MONONEUROPATHY MULTIPLEX IN RHESUS-MONKEYS WITH CHRONIC LYME-DISEASE

Peripheral neuropathy is a recognized but poorly understood manifestat ion of Lyme disease. We performed serial electrophysiological studies on 8 rhesus monkeys chronically infected with the JD1 strain of Borrel ia burgdorferi and compared the results with those of similar studies on 10 uninfected control monkeys. Four infected and 2 uninfected anima ls underwent sural nerve biopsy. Five of the infected and 1 of the uni nfected animals also had postmortem neuropathological examinations. Al together, 5 of the infected monkeys demonstrated primarily axonal-loss -variety multifocal neuropathies. Only one nerve lesion exhibited find ings compatible with demyelination. Pathologically, peripheral nerve s pecimens showed multifocal axonal degeneration and regeneration and oc casional perivascular inflammatory cellular infiltrates without vessel wall necrosis. Free spirochetal structures were not seen, but several macrophages exhibited positive immunostaining with a highly specific anti-B. burgdorferi, 7.5-kd lipoprotein monoclonal antibody. In the in fected animals, serial analysis of serum antibodies to B. burgdorferi showed increasing numbers of IgG specificities and new IgM specificiti es, suggesting persistent infection. Thus, peripheral neuropathy in th e form of a mononeuropathy multiplex develops frequently in rhesus mon keys chronically infected with B. burgdorferi. The pathogenesis of the se nerve lesions is not yet known, but our studies suggest an immune-m ediated process perhaps driven by persistent infection with B. burgdor feri.