5 days after attachment). Later, in the phase of
systemic infection, spirochetes may be found there only
sporadically. Therefore, such pathophysiology of borrelia infection may be involved in the regulation of systemic infection of the tick defence mechanisms in
haemolymph. The lectin that was found in the haemolymph of I. ricinus (Grubhoffer et al. 1991, Kuhn et al.
1996) may be a molecular factor of the defensive
mechanism that serves to restrict systemic infection of
the vector by borrelia spirochetes. This lectin has the
binding specificity to sialic acid and, therefore, may
interact with lipooligosaccharides of the spirochete’s
outer membrane due to a steric similarity of sialic acid
with 2-keto-3-deoxyoctonate acid, or with sialic acid
itself. The presence of sialic acid in the wall of B.
burgdorferi was proposed in 1991 (Hulínská et al.
1991). LB spirochetes also have other glycosylated
components or glycoconjugates on their surface (like
“slime layer” component or the “major extracellular
protein” [MEP] of 83 kDa). The latter one, however, has
never been proved and according to Shoberg and Thomas (1995), MEP is an artificial structural unit at borrelia surface that might also provide suitable target ligands
from other tissue lectins of the ticks. Other factors with
lectin or lectin-like binding activity may also interact
with structural components of B. burgdorferi in the salivary glands or in saliva itself. During the systemic infection, B. burgdorferi spirochetes may be found in both
type I and granular acini of salivary glands, where they
pass through into the lumen of the acinus, and then can
be transported into the saliva (Zung et al. 1989, Friedhoff 1990). Saliva containing glycoproteins of unknown
function, esterase and some pharmacologically efficient
substances, make the transmission of B. burgdorferi
significantly easier by decreasing the functional activity
of host neutrophils (Ribeiro 1987, Walker and Fletcher
1990).
2.2. Tick-borrelia immune interactions
In recent years, the immune response of I. ricinus and
the major American vector of B. burgdorferi s.l., I.
scapularis, have been investigated with respect to the
innate immune response of the ticks to several bacteria
(Johns et al. 1998, 2000, 2001). These studies have focused primarily on bacterial survival in the tick, observations of phagocytosis and finding evidence of antibacterial peptides in the haemolymph. During this time,
progress has been made in understanding the molecular
basis of vector-parasite compatibility and the cellular
interactions between mosquitoes and malaria parasites
(Barrilas-Mury et al. 2000, Christophides et al. 2004). In
contrast, very little has been published on mechanisms
of molecular interactions between tick vectors and B.
burgdorferi spirochetes.
The midgut is the first site of interaction between
ticks and B. burgdorferi. Unlike other tick-borne borrelia spirochetes that leave the midgut of their vector
shortly after ingestion and cause either a haemocoellimited or a systemic infection, B. burgdorferi spirochetes remain in the tick midgut, where they aggregate
within the microvillar brush-border and in the intracellular space between epithelial cells. From the midgut, B.
burgdorferi may penetrate the gut wall during and after
blood feeding and may initiate a systemic infection
(Burgdorfer et al. 1989). Regardless of such generalised
infections, the midgut remains infected throughout the
life span of the tick. Since the tick gut is the principal
site where B. burgdorferi persist in the vector, and the
spirochetes almost exclusively reside within this tissue
during the long intervals between the tick blood meals,
it is likely that B. burgdorferi has evolved mechanisms
to specifically interact with arthropod receptors within
the gut. Some tick proteins, binding to OspA, that play
an important role in spirochete-vector interactions have
been described (Pal et al. 2004b).
The physiological mechanisms of vector competence
in various tick species remain to be explained and require further studies. Mátlová et al. (1996) showed that
unlike Ixodes ricinus, another hard tick Dermacentor
reticulatus reveals a gradual decline and the loss of LB
spirochetes shortly after infection. This indicates a lack
of this ixodid species to serve as a competent vector of
B. burgdorferi. Regarding vector competence of I.
ricinus and D. reticulatus, the effect of both salivary
gland and midgut extracts on the growth of LB spirochetes in vitro was tested (Rudolf and Hubálek 2003).
While extract derived from I. ricinus (a competent vector) stimulated growth significantly, extracts from D.
reticulatus (a non-competent vector) did not affect the
growth of borreliae markedly, or even inhibited borrelia
growth in vitro.
To infect a subsequent host, the bacteria must escape
the tick gut and migrate to the salivary glands. During
this migratory stage, the spirochetes are exposed to the
tick’s cellular defence or anti-bacterial peptides in the
haemocoel. Ticks have an open circulatory system that
functions in fluid transport of nutrients and in the defence response against pathogens. Plasmatocytes and
granulocytes are active components of such cellular
defence response. Both are involved in recognition and
phagocytosis of foreign bodies, and the encapsulation
response of ticks occurs in a similar manner as it does in
insects. The process includes degranulation of granulocytes followed by deposition of the matrix on the surface of the foreign body and the formation of a multicellular layer of granulocytes and plasmatocytes (Eggenberger et al. 1990). In the American dog tick Dermacen-
285
tor variabilis, infection with B. burgdorferi results in an
increase of plasma borreliacidal factors and a six-fold
rapid increase in phagocytic cells to clear the infection
and limit tissue invasion (Johns et al. 1998, 2000, 2001).
Phagocytosis of B. burgdorferi by haemocytes has been
reported in I. scapularis (Coleman et al. 1997). In this
study, haemocytes with bound or incorporated spirochetes increased gradually, from only 2% of the haemocyte population on feeding day 3 to 13% by feeding day
5. Haemocyte abundance was distinctly higher in the B.
burgdorferi-challenged I. scapularis ticks for at least 1
h after spirochete inoculation, suggesting that an increase in the number of haemocytes may contribute to
the eventual clearance of spirochetes.
Inducible humoral defensive proteins have not been
as well characterized in ticks as they have in some insects. Nevertheless, two isoforms of a member of the
arthropod defensin family have been cloned from Ornithodoros moubata (Nakajima et al. 2001). Importantly,
Ornithodoros defensin mRNA is up-regulated by blood
feeding and bacterial injection. Also, an anti-bacterial
humoral response against the protozoan parasite Theileria parva was recently investigated in its tick vector,
Rhipicephalus appendiculatus (Watt et al. 2001). The
exoskeletons of adult ticks were initially pierced with
one of three type needles: (1) bacteria-coated, (2) salinecoated, or (3) sterile dry glass. Haemolymph was extracted from the ticks at 6, 24, 48, and 72 h postinjection and applied to bacterial plates to measure the
growth inhibition effects. The inhibition zones were
larger with all the injected groups compared to uninjected controls. The largest inhibition zones were seen
24 h after injection with bacteria-coated needles.
Ixodes scapularis, a major vector of B. burgdorferi
spirochetes, has a significantly less robust response
against B. burgdorferi than the incompetent vector
American dog tick, Dermacentor variabilis (Johns et al.
2001). Following intrathoracic inoculation, some Borrelia spirochetes were found associated with I. scapularis
haemocytes, while the majority of intact bacteria remained free in the haemolymph. In contrast, in D. variabilis only remnants of the bacteria were evident in the
haemolymph, indicating lysis; intact spirochetes were
rare. Spirochetes were observed bound to or within organs of both tick species, although many more spirochetes were found associated with organs of I. scapularis. The few spirochetes observed in D. variabilis appeared to be dead because D. variabilis tissues rarely
contained cultivable bacteria, unlike those isolated from
I. scapularis tissues. When spirochetes were incubated
with haemolymph plasma of I. scapularis in vitro, bacterial survival and motility were not reduced. In contrast, incubation of spirochetes with D. variabilis
haemolymph plasma resulted in >50% of the spirochetes becoming nonmotile by 45 min. The differences
in the responses of these two different tick species indicate that I. scapularis is relatively immunotolerant when
286
challenged with B. burgdorferi compared to D. variabilis. I. scapularis may depend on a slow phagocytic response to clear borreliae from the haemolymph. In contrast, D. variabilis is highly immunocompetent, using
plasma borreliacidal factors and a rapid increase in
phagocytic cells to clear the infection and limit tissue
invasion.
Other experimental data suggest a high level of variability in the response of I. scapularis and I. ricinus
against borrelia infection. Also, responses to different
strains of bacteria have been shown to differ markedly
(Dolan et al. 1998). In these experiments, the vector
competence of I. ricinus and I. scapularis was determined and compared with two strains of B. burgdorferi
s.s. (B-31 and B-31.D1 clone), B. afzelii (strain Pgau.
C3), and B. garinii (strains VS286 and VSBP). Tick
larvae were assayed for infection by culture in media
every 7 days for 4 weeks. Infection frequencies in I.
scapularis exposed to the five strains were as follows:
B-31 (90%), B-31.D1 (83%), Pgau.C3 (87%), VS286
(10%), and VSBP (5%). The comparable infection frequencies for I. ricinus were B-31 (3%), B-31.D1 (3%),
Pgau.C3 (90%), VS286 (5%), and VSBP (3%). Nymphal I. scapularis successfully transmitted B-31, B31.D1, Pgau.C3, and VS286 to outbred mice. Nymphs
of I. ricinus transmitted Pgau.C3 and VS286. Both species failed to transmit strain VSBP. Although I. ricinus
ticks do not have a robust immune response, it is likely
that they are capable of innate reaction. It is now appreciated that B. garinii includes strains that cannot infect
rodents (the majority) and a serotype 4 that can infect
rodents. This fact might have influenced the results obtained by Dolan et al. (1998).
2.3. Lectins as carbohydrate-binding proteins in tickspirochete interaction
Currently, even partially characterized tick lectins
show significantly various affinities to sialic acid and to
N-acetyl-D-glucosamine and differ in their binding
specificity to other sugars. Their interaction with glycosylated structures of transmitted pathogens is suspected,
but has not yet been proved (for review, Grubhoffer et
al. 2004). However, some data in support of this expectation have appeared recently. The first lectin studies
were done on haemolymph of the soft ticks Ornithodoros tartakovskyi, O. papillipes and Argas polonicus (Grubhoffer et al. 1991). Afterwards, Kamwendo et
al. (1993) reported haemagglutinating activities in
haemolymph, gut homogenates, and salivary glands in
the hard tick Rhipicephalus appendiculatus, the field
vector of East Coast fever (a tick-borne disease of cattle
caused by the protozoan parasite Theileria parva). Bovine red blood cells were found as the most sensitive
detection system for all of these activities possessing no
significant differences between those in extracts from
unfed and fed ticks. The highest increase was recorded
in the gut extract. Kamwendo et al. (1995) dealt with a
specific functional role of the tick salivary gland
Grubhoffer et al.: Lyme borreliosis
Figs. 7–12. Isolated haemocytes of Ixodes ricinus and their interactions with Borrelia burgdorferi B31 in vitro. Fig. 7. The adhesion of the ends of B. burgdorferi cells to the surface of haemocytes. Fig. 8. Phagocytosis of B. burgdorferi via symmetrical
phagocytic cup (conventional phagocytosis). Fig. 9. A haemocyte engulfing B. burgdorferi spirochetes via overlapping pseudopods (coiling phagocytosis). Fig. 10. Two haemocytes with partially phagocytosed borrelia spirochetes. Fig. 11. Borrelia spirochetes coiled in phagosomes of a haemocyte. Fig. 12. An ultrathin section of coiled B. burgdorferi residing within phagosome.
Figs. 7, 10, 11 – B. burgdorferi labeled with anti-flagellin specific antibodies followed by FITC-conjugated secondary antibodies;
Figs. 10, 11 – nuclei stained with DAPI; Fig. 7 – cytoplasm stained with Evans blue; Figs. 7, 10, 11 – fluorescence microscopy;
Figs. 8, 9, 12 – transmission electron microscopy. Scale bars: Figs. 7, 10, 11 = 10 µm; Figs. 8, 9, 12 = 500 nm. (From Slavíčková
2004.)
haemagglutinin of R. appendiculatus, searching for a
mechanism of T. parva transmission. A significant increase in infection rates of T. parva occurred in salivary
gland acini of R. appendiculatus that were fed on ears of
rabbits infused with mellibiose and raffinose. In contrast, mannose and turanose (non-inhibitory sugars) did
not cause an elevation of T. parva acinar infection rates.
Haemagglutination activity has been found and partially characterized in a midgut homogenate of I. ricinus
(Uhlí et al. 1996). Native mouse erythrocytes were the
most sensitive detection cell system in a wide pH range
of 6.5–8.0. Binding specificity analysis has shown that
the simple sugars N-acetyl-D-galactosamine, N-acetylD-glucosamine, rhamnose, dulcit and glycoconjugates
fetuin, hyaluronic acid, laminarin (beta 1,3-glucan) and
bacterial lipopolysaccharides are the molecules with the
highest inhibitory effect in haemagglutination assays.
Midgut extracts from unfed ticks lack haemagglutination activity. Mouse polyclonal antibodies raised against
midgut haemagglutination activity have discriminated
on western blot gels four protein molecules of 37, 60,
65, and 73 kDa. These are putative structural compo-
287
nents of the lectin(s) or the whole haemagglutination
complex. A protein with a molecular size of 65 kDa was
found to be the main agglutinin with binding affinity to
highly sialylated bovine submaxillary mucin, whereas
the other purified protein of about 37 kDa had a strong
binding specificity for laminarin (beta-1,3 glucan)
(Durnová 1998). Compounds of 37 and 60 kDa are glycoproteins modified by both high mannose and complex
types of N-glycans; a 70 kDa subunit is likely modified
only by complex glycans (Uhlí et al. 1994). Using the
specific mouse polyclonal antibodies, the midgut haemagglutinin has been immunohistologically localised
only in the midgut cells, and not in the gut content or
other tick tissues including haemolymph.
Agglutinins found in haemolymph/haemocytes and in
salivary gland extract of adult I. ricinus are apparently
lectins that have different binding features than those in
the midgut (Grubhoffer et al. 1991, Grubhoffer and Durnová 1996, Kuhn et al. 1996, Grubhoffer and Ková
1998). Haemolymph/haemocyte haemagglutinin has
been characterized as an 85-kDa Ca2+-dependent, sialic
acid-binding lectin with additional affinity for N-acetylD-glucosamine and D-galactose (Grubhoffer et al.
1991). Ixodes ricinus haemolymph lectin was immunolocalised in tick tissues and its distribution supports
the hypothesis that the lectin is produced and/or stored
in haemocytes and contributes to the immune system of
the tick by recognition of foreign substances (Kuhn et
al. 1996). Lectin molecules were detected in the granules of both types of granular haemocytes, the membrane of haemocytes, the basal laminae surrounding the
haemocoel, cells attached to the midgut, invaginations
of Géne’s organ, and granular inclusions of nephrocytes
(Kuhn et al. 1996). Like Dorin M, the sialic acidspecific plasma lectin of the soft tick Ornithodoros
moubata (Grubhoffer and Ková 1998, Ková et al.
2000, Rego et al. 2005 a, b) and some other sialic acidspecific lectins of chelicerates, the haemolymph lectin
(Ixoderin A) of ixodid ticks may also recognize a wide
range of gram-negative bacteria due to its binding specificities for N-acetyl-D-glucosamine, D-galactose and 2keto-3-deoxyoctonate acid (Vasta and Marchalonis
1983, Grubhoffer et al. 1991, Kuhn et al. 1996). Dorin
M is the first lectin purified from ticks which was
cloned as well. It remains to be proved whether I.
ricinus plasma lectin has a structural similarity to Dorin
M or not. Rittig et al. (1996) report that the haemocytes
of I. ricinus phagocytose the borrelia spirochetes by the
“coiling-way” (Figs. 7–12). Coiling phagocytosis is
likely a lectin-mediated process described in many other
cases (Kuhn et al. 1994, Slavíčková 2004).
Agglutinin in the tick salivary gland extracts has
been determined to be a lectin with the structural subunit of 70 kDa and the binding specificity for sialic acid
288
and some other saccharides (D-mannosamine, N-acetylD-galactosamine, trehalose), and for sialylated glycoproteins as well (Grubhoffer and Durnová 1996).
Based on the binding characteristics, the tick midgut
agglutinin can function as a LPS-binding protein analogous to carbohydrate binding activities in the gut tissue
of other blood sucking arthropods. It appears that the
midgut agglutinin is a potential LPS-binding protein
that might play a key role in cooperation with the digestive enzymes once gram-negative B. burgdorferi spirochetes have penetrated the gut epithelium/wall into the
haemocoel. Sialic acid-binding lectins from haemolymph and salivary glands might be able to bind borrelia
cells by interactions with sialic acid or with steric analogs of sialic acid, structural parts of the borrelia
lipopolysaccharide or lipooligosaccharide.
3. CONCLUSION
LB is an infectious disease of humans and some other
mammals and is a complex public health problem both
epidemiologically and ecologically. By definition, it
represents exoanthropic zoonoses outside human habitats (Hubálek 2003). Each functional unit of the ‘tick–
borrelia–host’ system may have been in an interaction
with external or internal environment, and those interactions are performed at the level of organisms as well as
molecules. Although it has yet to be proven, it is likely
that specific protein(lectin)-carbohydrate interactions
might be involved in the process of transmission of LB
spirochetes by ticks. If so, then those interactions may
function as reciprocal ones, where tissue-specific tick
lectins may enter counterpart interactions equally as
lectins of LB spirochetes. Carbohydrate/glycan moieties
of the membrane-bound or soluble proteins in tick tissues may serve as receptors of those lectin molecules
(Grubhoffer et al. 1997). Based on published results, a
binding affinity to sialic acid and their derivatives or
steric analogs has been revealed as a common feature of
tissue-specific tick lectins. Sialic acid as well as its analogs appear to be receptor candidates for those interactions. Currently, lectins are considered as one of ‘pattern
recognition proteins’, which are considerably employed
in mechanisms of recognition of foreign material and of
innate immunity.
Acknowledgements. This study was funded by the Grant
Agency of the Czech Republic (524/03/1326 and 206/03/
1323), the Ministry of Education, Youth and Sports (MSM
6007665801), NATO Science Senior Fellowship 8 (2003),
Science and Technology collaboration between ASCR and
NRC Canada (Z60220518/58-8500), and by grant R37 AI24899 from the U.S. National Institutes of Health.
Grubhoffer et al.: Lyme borreliosis
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Received 18 January 2005
Accepted 23 June 2005
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