Modulation of cytokine release in ex vivo-stimulated blood from borreliosis patients

In lipopolysaccharide-stimulated blood from 71 late-stage borreliosis patie nts, the ex vivo cytokine release capacity of tumor necrosis factor alpha ( TNF-alpha) and gamma interferon (IFN-gamma) was reduced to 28% +/- 5% and t o 31% +/- 5% (P less than or equal to 0.001), respectively, compared to tha t of 24 healthy controls. White blood cell counts were normal in both group s. To investigate direct interactions between the pathogen and the immune c ells, blood from healthy controls was exposed in vitro to live or heat-kill ed Borrelia or to Borrelia lysate. Compared to the pattern induced by bacte rial endotoxins, a reduced release of TNF-alpha and IFN-gamma and an enhanc ed secretion of interleukin-10 and granulocyte colony-stimulating factor wa s found. In blood from 10 borreliosis patients stimulated with Borrelia lys ate, TNF-alpha formation was decreased to 31% +/- 14% and IFN-gamma formati on was decreased to 8% +/- 3% (P less than or equal to 0.001) compared to t he cytokine response of blood from healthy controls (n = 24), We propose to consider anti-inflammatory changes in the blood cytokine response capacity elicited by Borrelia as a condition that might favor the persistence of th e spirochete.