NEOPTERIN PRODUCTION AND TRYPTOPHAN DEGRADATION IN ACUTE LYME NEUROBORRELIOSIS VERSUS LATE LYME ENCEPHALOPATHY

Fourteen patients with Borrelia burgdorferi infection were investigate d for possible abnormalities of tryptophan and neopterin metabolism. F our patients (2 were investigated before therapy, 2 when therapy had b een already started) had acute Lyme neuroborreliosis, and 10 patients were investigated months to years after an acute infection. Increased concentrations of neopterin and of the tryptophan-degradation product, L-kynurenine, were detected in the cerebrospinal fluid of patients wi th acute Lyme neuroborreliosis; one patient presented with subnormal t ryptophan. Similar but less marked changes were seen in the treated pa tients and in some of the patients with Lyme encephalopathy. No such a bnormalities were seen in the serum of the patients. The data indicate a role of the immune system and particulary of endogenously formed cy tokines, like interferon-gamma and tumour necrosis factor-alpha, effec ting tryptophan and neopterin metabolism in patients with acute Lyme n euroborreliosis.