Steere A C, Berardi V P, Weeks K E, Logigian E L, Ackermann R
Division of Rheumatology/Immunology, New England Medical Center, Tufts University School of Medicine, Boston, MA 02111.
J Infect Dis. 1990 Jun;161(6):1203-9. doi: 10.1093/infdis/161.6.1203.
The intrathecal antibody response to Borrelia burgdorferi was evaluated in American and West German patients with Lyme neuroborreliosis. By an antibody capture enzyme immunoassay, 12 (92%) of 13 patients from the USA with Lyme meningitis were found to have intrathecal antibody production to B. burgdorferi, usually of multiple isotypes, most commonly IgA. Of 12 patients with putative late central nervous system manifestations of Lyme disease, 5 (42%) had local production of IgG or IgA spirochetal antibody, but cerebrospinal fluid (CSF) abnormalities could not be demonstrated in 6 patients with late peripheral nervous system manifestations of the disorder. Compared with American patients, 30 European patients with neuroborreliosis had significantly higher CSF:serum ratios of specific antibody both early and late in the illness. Intrathecal antibody determinations are the most specific diagnostic test currently available for Lyme neuroborreliosis, but local antibody production in CSF is an inconsistent finding in American patients with late neurologic manifestations of the disorder.
对美国和西德莱姆病神经螺旋体病患者的鞘内抗伯氏疏螺旋体抗体反应进行了评估。通过抗体捕获酶免疫测定法，发现13例美国莱姆脑膜炎患者中有12例（92%）产生了鞘内抗伯氏疏螺旋体抗体，通常为多种同种型，最常见的是IgA。在12例疑似莱姆病晚期中枢神经系统表现的患者中，5例（42%）产生了局部IgG或IgA螺旋体抗体，但6例莱姆病晚期周围神经系统表现的患者脑脊液（CSF）异常未得到证实。与美国患者相比，30例欧洲神经螺旋体病患者在疾病早期和晚期的CSF:血清特异性抗体比值均显著更高。鞘内抗体测定是目前可用于莱姆病神经螺旋体病的最特异的诊断测试，但在美国患有该疾病晚期神经系统表现的患者中，CSF中局部抗体产生的情况并不一致。
