Central and peripheral nervous system infection, immunity, and inflammation in the NHP model of Lyme borreliosis

The relationship between chronic infection, antispirochetal immunity, and i nflammation is unknown in Lyme neuroborreliosis. In the nonhuman primate mo del of Lyme neuroborreliosis, we measured spirochetal density in the nervou s system and other tissues by polymerase chain reaction and correlated thes e values to anti-Borrelia burgdorferi antibody in the serum and cerebrospin al fluid, and to inflammation in tissues. Despite substantial presence of B orrelia burgdorferi, the causative agent of Lyme borreliosis, in the centra l nervous system, only minor inflammation was present there, though skeleta l and cardiac muscle, which contained similar levels of spirochete, were hi ghly inflamed. Anti-Borrelia burgdorferi antibody was present in the cerebr ospinal fluid but was not selectively concentrated. All infected animals de veloped anti-Borrelia burgdorferi antibody in the serum, but increased ampl itude of antibody was not predictive of higher levels of infection. These d ata demonstrate that Lyme neuroborreliosis is a persistent infection, that spirochetal presence is a necessary but not sufficient condition for inflam mation, and that antibody measured in serum may not predict the severity of infection.