Summary
Follow-up studies on 56 patients who suffered from antibiotically untreated, acute, monophasic neuroborreliosis five to 23 years ago revealed significant positive levels of IgG antibodies toBorrelia burgdorferi (Bb) in the serum and cerebrospinal fluid (CSF) of 20 patients (IFT, ELISA, Bb-specific IgG Western blot, Bb-specific IEF-IgG immunoblot). Nine of 10 tested patients had a definitely positive T-cell proliferative response to wholeB. burgdorferi, with a mean (±-SEM) stimulation index of 7.2±1.8. Because the patients studied exhibited no, or only mild to medium sequelae without any evidence of a chronic-progressive disease, we interpret the long-term persistence of specific T- and B-lymphocyte responses toB. burgdorferi as an “immunological scar syndrome”. Finally, diagnostic criteria of active neuroborreliosis are proposed.
Zusammenfassung
Verlaufsuntersuchungen von 56 Patienten, die vor fünf bis 23 Jahren an einer antibiotisch nicht behandelten, akuten monophasischen Neuroborreliose erkrankt waren, zeigten signifikant positive IgG-Antikörpertiter fürBorrelia burgdorferi im Serum und Liquor von 20 Patienten (IFT, ELISA,B. burgdorferi-spezifischer IgG-Westernblot,B. burgdorferi-spezifischer IEF-IgG-Immunoblot). Neun von zehn getesteten Patienten wiesen eine signifikant positive T-Zellproliferationsantwort gegenüber dem gesamtenB. burgdorferi-Antigen mit einem mittleren (±SEM) Stimulationsindex von 7.2±1.8 auf. Da die untersuchten Patienten keine oder nur leichte bis mittelgradige Residualsymptome ohne irgendeinen Hinweis auf eine chronisch-progressive Krankheit hatten, interpretierten wir die Langzeit-Persistenz der spezifischen T- und B-Lymphozytenantworten fürB. burgdorferi als ein “immunologisches Narbensyndrom”. Abschließend werden diagnostische Kriterien der aktiven Neuroborreliose vorgeschlagen.
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Krüger, H., Martin, R., Sticht-Groh, V. et al. Long-term persistence of specific T- and B-lymphocyte responses to Borrelia burgdorferi following untreated neuroborreliosis. Infection 18, 263–267 (1990). https://doi.org/10.1007/BF01646998
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DOI: https://doi.org/10.1007/BF01646998