Cepok Sabine, Zhou Dun, Vogel Friederike, Rosche Berit, Grummel Verena, Sommer Norbert, Hemmer Bernhard
Clinical Neuroimmunology Group, Department of Neurology, Philipps University, Marburg, Germany.
Arch Neurol. 2003 Jun;60(6):849-55. doi: 10.1001/archneur.60.6.849.
Borrelia burgdorferi causes a wide range of neurologic syndromes. In Europe, acute meningoradiculitis is the most common manifestation.
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).
Serial immunophenotyping was performed and cytokine measurements were obtained in the peripheral blood and CSF of 12 European patients with definite B burgdorferi meningoradiculitis.
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.
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.
伯氏疏螺旋体可引发多种神经系统综合征。在欧洲，急性脑脊神经根炎是最常见的表现形式。
探讨伯氏疏螺旋体脑脊神经根炎病程中免疫反应的本质，特别关注脑脊液（CSF）的早期和晚期变化。
对12例确诊为伯氏疏螺旋体脑脊神经根炎的欧洲患者的外周血和脑脊液进行连续免疫表型分析并检测细胞因子。
在感染早期及开始治疗前，我们观察到大多数患者脑脊液中白细胞介素（IL）-10、IL-6和IL-8水平升高，且存在大量B细胞和浆细胞。同时，我们发现主要是非特异性鞘内抗体合成。在感染消退过程中，细胞因子水平迅速恢复正常，浆细胞从脑脊液中消失。与此同时，脑脊液中B细胞百分比在数月内增加，同时鞘内产生的伯氏疏螺旋体特异性抗体水平上升。
我们的研究结果表明，伯氏疏螺旋体脑脊神经根炎的早期阶段以协调良好的免疫反应为特征，包括特定细胞因子的释放和浆细胞的募集，随后是中枢神经系统中持久的抗原特异性B细胞反应。
