Pediatric Rheumatology Online Journal → August 2003 → Lyme Disease → Abstract #158

ANTIBIOTIC RESISTANT LYME ARTHRITIS (ARLA): PRELIMINARY OBSERVATIONS ON CULTURED SYNOVIAL CELLS

A. C. Brescia, P. T. Fawcett, L. B. Fawcett, C. D. Rose

¹Pediatrics, Thomas Jefferson University, Wilmington, DE, United States

We reported on the course of a 1998-2002 cohort of 94/207 children with Lyme Disease who met CDC criteria for Lyme Arthritis (A&R 2002: S312). K-M survival curves showed 39 & 13% requiring6 &12 mos respectively for resolution. ARLA defines as resolution @6 mos from antibiotics. We found no clinical, demographic or serologic predictor of ARLA. Mechanisms may include bacterial 'sanctuary effect', mimicry in a given MHC or synovial pseudotransformation. For the latter we studied growth in cultured synovial fibroblasts from SF of 6 L Arthritis children (4 acute/2 ARLA). Our preliminary observations in Passaged culture are: The two synovial culture samples from the ARLA patients showed
Rapid Growth velocity and high fibroblast count. The 4 samples from acute
Lyme arthritis had low fibroblast count and their growth velocity was
moderate in 2/4 and slow in the remaining 2.
Summary: A pattern of disregulated growth among fibroblast-like cells from SF of ARLA patients may be emerging suggesting pseudo-transformation. Experiments to quantify proliferation and expression of regulatory genes are underway.