title: Up-regulation of Borrelia-specific IL-4- and IFN-gamma-secreting cells in cerebrospinal fluid from children with Lyme neuroborreliosis.
abstract: The clinical course and outcome of several infectious diseases are dependent on the type of immune response elicited against the pathogen. In adults with neuroborreliosis (NB), a type 1 response with high production of Borrelia-specific IFN-gamma, but no IL-4, has been reported. Since children have a more benign course of NB than adults, we wanted to investigate type 1 and type 2 responses in children with NB. Cerebrospinal fluid (CSF) and blood were collected from children during the acute stage of 'confirmed NB' (n = 34), 'possible NB' (n = 30) and 'non-NB' (n = 10). The number of Borrelia-specific IL-4- and IFN-gamma-secreting cells was measured by enzyme-linked immunospot assay. Borrelia-specific secretion of both IL-4 and IFN-gamma was increased in CSF in confirmed (P < 0.05) and possible (P < 0.01) NB, when compared with non-NB controls. Furthermore, children with NB had significantly higher Borrelia-specific IL-4 secretion in CSF than an adult reference material with NB (P < 0.05). There were no differences in cytokine secretion in relation to onset or recovery of neurological symptoms. Since IL-4 is known to down-regulate the pro-inflammatory and possibly harmful effects of prolonged IFN-gamma responses, the prominent IL-4 response observed in the central nervous system compartment might contribute to the more benign disease course seen in children with Lyme NB.
authors.affiliation: Division of Clinical Immunology, University of Linköping, Sweden. mona.widhe@cmm.ki.se
authors.forename: Mona
authors.initials: M
authors.lastname: Widhe
authors.forename: Barbro Hedin
authors.initials: BH
authors.lastname: Skogman
authors.forename: Sara
authors.initials: S
authors.lastname: Jarefors
authors.forename: Mattias
authors.initials: M
authors.lastname: Eknefelt
authors.forename: Gunilla
authors.initials: G
authors.lastname: Eneström
authors.forename: Maria
authors.initials: M
authors.lastname: Nordwall
authors.forename: Christina
authors.initials: C
authors.lastname: Ekerfelt
authors.forename: Stefan
authors.initials: S
authors.lastname: Croner
authors.forename: Sven
authors.initials: S
authors.lastname: Bergström
authors.forename: Pia
authors.initials: P
authors.lastname: Forsberg
authors.forename: Jan
authors.initials: J
authors.lastname: Ernerudh
mesh_terms: D000293:Adolescent; D000328:Adult; D025065:Borrelia burgdorferi / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007371:Interferon-gamma / Q000378:metabolism*; D015847:Interleukin-4 / Q000378:metabolism*; D020852:Lyme Neuroborreliosis / Q000134:cerebrospinal fluid* / Q000276:immunology* / Q000473:pathology; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000276:immunology / Q000378:metabolism; D008297:Male; D011446:Prospective Studies; D015854:Up-Regulation / Q000276:immunology*
chemical_list: D015847:Interleukin-4; D007371:Interferon-gamma