Coyle P K, Schutzer S E, Belman A L, Krupp L B, Golightly M G
Department of Neurology, State University of New York, Stony Brook 11794.
Ann Neurol. 1990 Dec;28(6):739-44. doi: 10.1002/ana.410280603.
We analyzed cerebrospinal fluid (CSF) from 32 patients with neurological symptoms and evidence of Borrelia burgdorferi infection (29 were seropositive as determined by enzyme-linked immunosorbent assay, 2 were cell-mediated immune positive, and 1 had been seropositive as shown by enzyme-linked immunosorbent assay 9 months previously). CSF immune complexes were found in 22 (69%) of 32 patients; in 18, there was sufficient sample to isolate immune complexes. By enzyme-linked immunosorbent assay, isolated immune complexes from 10 of these 18 patients contained antibody specific for B. burgdorferi antigens. The isotypes were IgG (n = 8), IgM (n = 3), and IgA (n = 2). By immunoblot, these antibodies were directed against B. burgdorferi 41-kDa antigen and occasionally against the 33- and 17-kDa antigens. Anti-B. burgdorferi IgM was present in patients with acute neurological symptoms, was predominantly complexed rather than free, and decreased with clinical recovery in the one serial study. Three patients were nonreactive for free CSF antibodies, but had complexed antibodies to the organism. The preliminary finding of specific B. burgdorferi components in immune complexes in CSF suggests an active process triggered by the organism, even in the absence of other CSF abnormalities.
我们分析了32例有神经症状且有伯氏疏螺旋体感染证据患者的脑脊液（CSF）（29例经酶联免疫吸附测定为血清阳性，2例细胞介导免疫阳性，1例9个月前经酶联免疫吸附测定显示为血清阳性）。32例患者中有22例（69%）脑脊液中发现免疫复合物；其中18例有足够样本用于分离免疫复合物。通过酶联免疫吸附测定，这18例患者中有10例分离出的免疫复合物含有针对伯氏疏螺旋体抗原的特异性抗体。其同种型为IgG（n = 8）、IgM（n = 3）和IgA（n = 2）。通过免疫印迹法，这些抗体针对伯氏疏螺旋体41-kDa抗原，偶尔也针对33-kDa和17-kDa抗原。抗伯氏疏螺旋体IgM存在于有急性神经症状的患者中，主要以复合物形式而非游离形式存在，在一项系列研究中随临床恢复而降低。3例患者脑脊液游离抗体无反应，但有针对该病原体的复合抗体。脑脊液免疫复合物中存在伯氏疏螺旋体特异性成分这一初步发现表明，即使在没有其他脑脊液异常的情况下，该病原体也会引发一个活跃过程。
