LYME NEUROBORRELIOSIS - EVIDENCE FOR PERSISTENT UP-REGULATION OF BORRELIA BURGDORFERI-REACTIVE CELLS SECRETING INTERFERON-GAMMA

The T-cell response to the aetiologic pathogen Borrelia (B.) burgdorfe ri in patients with Lyme neuroborreliosis (LN) and in control patients with other neurological diseases was examined by enumerating B. burgd orferi-reactive T cells secreting interferon-gamma (IFN-gamma) with an ELIspot assay. LN patients had elevated numbers of B. burgdorferi-rea ctive IFN-gamma secreting cells in blood and approximately 20-fold enr iched in the cerebrospinal fluid (CSF). A positive correlation existed in CSF between B. burgdorferi-reactive IFN-gamma secreting cells and B cells secreting anti-B. burgdorferi IgG antibodies. The up-regulatio n of antigen-specific IFN-gamma secreting cells persisted in periphera l blood up to at least 9 months and in the CSF for at least 4 months a fter termination of treatment with antibiotics, when the patients were mostly free from clinical signs and symptoms due to LN. How IFN-gamma interplays with other cytokines and influences the pathogenesis of LN remains to be studied.