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Journal of Clinical Microbiology, December 1999, p. 3965-3970, Vol. 37, No. 12
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Genetic Analysis of Borrelia garinii
OspA Serotype 4 Strains Associated with Neuroborreliosis: Evidence for
Extensive Genetic Homogeneity
R. T.
Marconi,1
S.
Hohenberger,2
S.
Jauris-Heipke,2
U.
Schulte-Spechtel,2
C. P.
LaVoie,1
D.
Rößler,2 and
B.
Wilske2,*
Medical College of Virginia at Virginia
Commonwealth University, Richmond, Virginia
23298-0678,1 and Max von Pettenkofer
Institut, Ludwig-Maximilians-Universität München, D-80336
Munich, Germany2
Received 27 May 1999/Returned for modification 22 July
1999/Accepted 19 August 1999
 |
ABSTRACT |
Infection with Borrelia garinii outer surface protein
(Osp) A serotype 4 strains has been correlated with the development of
neuroborreliosis in Lyme borreliosis patients in Europe. OspA serotype
4 isolates have been recovered primarily from human cerebrospinal fluid, suggesting a tropism for this environment. Previous studies with
monoclonal antibodies directed against OspA and OspC demonstrated that
OspA serotype 4 strains are antigenically closely related. In view of
the pronounced antigenic and genetic variability that has been noted in
the Osps of other Borrelia isolates, we sought to determine
if OspA serotype 4 strains represent a recently emerged clonal lineage
of B. garinii. Toward this goal, a representative group of
OspA serotype 4 strains was analyzed for traits that typically exhibit
hypervariability among isolates that cause Lyme borreliosis. The
following criteria were assessed: (i) ospC sequences, (ii)
plasmid composition, (iii) genomic restriction fragment length polymorphism (RFLP) patterns, and (iv) the RFLP patterns of the upstream homology box (UHB) element which flanks members of the UHB
gene family at their 5' end. Collectively, these analyses demonstrate
genetic homogeneity, suggesting that OspA serotype 4 strains are a
recently emerged clonal lineage with an apparent tropism for the
central nervous system.
 |
INTRODUCTION |
The genus Borrelia
contains several spirochete species that are causative agents of
important human diseases such as Lyme borreliosis and relapsing fever
(for a review, see reference 7). Lyme borreliosis is
caused by pathogenic species of the Borrelia burgdorferi
sensu lato complex. While as many as nine species have been delineated
in the B. burgdorferi sensu lato complex, disease in humans
is attributed primarily to B. burgdorferi, B. garinii, and B. afzelii (2, 17, 18, 21, 23, 28,
29, 37, 38, 51, 52, 57). Members of the genus exhibit several unique features which distinguish them from other eubacteria. One such
feature is their genome, which is comprised of a linear chromosome and
a variable series of linear and circular plasmids (6).
Interestingly, the plasmids carry a large number of genes that appear
to be completely unique to the genus Borrelia
(15). The proteins encoded by these
Borrelia-specific genes likely play central roles in
defining the unique aspects of Borrelia biology and
pathogenesis. The plasmids also carry the majority of outer surface
protein (Osp) genes including the ospAB operon,
ospC, ospD, and the upstream homology box (UHB)
gene family (5, 12, 32, 33, 35, 40). Like the plasmids that
harbor them, the genes encoding surface-exposed proteins exhibit
significant degrees of inter- and intraspecies variation (20, 30,
33, 48, 51, 57-59).
Analyses of phenotypic diversity of the Lyme disease spirochetes have
centered primarily on the Osps, which have been the focus of efforts to
design Borrelia vaccines and diagnostic assays (43,
46). On the basis of variation in the Osps, isolates of the
B. burgdorferi sensu lato complex can be antigenically subtyped (53, 56, 57). On the basis of immunoreactivity with
monoclonal antibodies, seven OspA serotypes have been defined, and
specific serotypes have been demonstrated to correlate with specific
species of the B. burgdorferi sensu lato complex
(57). B. burgdorferi strains are serotype 1, and
B. afzelii strains are serotype 2. The OspA proteins of
B. garinii are more antigenically diverse and are divided
into five distinct OspA serotypes (serotypes 3 through 7). Another
important Osp carried by species of the B. burgdorferi sensu
lato complex is OspC (16). The ospC gene has been
mapped to a highly stable 26-kb circular plasmid that is universally
distributed among isolates (32, 40). The highly immunogenic
OspC protein exhibits a high degree of inter- and intraspecies
variation, with 16 distinct OspC types having been delineated (48,
56). OspE and OspF (22) are additional outer surface
proteins that are genetically and antigenically diverse (34,
47). These immunogenic proteins are members of a large protein
family called the UHB protein family (34, 47). UHB gene
family members are flanked at their 5' ends by a highly conserved upstream homology box (UHB) element and are carried by a series of
closely related 32-kb circular plasmids (cp32s) (12). A
striking feature of this gene family is that it appears to be
evolutionarily unstable and to undergo recombinational and mutational
events at a high frequency during infection (25). It has
been postulated that rearrangements in these genes may allow for the
continual generation of new antigenic variants which could aid in
evasion of the humoral immune response (34, 47).
Serotyping studies of isolates from Europe revealed a striking
correlation between neuroborreliosis and infection with B. garinii OspA serotype 4 strains (55). Specifically, the
majority of B. garinii isolates that have been recovered and
cultured from cerebrospinal fluid from patients in Germany, The
Netherlands, Denmark, and Slovenia are OspA serotype 4 (54, 55,
57). It is interesting that while strains of this serotype have
been recovered from Lyme borreliosis patients, they have not been
cultivated directly from ticks. Regarding the association between OspA
serotype 4 strains, neuroborreliosis, and central nervous system
invasion, it is possible that isolates of this serotype have a higher
pathogenic potential than isolates of other OspA serotypes. Support for
this comes from the observation that OspA serotype 4 strains exhibit a
greater degree of resistance to serum than do other B. garinii OspA serotypes, which are serum sensitive (49).
To determine if OspA serotype 4 strains represent a genetically and
antigenically homogeneous group of neurotropic organisms, we have
conducted a comparative analysis of a representative group of strains.
As a means for assessing homogeneity, we have characterized traits of
B. burgdorferi sensu lato isolates that have been
demonstrated to be highly variable among isolates. These analyses
demonstrate that B. garinii OspA type-4 serotype strains are
significantly more genetically homogeneous than any other defined group
of isolates analyzed to date. The data suggest that B. garinii OspA serotype 4 strains are a recently emerged clonal
lineage that appear to have a strong potential to disseminate and a
higher tropism for the central nervous system than strains of other
OspA serotypes.
 |
MATERIALS AND METHODS |
Bacterial strains and DNA isolation.
The B. garinii OspA serotype 4 strains investigated in this study are
described in Table 1. All strains except
those specifically indicated in Table 1 were isolated at the Max von
Pettenkofer-Institut, Munich, Germany. Strain AO1 was provided by A. van Dam, and strain DK6 was provided by K. Hansen. All bacterial
isolates were cultivated in modified Kelly medium as described
previously (59), and total genomic DNA was extracted as
described previously (27).
Amplification and sequence analysis of the ospC
gene.
The ospC genes were amplified from isolated
genomic DNA by PCR with the OspC1 (5'-GAG GGA TCC ATC ATG AAA AAG AAT
ACA TTA AGT GCG) and OspC3 (5'-GAG CTG CAG TTA AGG TTT TTT TGG ACT TTC TGC) primers. Cycling conditions and PCR conditions and reagents were
as described previously (20, 50). The ospC
amplicons were cloned by using the Original TA Cloning Kit as described by the manufacturer (Invitrogen). The ospC sequences were
determined by the dideoxy chain termination method using a variety of
oligonucleotide primers that target ospC. The sequences that
were determined were translated and were aligned with the OspC
sequences of three B. garinii OspA serotype 4 strains
published previously (strain PBi, EMBL accession no. X69595; strain
PTrob, EMBL accession no. X83554; and strain DK6, EMBL accession no.
X73626).
Pulsed-field gel electrophoresis of borrelial DNA.
Borrelial
strains were embedded in agarose plugs, and the DNA was released from
the cells as described previously (9). To analyze the
plasmid profiles, pulse times of 0.5 to 3.0 s for 30 h were
used. For restriction fragment length polymorphism (RFLP) analyses, the
embedded bacterial DNA was digested with ApaI,
BssHII, SmaI, and MluI under the
conditions recommended by the supplier (Boehringer Mannheim). The
products obtained from the ApaI and SmaI
digestions were separated for 30 h with pulse times of 1 to 20 and
1 to 30 s, respectively. The products obtained from the
BssHII and MluI digestions were separated for
30 h with pulse times of 1 to 40 s.
Hybridization analyses.
To assess the UHB RFLP patterns, the
isolated DNA was digested to completion with HaeIII,
fractionated in a 0.8% GTG agarose gel, vacuum blotted with the
VacuGene system (as described by the manufacturer; Pharmacia) onto a
Hybond-N membrane (Amersham), and fixed to the membrane by UV
cross-linking (Bio-Rad Gene Linker). Prehybridization and hybridization
were conducted in hybridization buffer consisting of 0.2% (wt/vol)
bovine serum albumin, 0.2% (wt/vol) polyvinylpyrrolidone (molecular
weight, 40,000), 50 mM Tris-HCl (pH 7.5), 0.1% (wt/vol) sodium dodecyl
sulfate (SDS), 10% (wt/vol) dextran sulfate, 100 µg of herring sperm
DNA ml
1, and 1 M NaCl. The uhb(+) oligonucleotide (5'-GTT
GGT TAA AAT TAC ATT TGC G) was radiolabeled with
[
-32P]ATP (6,000 Ci mmol
1; DuPont-NEN)
by using polynucleotide kinase under standard conditions. Hybridizations were conducted in a Hybaid hybridization oven at 37°C
overnight. Two 10-min washes with 2× SSC (1× SSC is 0.15 M NaCl plus
0.015 M sodium citrate)-0.1% SDS and a 1-h wash with 0.2× SSC-0.1%
SDS were performed, followed by a final 5-min wash with 0.2×
SSC-0.1% SDS at room temperature with vigorous shaking.
Nucleotide sequence accession numbers.
The B. garinii
ospC sequences determined in this report have been deposited in
the EMBL database under the following accession numbers: AJ132793
through AJ132798 for isolates PBaeII, PWa, PHoe, PFin, PFlk, and PMue,
respectively, and AJ236907 and AJ236908 for isolates PSh and PScf, respectively.
 |
RESULTS AND DISCUSSION |
Analysis of ospC genes in OspA type 4 strains.
To
assess possible genetic variation among the ospC genes of
B. garinii OspA serotype 4 strains, the genes were amplified with primers that target conserved segments of ospC. All
isolates yielded ospC PCR amplicons that were approximately
650 bp in length, indicating size conservation among isolates. The
ospC amplicons from B. garinii isolates PFin,
PBae, PFlk, PMue, PSh, PScf, PWa, and PHoe were sequenced in their
entirety (data not shown), and surprisingly, all were identical at the
nucleotide level. Comparative analyses were facilitated by the
extensive number of ospC sequences in the databases.
Alignment of the sequences determined here with the ospC
sequences available in the databases revealed that they are nearly
identical to the ospC genes of B. garinii PBi,
PTrob, and DK6. These isolates are serotype 4 strains, and both PBi and DK6 were isolated from cerebrospinal fluid (55). The only
difference among the sequences was in that of the ospC gene
of B. garinii PBi, which has a single nucleotide difference
from the other ospC gene sequences. This single point
mutation results in the replacement of a Gln residue by a Glu residue.
The observed high degree of ospC sequence identity among
strains is extremely unusual since ospC genes typically
exhibit a high degree of sequence variation (20, 48, 55). In
addition, diversity among ospC sequences is further driven
by the lateral transfer of the circular plasmid carrying the
ospC gene (20, 24). However, the conservation of
the ospC sequences suggests that lateral transfer of the
ospC plasmid between OspA serotype 4 strains and other OspA
serotypes has not occurred to any significant extent. This does not,
however, rule out the possibility that transfer has occurred among OspA serotype 4 isolates.
Plasmid and RFLP pattern analyses.
In recent years, the
plasmid profiles of hundreds of B. burgdorferi sensu lato
complex isolates have been determined and have been found to exhibit
extensive variation. To compare the plasmid profiles of the OspA
serotype 4 isolates, undigested genomic DNA was fractionated by
pulsed-field gel electrophoresis (Fig.
1). Overall, the plasmid profiles were
found to be strikingly similar. Previous studies of the plasmid
profiles of Lyme disease spirochetes obtained from a defined geographic
region have demonstrated that these patterns are rather variable
(42). Three large plasmids of approximately 66, 57.5, and 50 kb were observed in each isolate. In addition, three to four plasmids
between 20 and 30 kb were also noted. The similar plasmid profiles
demonstrate an unusual degree of conservation of this component of the
genome among B. garinii OspA serotype 4 strains.

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FIG. 1.
Plasmid profile analysis of B. garinii OspA
serotype 4 strains. Cells were embedded in agarose, treated to liberate
the DNA, and electrophoresed as described in the text. The DNA was
visualized by ethidium bromide staining. Size standards (in kilobases)
are indicated on the right.
|
|
To further assess the genetic relatedness among OspA serotype 4 strains, a variety of RFLP analyses were conducted. DNA in
agarose
plugs was digested with
ApaI,
BssHII,
MluI, or
SmaI. The
digested DNA was then
fractionated by pulsed-field gel electrophoresis.
Although some minor
variations in RFLP patterns were noted, the
patterns exhibited high
degrees of conservation among OspA serotype
4 strains, further
demonstrating an unusual level of genetic homogeneity
and sequence
conservation among the plasmids of these isolates.
The results obtained
for the
BssHII digestion are shown in Fig.
2.

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FIG. 2.
RFLP pattern analysis of BssHII-digested DNA
from B. garinii OspA serotype 4 strains. The DNA embedded in
agarose plugs was digested with BssHI and was then
fractionated by pulsed-field gel electrophoresis as described in the
text. The DNA was visualized by staining with ethidium bromide. Size
standards (in kilobases; lanes 1, 8, and 14) are indicated on the
right.
|
|
Hybridization analysis of UHB element.
The UHB gene family is
a large group of lipoprotein-encoding genes, all of which are flanked
at their 5' end by a highly conserved, upstream, promoter-carrying
sequence called the UHB element (34, 47). Although the
sequence of the UHB element itself is highly conserved, previous
analyses of the UHB-flanked genes have revealed that their coding
sequences exhibit variability among isolates, and the RFLP patterns of
the UHB element have been demonstrated to be hypervariable among
isolates of the B. burgdorferi sensu lato complex even at
the intraspecies level (34, 47). It has been hypothesized
that the pronounced variation in the RFLP patterns of UHB elements
among isolates has resulted from recent molecular rearrangements in the
UHB-flanked genes and the plasmids that carry them (34, 47),
and recent data suggest that immune pressures drive or select for
rearrangements (25). To assess the degree of variability in
the RFLP patterns of UHB elements of OspA serotype 4 strains, DNA
isolated from each strain was digested with HaeIII, fractionated, and probed with the uhb(+) oligonucleotide. In contrast to that noted in other B. burgdorferi sensu lato complex
isolates (34, 47), the RFLP patterns of the OspA serotype 4 strains differed from one another only in the number of hybridizing
bands detected (from two to five) rather than in variations in the
sizes of individual bands (Fig. 3). The
nature of these differences is important because the observed different
numbers of hybridizing bands suggest that differences in the RFLP
patterns of UHB elements are due primarily to the loss of some UHB
element-carrying plasmids among these isolates rather than to molecular
rearrangement events. The absence of detectable recombination events in
the UHB-flanked genes is consistent with the possibility that OspA
serotype 4 strains represent a recently emerged clonal lineage.

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FIG. 3.
RFLP pattern analysis of the UHB element. DNA isolated
from each strain was digested with HaeIII and was
fractionated in a 0.8% GTG agarose gel. The DNA was then transferred
to Hybond-N membranes and was hybridized with the 5'-end-labeled uhb(+)
oligonucleotide probe. All procedures are described in the text. Size
standards (in kilobases) are indicated on the right.
|
|
Conclusions.
It has been demonstrated that infection with
particular species or subspecies (OspA types) of the B. burgdorferi sensu lato complex correlates with the development of
certain clinical manifestations of Lyme borreliosis (1, 9, 10, 58,
60, 61). This has been demonstrated for the dermatological
manifestation acrodermatitis chronica atrophicans, which is associated
with B. afzelii. B. afzelii is OspA serotype 2. In contrast,
the causative agents of neuroborreliosis and arthritis in Europe are
heterogeneous, and the development of these manifestations cannot be
attributed to infection with a specific species or OspA serotype. The
diversity of the isolates associated with neuroborreliosis and
arthritis is reflective of the diversity of isolates recovered from
ticks in Europe. While OspA serotype 4 is not the only OspA serotype associated with neuroborreliosis, it is striking that isolates of this
serotype have been recovered almost exclusively from human cerebrospinal fluid (8, 13, 14, 50, 58, 60, 61). The goal of
this study was to determine if OspA serotype 4 strains represent a
recently emerged clonal lineage. If this is in fact the case, then one
would expect genetic homogeneity in traits that have been widely
demonstrated to exhibit variability among isolates. To assess this we
analyzed features or components of the Borrelia genome that
are known to be highly variable among isolates. These comparative
analyses focused on four areas: (i) ospC gene sequences,
(ii) plasmid profiles, (iii) RFLP patterns obtained with infrequently
cutting enzymes, and (iv) the RFLP patterns of the UHB element. In
summary, all four of these areas were found to be conserved among the
OspA serotype 4 strains investigated in this study, suggesting that
they represent a recently emerged clonal lineage.
Comparative analyses of the OspC amino acid sequences revealed sequence
identities of greater than 99%.
ospC sequence conservation
of this extent has not been reported for any other OspA serotypes.
In
fact, comparative analyses of OspC amino acid sequences from
isolates
of different
B. burgdorferi sensu lato species have revealed
extensive divergence, with identity values dropping to as low
as 62%
(
20). At the intraspecies level, OspC identities were
found
to be as low as 71, 76, and 68% in
B. burgdorferi,
B. afzelii,
and
B. garinii, respectively. When OspC
sequences from isolates
of OspA serotype 6 were analyzed, sequence
identities were as
low as 68% (
20). Hence, the
ospC sequences determined here provide
a clear indication of
the genetic homogeneity at this typically
variable locus in OspA
serotype 4
strains.
Pulsed-field gel electrophoresis fractionation of genomic DNA and
analysis of the plasmid profiles revealed strong conservation
of the
plasmid composition among the OspA serotype 4 strains.
As discussed
above, although the plasmids are thought to be essential
for survival,
as inferred from their ubiquitous distribution among
B. burgdorferi sensu lato complex isolates, it has been clearly
demonstrated that plasmid composition can vary widely among
B. burgdorferi sensu lato complex strains (
3,
11,
26,
31,
42,
45). Mechanisms that contribute to plasmid heterogeneity
include
plasmid loss (
35,
41), lateral transfer (
20,
33),
recombination (
30,
33,
39,
47), and dimer formation
(
19,
26). The presence of repeated sequences and gene
families on
plasmids may allow for interplasmid homologous
recombination (
4,
12,
34,
36,
44,
62).
To further analyze possible genetic homogeneity, RFLP patterns were
assessed with the enzymes
BssHII,
MluI,
ApaI, and
SmaI.
The RFLP patterns exhibited an
unusual degree of conservation,
with only minor differences noted. This
observation indicates
that both the plasmids and the chromosomes of
OspA serotype 4
strains have not undergone significant molecular
rearrangement
events. Similarly, analysis of the UHB-element RFLP
patterns of
the serotype 4 strains revealed that they are also highly
conserved.
Previous analyses of UHB-element RFLP patterns have
demonstrated
that they are variable even among closely related isolates
of
the same species (
47). In the OspA serotype 4 strains,
the differences
in the UHB-element RFLP patterns were primarily due to
the absence
of some hybridizing bands from some isolates. This is in
contrast
to the case for other
B. burgdorferi sensu lato
isolates, which
differ not only in the numbers of fragments but also in
the sizes
of the hybridizing fragments. Hence, it appears that in the
OspA
serotype 4 strains, differences in the UHB-element RFLP patterns
are due to the loss of some of the UHB-element-carrying plasmids
rather
than to rearrangements among
plasmids.
From the analyses presented here it can be concluded that OspA serotype
4 strains are a genetically homogeneous group of
B. burgdorferi sensu lato complex strains. The observed genetic
homogeneity
indicates that this serotype is a recently emerged clonal
variant
of
B. garinii. It is interesting that strains of
this serotype
have not been recovered from ticks but have been
recovered only
from humans. The basis for this observation is undefined
and warrants
further study. Furthermore, it remains to be determined
why this
particular variant has established an apparent tropism for the
central nervous system. Comparative analysis of type 4 strains
with
those of other OspA serotypes may allow the identification
of specific
factors that facilitate invasion of the central nervous
system and
persistence in cerebrospinal fluid. Since serum resistance
promotes
dissemination and, therefore, by extension, may allow
OspA serotype 4 strains to have greater pathogenic potential than
strains of other OspA
serotypes, comparative studies of the dissemination
characteristics of
OspA serotypes in ticks and mammals are
warranted.
 |
ACKNOWLEDGMENTS |
R. T. Marconi and C. P. LaVoie are supported in part by
grants from the Jeffress Trust and the National Institutes of Health.
 |
FOOTNOTES |
*
Corresponding author. Mailing address: Max von
Pettenkofer Institut, Ludwig-Maximilians-Universität
München, Pettenkoferstrasse 9 a, D-80336, Munich, Germany.
Phone: 49-89-51605225. Fax: 49-89-51604757. E-mail:
Bettina.Wilske{at}mvp-bak.med.uni-muenchen.de.
 |
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Journal of Clinical Microbiology, December 1999, p. 3965-3970, Vol. 37, No. 12
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