CXCR4 expression of metastases matches the expression of the primary tumor and does surpass it. A significantly higher CXCR4 expression is, however, observed in the trastuzumab-treated group and a higher expression in the AMD3100-treated group compared to the control group. The combined treatment with trastuzumab and AMD3100 leads to a significant reduction of primary tumor growth as well as to a relevant, if not significant reduction of overall metastatic spread and a reduction of micrometastases to liver and lung. This dual-treatment group shows heterogenous levels of HER2 intensity in the only two metastatic cases. Several hypotheses have been postulated regarding possible shared pathophysiologic mechanisms between the core pathophysiology of PD and the depressive symptoms in PD patients. “The inflammatory hypothesis” is based on the notion that inflammatory mechanisms might be Bortezomib involved in the pathophysiology of PD as well as Major Depressive Disorder. PD patients show signs of peripheral and central inflammation, including elevated cytokines in serum and cerebrospinal fluid, as well as activated microglia. Peripheral blood monocytes isolated from PD patients produce larger amounts of several cytokines, including tumor necrosis factor alpha, than healthy controls – indicating that the elevated serum levels of cytokines are symptoms of immunological dysregulation, rather than just secondary to the dopaminergic cell degeneration. Some of these signs are also demonstrable in depressed, non-PD patients. For example, several studies report elevated cytokines such as interleukin-6 and TNF-a as well as soluble interleukin-2 receptor in serum of MDD patients compared with controls. Interestingly, Palhagen and colleagues reported a neurobiological distinction between patients with PD and MDD and patients with solely MDD, in that the latter group displayed higher levels of corticosterone and IL-6 in CSF. In a recent review by Barnum & Tansey, it was suggested that inflammation might contribute to the development of non-motor PD symptoms. Only a few clinical studies have, however, investigated potential associations between such symptoms and peripheral cytokines. Menza et al. showed that TNF-a in serum is correlated with several non-motor symptoms, including cognition and depressive symptoms, and Scalzo et al showed that IL-6 correlated with scores on the Mini-Mental State Examination in PD patients without dementia. As studies on inflammatory markers and non-motor aspects of PD are scarce, we wanted to further explore this area. In this study we measured four pro-inflammatory substances in the blood of 86 PD-patients and 40 controls, evaluated for non-motor symptoms such as fatigue, depression, anxiety, and sleeping difficulties. We wanted to compare the groups for cytokine levels and symptoms severity, and finally investigate correlations between cytokines and non-motor symptoms. We report significant differences in IL-6 levels and severity of non-motor symptoms between PD patients and controls. Symptoms of fatigue, depression, and anxiety were associated with cytokines in serum. Emerging and re-emerging diseases transmitted by blood feeding arthropods are significant global public health problems. Ticks transmit the greatest variety of pathogenic spirochetes, rickettsiae and viruses of any blood feeding arthropod. Infectious agents transmitted by ticks are delivered to the vertebrate host together with saliva at the bite site.