Weller M, Stevens A, Sommer N, Wiethölter H, Dichgans J
Department of Neurology, University of Tübingen, Federal Republic of Germany.
Arch Neurol. 1991 Aug;48(8):837-41. doi: 10.1001/archneur.1991.00530200079022.
Intrathecal synthesis of IgM and IgG, oligoclonal immunoglobulin bands, and the levels of fibronectin, soluble interleukin 2 receptor, interleukin 6, and tumor necrosis factor alpha were investigated with the use of enzyme-linked immunosorbent assay in 46 paired cerebrospinal fluid and serum samples from 32 patients with meningopolyradiculoneuritis due to Borrelia burgdorferi (Lyme borreliosis stage 2). Cerebrospinal fluid and serum interleukin 6, although not specific for neuroborreliosis, were good indicators of disease activity, while the serum soluble interleukin 2 receptor level was only mildly elevated. Tumor necrosis factor alpha was never detected in cerebrospinal fluid or serum specimens, and cerebrospinal fluid IgM, IgM index, and cerebrospinal fluid IgM/cerebrospinal fluid IgG ratios were significantly higher than in all other neuroimmunologic disorders evaluated and may be valuable diagnostic indicators for neuroborreliosis. The estimation of intrathecally synthesized IgG and IgM fractions for the differential diagnosis of neuroimmunologic disorders did not add to IgG and IgM index calculations.
采用酶联免疫吸附测定法，对32例因伯氏疏螺旋体引起的脑膜多神经根神经炎（莱姆病疏螺旋体病2期）患者的46对脑脊液和血清样本进行检测，以研究鞘内IgM和IgG的合成、寡克隆免疫球蛋白带以及纤连蛋白、可溶性白细胞介素2受体、白细胞介素6和肿瘤坏死因子α的水平。脑脊液和血清白细胞介素6虽对神经型莱姆病无特异性，但却是疾病活动的良好指标，而血清可溶性白细胞介素2受体水平仅轻度升高。在脑脊液或血清标本中从未检测到肿瘤坏死因子α，脑脊液IgM、IgM指数以及脑脊液IgM/脑脊液IgG比值显著高于所有其他评估的神经免疫性疾病，可能是神经型莱姆病的重要诊断指标。用于神经免疫性疾病鉴别诊断的鞘内合成IgG和IgM组分的评估，并未增加IgG和IgM指数的计算价值。
