INTERFERON-TASON NOUSU KROONISESSA BORRELIOOSISSA

[Bb]

Lähettäjä: Soijuv Lähetetty: 28.4.2004 8:39

Kroonista neuroborrelioosia sairastavilta löydettiin selkäydinnesteestä Borrelia spesifiä Interferon gamma -tason nousua. Se saattaa tutkimuksen mukaan johtaa krooniseen borrelioosiin. Eli jälleen kerran tutkimus joka vahvistaa immuunijärjestelmän osuutta kroonisessa borrelioosissa.


The Journal of Infectious Diseases 2004;189:000

Prepublished

Borrelia-Specific Interferon-gamma and Interleukin-4 Secretion in Cerebrospinal Fluid and Blood during Lyme Borreliosis in Humans: Association with Clinical Outcome

Mona Widhe,1,2,4 Sara Jarefors,1,2,4 Christina Ekerfelt,1,4 Magnus Vrethem,3 Sven Bergström,5 Pia Forsberg,2,4 and Jan Ernerudh1,4

Divisions of 1Clinical Immunology and 2Infectious Diseases, Department of Molecular and Clinical Medicine, and 3Division of Neurology and Neurophysiology, Department of Neuroscience and Locomotion, and 4Clinical Research Centre, Faculty of Health Sciences, Linköping University, Linköping, and 5Department of Molecular Biology, University of Umeå, Umeå, Sweden

Received 19 May 2003; accepted 19 October 2003; electronically published 26 April 2004.

The Borrelia-specific interferon (IFN) and interleukin (IL)4 responses of 113 patients and control subjects were analyzed using the sensitive enzyme-linked immunospot method. Cerebrospinal fluid (CSF) and blood samples were obtained, during the course of disease, from patients with chronic or nonchronic neuroborreliosis (NB) and from control subjects without NB. Blood samples were obtained from patients with Lyme skin manifestations and from healthy blood donors. Early increased secretion of Borrelia-specific IFN-gamma (P < .05) and subsequent up-regulation of IL-4 (P < .05) were detected in the CSF cells of patients with nonchronic NB. In contrast, persistent Borrelia-specific IFN-gamma responses were observed in the CSF cells of patients with chronic NB (P < .05). In patients with erythema migrans, increased IFN-gamma (P < .001) was observed in blood samples obtained early during the course of disease, whereas increased IL-4 (P < .05) was observed after clearance.

On the contrary, patients with acrodermatitis chronica atrophicans had Borrelia-specific IFN-gamma (P < .001), but not IL-4, detected in blood samples. The present data suggest that an initial IFN-gamma response, followed by up-regulation of IL-4, is associated with nonchronic manifestations, whereas a persistent IFN-gamma response may lead to chronic Lyme borreliosis.