Lyme neuroborreliosis: Cerebrospinal fluid contains myelin protein-reactive cells secreting interferon-gamma

The mechanisms causing neurological manifestations and influencing the outcome in patients infected with the spirochete Borrelia burgdorferi are unknown. To study the involvement of autoimmune mechanisms in patients with Lyme neuroborreliosis (LN), ELIspot assays were used to determine the numbers of T lymphocytes which, upon stimulation with the myelin components myelin basic protein (MBP) and proteolipid protein (PLP) and two MBP peptides, responded by the secretion of interferon-gamma (IFN-gamma). LN patients had compared to patients with other neurological,diseases and tension headache in CSF elevated numbers of MBP- and PLP-reactive T helper type 1 (Th1) like IFN-gamma secreting cells at mean frequencies of about 1 per 1300 and 1 per 1500 CSF cells, respectively, Numbers were elevated up to 5 months after successful treatment of LN, and they did not correlate with clinical findings, Autoreactive T cells were not elevated in the LN patients' blood, These findings match the previously reported elevation of anti-MBP Ige antibody secreting cells exclusively in CSF in LN, The IFN-gamma release by autoreactive cells and the secretion of autoantibodies in the CSF may have relevance for development and outcome of LN.