Borrelia-Specific Interferon-γ and Interleukin-4 Secretion in Cerebrospinal Fluid and Blood during Lyme Borreliosis in Humans: Association with Clinical Outcome

• Published in: The Journal of infectious diseases Vol. 189; no. 10; pp. 1881 - 1891
• Main Authors: Widhe, Mona, Jarefors, Sara, Ekerfelt, Christina, Vrethem, Magnus, Bergström, Sven, Forsberg, Pia, Ernerudh, Jan
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15.05.2004; University of Chicago Press; Oxford University Press
• Subjects: Acrodermatitis - blood; Acrodermatitis - cerebrospinal fluid; Acrodermatitis - immunology; Acrodermatitis/blood/cerebrospinal fluid/immunology; Adult; Aged; Aged, 80 and over; Antibodies, Bacterial - blood; Bacterial diseases; Bacterial Outer Membrane Proteins - immunology; Bacteriology; Biological and medical sciences; Borrelia burgdorferi - immunology; Borrelia infections; Erythema Chronicum Migrans - blood; Erythema Chronicum Migrans - cerebrospinal fluid; Erythema Chronicum Migrans - immunology; Erythema Chronicum Migrans/blood/cerebrospinal fluid/immunology; Female; Fundamental and applied biological sciences. Psychology; Human bacterial diseases; Humans; Immunoenzyme Techniques - methods; Infectious diseases; Interferon Type II/blood/cerebrospinal fluid/immunology/secretion; Interferon-gamma - blood; Interferon-gamma - cerebrospinal fluid; Interferon-gamma - immunology; Interferon-gamma - secretion; Interleukin-4 - blood; Interleukin-4 - cerebrospinal fluid; Interleukin-4 - immunology; Interleukin-4 - secretion; Interleukin-4/blood/cerebrospinal fluid/immunology/secretion; Lyme Neuroborreliosis - blood; Lyme Neuroborreliosis - cerebrospinal fluid; Lyme Neuroborreliosis - immunology; Lyme Neuroborreliosis/blood/cerebrospinal fluid/immunology; Male; Medical sciences; MEDICIN; MEDICINE; Microbiology; Middle Aged; Miscellaneous; Statistics, Nonparametric; Tropical bacterial diseases; Up-Regulation - immunology; Human; Lyme disease; Prognosis; Spirochaetaceae; Spirochaetales; Microbiology; Secretion; Borrelia infection; Cytokine; Cerebrospinal fluid; Blood; Infection; Interleukin 4; Borrelia; Spirochaetosis; Bacteriosis; Bacteria; Gamma interferon; 80 and over; Antibodies; Nonparametric; Aged; Statistics; Bacterial/blood
• ISSN: 0022-1899; 1537-6613; 1537-6613
• DOI: 10.1086/382893

The Borrelia-specific interferon (IFN)-γ and interleukin (IL)-4 responses of 113 patients and control subjects were analyzed using the sensitive enzyme-linked immunospot method. Cerebrospinal fluid (CSF) and blood samples were obtained, during the course of disease, from patients with chronic or nonchronic neuroborreliosis (NB) and from control subjects without NB. Blood samples were obtained from patients with Lyme skin manifestations and from healthy blood donors. Early increased secretion of Borrelia-specific IFN-γ (P < .05) and subsequent up-regulation of IL-4 ( P < .05) were detected in the CSF cells of patients with nonchronic NB. In contrast, persistent Borrelia-specific IFN-γ responses were observed in the CSF cells of patients with chronic NB ( P < .05). In patients with erythema migrans, increased IFN-γ (P < .001 ) was observed in blood samples obtained early during the course of disease, whereas increased IL-4 ( P < .05) was observed after clearance. On the contrary, patients with acrodermatitis chronica atrophicans had Borrelia-specific IFN-γ (P < .001 ), but not IL-4, detected in blood samples. The present data suggest that an initial IFN-γ response, followed by up-regulation of IL-4, is associated with nonchronic manifestations, whereas a persistent IFN-γ response may lead to chronic Lyme borreliosis.