INCREASED CEREBROSPINAL-FLUID LEVELS OF GLIAL FIBRILLARY ACIDIC PROTEIN (GFAP) IN LYME NEUROBORRELIOSIS

Glial fibrillary acidic protein (GFAp), the main protein constituent o f the intermediate filaments of astrocytes, was analysed in the cerebr ospinal fluid (CSF) of 20 patients with Lyme neuroborreliosis as a mar ker of the astroglial reaction. The mean GFAp level before antibiotic treatment in the study group was significantly elevated (592 pg/ml +/- 596 [SD]) compared to that in 24 healthy controls (121 +/-87 [SD]) (p< 0.01). The highest CSF-GFAp levels were seen in the patients with the most severe disease, but the levels were also increased in patients wi th peripheral paresis, such as facial palsy with no or only minor ence phalitic symptoms. This implies that the infection was not limited to radix dorsalis or the meningeal tissues, but affected the central nerv ous;system as well. Furthermore, the astroglial reaction seemed to occ ur early in Lyme neuroborreliosis since CSF-GFAp levels were elevated also in patients with recent (<3 weeks) onset of disease. After antibi otic treatment, the GFAp levels decreased. It is suggested that CSF-GF Ap concentrations might be useful for monitoring CNS involvement in Ly me neuroborreliosis.