Biesiada Grazyna, Czepiel Jacek, Garlicki Aleksander, Mach Tomasz
Klinika Chorób Zakaźnych, Katedry Gastroenterologii, Hepatologii i Chorób Zakaźnych, Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie.
Przegl Lek. 2009;66(9):508-10.
Lyme disease is a multiorgan disease, caused by spirochetes of Borrelia species. Clinical picture is diverse, borreliosis can affect skin, nervous system, musculoskeletal system and heart. Neopterin is a marker of cytotoxic lymphocytes T activities, it is produced by monocytes/macrophages stimulated with IFNgamma.
The aim of our study was to evaluate the level of neopterin in serum and cerebrospinal fluid in borreliosis and correlate it with the symptoms, markers of inflammation in cerebrospinal fluid (CSF), and serological tests against Borrelia burgdorferi.
We have enrolled in the study 39 patients treated for Lyme borreliosis. The level of neopterin in serum was assessed in all patients, among patient with suspicion of neuroborreliosis (n = 33) we assessed the level of neopterin, protein, glucose and chlorium in CSF.
The level of neopterin in CSF was lower among patients who were treated due to presence of erithema migrans in their past regarding patients who had never had erithema migrans (p = 0.008). The level of neopterin in CSF was higher (6.6 nmol/l) in patients with the presence of inflammation in CSF versus patients with no changes in CSF (3.8 mmol/l; p = 0.019). There was no correlation between neopterin in serum or CSF and Westernblot test.
Patients with neuroborreliosis who had lymphocytic meningitis had higher level of neopterin in CSF. We suggest the role of neopterin in pathogenesis on neuroborreliosis. Neopterin as a marker of cytotoxic lymphocytes T activities can be useful in borreliosis diagnosis but more studies regarding this problem should be done.
莱姆病是一种多器官疾病，由疏螺旋体属的螺旋体引起。临床表现多样，疏螺旋体病可影响皮肤、神经系统、肌肉骨骼系统和心脏。新蝶呤是细胞毒性T淋巴细胞活性的标志物，由干扰素γ刺激的单核细胞/巨噬细胞产生。
我们研究的目的是评估疏螺旋体病患者血清和脑脊液中新蝶呤的水平，并将其与症状、脑脊液中的炎症标志物以及针对伯氏疏螺旋体的血清学检测结果相关联。
我们招募了39例接受莱姆疏螺旋体病治疗的患者。对所有患者评估血清中新蝶呤的水平，对疑似神经型疏螺旋体病的患者（n = 33）评估脑脊液中新蝶呤、蛋白质、葡萄糖和氯化物的水平。
过去有游走性红斑的患者脑脊液中新蝶呤水平低于从未有过游走性红斑的患者（p = 0.008）。脑脊液中有炎症的患者脑脊液中新蝶呤水平较高（6.6 nmol/l），而脑脊液无变化的患者为3.8 mmol/l（p = 0.019）。血清或脑脊液中的新蝶呤与免疫印迹试验之间无相关性。
患有淋巴细胞性脑膜炎的神经型疏螺旋体病患者脑脊液中新蝶呤水平较高。我们认为新蝶呤在神经型疏螺旋体病的发病机制中起作用。新蝶呤作为细胞毒性T淋巴细胞活性的标志物在疏螺旋体病诊断中可能有用，但关于这个问题还需要更多的研究。
