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Complement split products c3a and c4a in chronic lyme disease.

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Abstract

Complement split products C3a and C4a are reportedly elevated in patients with acute
Lyme disease. We have now examined these immunologic markers in patients with chronic
Lyme disease compared to appropriate
disease controls. The study population consisted of 29 healthy controls, 445 patients with chronic
Lyme disease, 11 patients with systemic lupus erythematosus (SLE) and six patients with AIDS. The
Lyme disease patients were divided according to predominant musculoskeletal symptoms (324 patients) or predominant neurologic symptoms (121 patients). C3a and C4a levels were measured by radioimmunoassay. All patients with chronic
Lyme disease and AIDS had normal C3a levels compared to controls, whereas patients with SLE had significantly increased levels of this marker. Patients with predominant musculoskeletal symptoms of
Lyme disease and AIDS patients had significantly increased levels of C4a compared to either controls, patients with predominant neurologic symptoms of
Lyme disease or SLE patients. Response to antibiotic therapy in chronic
Lyme disease was associated with a significant decrease in the C4a level, whereas lack of response was associated with a significant increase in this marker. In contrast, AIDS patients had persistently increased C4a levels despite antiretroviral therapy.
Lyme patients with positive single-photon emission computed tomographic (SPECT) scans had significantly lower C4a levels compared to
Lyme patients with normal SPECT scan results. Patients with predominant musculoskeletal symptoms of
Lyme disease have normal C3a and increased C4a levels. This pattern differs from the increase in both markers seen in acute
Lyme disease, and C4a changes correlate with the response to therapy in chronic
Lyme disease. C4a appears to be a valuable immunologic marker in patients with persistent symptoms of
Lyme disease.

Scand J Immunol. 2009 Jan;69(1):64-9. doi: 10.1111/j.1365-3083.2008.02191.x. Comparative Study

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