Soluble CD14 levels in the serum, synovial fluid, and cerebrospinal fluid of patients with various stages of Lyme disease

Levels of circulating soluble CD14 (sCD14) in patients with various stages of Lyme disease (LD) were examined. Patients with early or untreated late L D had significantly higher levels of sCD14 than did healthy controls (P = . 0001 and .0007, respectively); levels returned to normal within 3 months af ter antibiotic therapy, Patients with persistent posttreatment symptoms of LD had sCD14 levels equivalent to those of healthy controls. Differences in the serum sCD14 levels in patients with various stages of LD are likely to be directly correlated with differences in bacterial burden, suggesting th at posttreatment symptoms may not require continued presence of the organis m, sCD14 levels in the cerebrospinal fluid (CSF) of patients with any stage of LD were no different from those of control subjects. Levels of synovial fluid sCD14 from patients with Borrelia burgdorferi in their joints were e levated, compared with levels in normal serum, and may play a role in the p athogenesis of arthritis.