The immune response at onset and during recovery from Borrelia burgdorferi meningoradiculitis.
BACKGROUND
Borrelia burgdorferi causes a wide range of neurologic syndromes. In Europe, acute meningoradiculitis is the most common manifestation.


OBJECTIVE
To address the nature of the immune response during the course of B burgdorferi meningoradiculitis, with special respect to the early and late changes in cerebrospinal fluid (CSF).


METHODS
Serial immunophenotyping was performed and cytokine measurements were obtained in the peripheral blood and CSF of 12 European patients with definite B burgdorferi meningoradiculitis.


RESULTS
Early during infection and before initiation of treatment, we observed high levels of interleukin (IL) 10, IL-6, and IL-8, and large numbers of B cells and plasma cells in the CSF of most patients. At the same time, we found a mainly unspecific intrathecal antibody synthesis. During resolution of the infection, cytokine levels normalized rapidly and plasma cells disappeared from the CSF. In parallel, the percentage of B cells in the CSF increased over several months, accompanied by rising levels of intrathecally produced B burgdorferi-specific antibodies.


CONCLUSIONS
Our findings demonstrate that the early phase of B burgdorferi meningoradiculitis is characterized by a well-coordinated immune response involving specific cytokine release and plasma cell recruitment, followed by a long-lasting, antigen-specific B-cell response in the central nervous system.
Cepok
Sabine
S
Clinical Neuroimmunology Group, Department of Neurology, Philipps University, Marburg, Germany.
Zhou
Dun
D
Vogel
Friederike
F
Rosche
Berit
B
Grummel
Verena
V
Sommer
Norbert
N
Hemmer
Bernhard
B
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001402:B-Lymphocytes / Q000276:immunology / Q000502:physiology; D015153:Blotting, Western; D025065:Borrelia burgdorferi / Q000276:immunology*; D016207:Cytokines / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology; D007378:Interleukins / Q000097:blood; D008193:Lyme Disease / Q000134:cerebrospinal fluid / Q000276:immunology*; D018655:Lymphocyte Count; D008297:Male; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid / Q000276:immunology*; D008875:Middle Aged; D010641:Phenotype; D010950:Plasma Cells / Q000502:physiology; D011843:Radiculopathy / Q000134:cerebrospinal fluid / Q000276:immunology*
D016207:Cytokines; D007378:Interleukins