Title:T Lymphocyte Interferon-gamma Response to Anaplasmataceae-related
Major Surface Proteins and Ankyrin A in Fibromyalgia
Volume: 23
Issue: 11
Author(s): Basant K. Puri*, Rosemarie Preyer, Gary S. Lee and Armin Schwarzbach
Affiliation:
- Faculty of Health and Wellbeing, University of Winchester, Winchester, UK
Keywords:
Anaplasma, Anaplasmataceae, antinuclear antibodies, Ehrlichia, enzyme-linked immune absorbent spot, fibromyalgia.
Abstract:
Background: The aetiology of fibromyalgia is unknown; its symptoms may be related to
a T-lymphocyte-mediated response to infectious organisms.
Objectives: First, to test the hypothesis that fibromyalgia is associated with increased interferon
(IFN)-γ-secreting T-lymphocytes after stimulation with Anaplasmataceae-related major surface proteins
(MSPs) and the macromolecular translocation type IV secretion system effector ankyrin repeat
domain-containing protein A (AnkA). Second, to ascertain the relationship in fibromyalgia between
(i) the IFN-γ-secreting T-lymphocyte response to stimulation with Anaplasmataceae-related MSPs
and AnkA, and (ii) co-infection by Borrelia and Yersinia spp., and antinuclear antibodies.
Methods: Using a case-control design, patients fulfilling the American College of Rheumatology
revised criteria for fibromyalgia, and controls, underwent the following blinded assessments: (i) enzyme-
linked immune absorbent spot (ELISpot) IFN-γ release assay of T-lymphocyte reactivity to
Anaplasmataceae-related MSPs and AnkA; (ii) ELISpot IFN-γ release assays of T-lymphocyte reactivity
to three Borrelia antigens, namely Borrelia burgdorferi full antigen (B31); peptide mix (from
Borrelia burgdorferi sensu stricto, Borrelia afzelii, Borrelia garinii); and Borrelia burgdorferi lymphocyte
function-associated antigen-1; (iii) immunoglobulin (Ig) A assay by enzyme-linked immunosorbent
assay (ELISA) of antibodies to Yersinia spp.; (iv) IgG (ELISA) antibodies to Yersinia
spp.; (v) serum antinuclear antibodies (immunofluorescence).
Results: The groups were age- and sex-matched. The mean (standard error) value of IFN-γ release
for the fibromyalgia group was 1.52 (0.26), compared with 1.00 (0.22) for the controls. Generalised
linear modelling (p<0.001) of IFN-γ release in the fibromyalgia patients showed significant main
effects of all three indices of Borrelia infection and of antinuclear antibodies.
Conclusion: Anaplasmataceae may play an aetiological role in fibromyalgia.
