Clinical Research Directory

FINtick - a Prospective Multicenter Study on Tick-borne Infections in Finland

Ticks in Finland can carry several microbes that may infect humans. The best known tick-borne diseases are Lyme borreliosis and tick-borne encephalitis (TBE). In recent years, scientists have also found other microbes in Finnish ticks, such as Anaplasma, Rickettsia, Neoehrlichia, Borrelia miyamotoi, and Babesia. Infections caused by these microbes are called emerging tick-borne diseases. Climate change may also increase the number of ticks and expand their range further north. This could lead to more tick-borne diseases in the future. The public health impact of these emerging infections is still unclear. Some of them may cause severe illness, especially in people with weakened immune systems or without a spleen. However, we still know little about how common these infections are, how they develop in the body, and what symptoms they cause. Some people may have no symptoms, while others may become seriously ill. Good diagnostic tests are also lacking. More knowledge is also needed about Lyme borreliosis and TBE. Some forms of Lyme disease, such as arthritis, heart inflammation, or eye problems, may be underdiagnosed. In addition, TBE cases have increased in Finland in recent years. This study will examine the symptoms, recovery, and quality of life of patients with these infections. Another goal is to improve laboratory diagnostics. Current tests for Lyme disease and TBE mainly detect antibodies. These tests cannot always tell when the infection occurred or distinguish a past Lyme borreliosis infection from a current one. This also makes it difficult to detect reinfections in Lyme borreliosis or TBE-infections in vaccinated individuals. By collecting samples from patients, we aim to develop better diagnostic methods. The main goal of the study is to improve knowledge about tick-borne diseases in Finland. We will study how common emerging infections are, what symptoms they cause, and whether people can have more than one tick-borne infection at the same time. We will also examine how the immune system responds to these infections and how this relates to disease severity and recovery. This study includes both children and adults who are being examined for a suspected tick-borne disease. Participants will be followed for six months using questionnaires at initiation, one, three, and six months. Blood samples and other samples, depending on the patient's symptoms, will be collected together with routine clinical samples. The samples will be analyzed to detect tick-borne pathogens and antibodies against them. Molecular tests (PCR) will look for the genetic material of the microbes. Researchers will also search for new biological markers of these diseases and study the immune response using advanced laboratory methods. The study will be conducted in collaboration with the SWETICK study.

Implementation of an RT-PCR Assay for the Diagnosis of Rickettsia Spp. Infection

Rickettsia2024 is a multicenter, tissue observational, retrospective and prospective cohort study. Enrollment will take place within the outpatient clinics of the Infectious Diseases and Dermatology Unit of the IRCCS AOUBO and, following an infectious disease consultation in the Bologna Metropolitan area, at the Hospitals and CAUs of the Bologna Local Health Authority. Within these UUOOs, biopsy samples from normal clinical practice are performed on patients with strong clinical suspicion of Rickettsia infection: therefore, it will not be necessary to perform any additional samples for the conduct of this study. Samples from the normal diagnostic process are sent to the Microbiology UOC, where they are subjected to various analyses. RT-PCR analyses (commercial or in-house kit) and assay of species-specific IgG antibodies will be performed according to clinical practice. Additional tests will be performed with a commercial kit for retrospective samples and with a home-made method for prospective samples.