RELATIONSHIP BETWEEN THE BORRELIA-BURGDORFERI SPECIFIC IMMUNE-RESPONSE AND DIFFERENT STAGES AND SYNDROMES IN NEUROBORRELIOSIS

One hundred untreated neuroborreliosis patients were investigated by I gG/IgM immunoblot to find out if different stages and syndromes are ch aracterized by different patterns of their Borrelia burgdorferi specif ic immune responses in CSF and serum, Stage III (n = 10) was character ized by a broad, highly specific intrathecal immune response (the mean number of IgM bands in CSF was 3.1 and of IgG bands 6.3), All patient s recognized one or more of the following proteins (p35, p21, p18) or the 5 lid glycolipid. In contrast, the immune response in stage II (n = 90) was less restricted (28%) and heterogeneous (mean number of IgM bands 1.4 and of IgG bands 3.4), It was mainly directed against the hi ghly crossreactive p41 antigen (91%), The different clinical features of stage II were comparable regarding the intrathecal immune response, However anti-glycolipid and anti-p35, -p21, -p18 IgG antibodies were detected in a small subset of patients, mainly corresponding to more s evere courses of the disease, Our data are compatible with a direct ag ent related pathomechanism in neuroborreliosis, Antibodies against cer tain proteins and the glycolipid of B, burgdorferi seem to have a prog nostic value as to the development of more severe disease or transitio n to stage III.