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These barriers include borrelial relocation from the midgut of the feeding tick to its body cavity and further to the salivary glands, deposition to the skin, haematogenous dissemination, extravasation from blood circulation system, evasion of the host immune responses, localization to protective niches, and establishment of local as well as distal infection in multiple tissues and organs

278 These pathways lead to granzyme release, ROS production, 279 and the activation of transcription factors, including STAT3, 280 NF-B, activator protein 1 (AP-1), 281 and cAMP-responsive element-binding protein (CREB), 277 which further contributes to the expression of pro-inflammatory cytokines, co-stimulatory molecules, and complement components

Psychiatry 6 , e894 (2016)

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