Krause A, Brade V, Schoerner C, Solbach W, Kalden J R, Burmester G R
Department of Medicine III, University of Erlangen-Nüernberg, Germany.
Arthritis Rheum. 1991 Apr;34(4):393-402. doi: 10.1002/art.1780340404.
The cellular immune response to Borrelia burgdorferi was studied in 24 patients with seropositive and seronegative Lyme borreliosis, 30 patients with arthritides of different origin (non-Lyme arthritides), and 20 normal blood donors. By far, the strongest T cell stimulation was induced by incubation with autologous serum; there was a significantly lower response or no response after incubation with allogeneic or heterologous sera. In patients with Lyme borreliosis, including seronegative patients, there was a strikingly elevated proliferation in response to whole B burgdorferi bacteria (mean 64,750 dpm) compared with that of normal donors (mean 19,700 dpm; P less than 0.0001) and especially that of non-Lyme arthritis patients (mean 11,600 dpm; P less than 0.0001). Levels of proliferation declined significantly in patients with Lyme borreliosis after successful antibiotic treatment. Parallel cultures using B burgdorferi and Treponema phagedenis as antigens showed that cells from patients with Lyme borreliosis responded significantly more to B burgdorferi than to T phagedenis, but this did not occur with cells from individuals with non-Lyme arthritides. There was no correlation between disease stages and proliferation values. These data indicate that lymphocyte proliferation assays may provide an important tool for the diagnosis of Lyme borreliosis, most notably in patients with arthritides and in those who are seronegative. Conversely, the lack of reactivity appears to be a strong indicator of the absence of active Lyme disease. It seems to be crucial, however, to use autologous sera in these assays.
对24例血清学阳性和血清学阴性的莱姆病患者、30例不同病因的关节炎患者（非莱姆关节炎）以及20名正常献血者，研究了其对伯氏疏螺旋体的细胞免疫反应。迄今为止，与自体血清孵育诱导的T细胞刺激最强；与同种异体或异种血清孵育后，反应明显较低或无反应。在莱姆病患者中，包括血清学阴性患者，与正常献血者（平均19,700 dpm）尤其是非莱姆关节炎患者（平均11,600 dpm；P<0.0001）相比，对全伯氏疏螺旋体细菌的增殖反应显著升高（平均64,750 dpm）。成功进行抗生素治疗后，莱姆病患者的增殖水平显著下降。以伯氏疏螺旋体和噬齿密螺旋体作为抗原的平行培养显示，莱姆病患者的细胞对伯氏疏螺旋体的反应比对噬齿密螺旋体的反应明显更强，但非莱姆关节炎患者的细胞未出现这种情况。疾病阶段与增殖值之间无相关性。这些数据表明，淋巴细胞增殖试验可能为莱姆病的诊断提供重要工具，尤其是在关节炎患者和血清学阴性患者中。相反，缺乏反应性似乎强烈表明无活动性莱姆病。然而，在这些试验中使用自体血清似乎至关重要。
