MATRIX METALLOPROTEINASES IN THE CEREBROSPINAL-FLUID OF PATIENTS WITHLYME NEUROBORRELIOSIS

Neurologic manifestations of Lyme disease include meningitis, encephal opathy, and cranial and peripheral neuropathy. There are no sensitive markers for neuroborreliosis, and diagnosis is often based on clinical presentation and cerebrospinal fluid (CSF) abnormalities, including i ntrathecal antibody production. Matrix metalloproteinase (MMP) activit y in CSF was compared in patients with neuroborreliosis, patients with diverse neurologic disorders, and healthy controls. The CSF of 17 of 18 healthy subjects and 33 of 37 patients with neurologic symptoms and normal CSF and imaging studies contained only MMP2. The CSF of severa l patients with neurologic disorders contained MMP2, MMP9, and gelatin olytic activity at 130 and 250 kDa The 130-kDa MMP was found without t he 92-kDa MMP9 in the CSF of 11 (79%) of 14 patients with neuroborreli osis and only 7 (6%) of 118 control patients (P < .001). This pattern of CSF gelatinase activity may be a useful marker for neuroborreliosis .