The Immune Response at Onset and During Recovery From Borrelia burgdorferi Meningoradiculitis

Cepok, Sabine; Zhou, Dun; Vogel, Frederick; Rosche, Berit; Grummel, Verena; Sommer, Norbert; Hemmer, Bernhard

doi:10.1001/archneur.60.6.849

Cited by 71 publications

(66 citation statements)

References 29 publications

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“…The reason may be that neuroinvasive Borrelia spirochetes contain a lipoprotein moiety that is critical for the induction of CXCL 13 secretion by monocytes [9,12], but the immune response in LNB has to be further studied to clarify this.…”

Section: Discussionmentioning

confidence: 99%

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CSF B – lymphocyte chemoattractant (CXCL13) in the early diagnosis of acute Lyme neuroborreliosis

Ljøstad

Mygland

2008

J Neurol

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Recent studies have suggested a diagnostic role of the B-lymphocyte attracting chemokine (CXCL13) in the cerebrospinal fluid (CSF) in Lyme neuroborreliosis (LNB). Our aim was to evaluate diagnostic accuracy of CSF CXCL13 in a cohort of 59 consecutive patients referred to hospital for suspected LNB. Thirty-seven patients were classified as definite LNB and used as the reference standard. Seven were classified as probable, and seven as possible LNB. Eight patients did not fulfil case definitions and were used as controls. At presentation, CSF CXCL13 was elevated in all patients with definite LNB, as compared to a positive CSF B. burgdorferi (Bb) antibody index (AI) in 33 of 37. Pre-treatment sensitivity of elevated CSF [corrected] Bb Al [corrected] was 100 % (95 % CI = 91-100) and 89 % [corrected] (95 % CI = 75-96) respectively (p = 0.053). Among the eight control patients, CSF CXCL13 was normal in five and only slightly elevated in three, and Bb AI was negative in five. Specificity of CSF CXCL13 and Bb AI was similar 63 % (95 % CI = 31-86) (p = 1.0).CSF CXCL13 was elevated in 6/7 patients with probable LNB and 3/7 patients with possible LNB. Bb AI was negative in all these 14 patients. An additional control group consisted of 31 patients with multiple sclerosis (MS), 11 with non-inflammatory neurological diseases, and ten with verified non-Lyme meningitis and high CSF cell count. CSF CXCL13 was slightly elevated in 15 MS patients, and in nine meningitis patients. Mean CSF CXCL13 was higher in definite LNB (3524 ng/g CSF protein) than in MS (27 ng/g) and non-Lyme meningitis (23 ng/g) (p < 0.001). Four months post-treatment CSF CXCL13 was normalized in 82 % of patients with definite LNB, as compared to a negative Bb AI in 10 % (p < 0.001).CSF CXCL13 may be a useful supplement in early diagnosis of acute LNB.

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Section: Discussionmentioning

confidence: 99%

“…The early immune response in the CSF of LNB patients is characterized by cytokines that promote a humoral immune response, and a high percentage of plasma cells and B cells [9]. The chemokine B-lymphocyte chemoattractant (CXCL13) serves as a selective attractant of B lymphocytes.…”

Section: Introductionmentioning

confidence: 99%

CSF B – lymphocyte chemoattractant (CXCL13) in the early diagnosis of acute Lyme neuroborreliosis

Ljøstad

Mygland

2008

J Neurol

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“…34 B cells, PBs, and PCs have also been observed in the CSF during acute infectious diseases of the nervous system. 35 In neuroborreliosis or viral meningitis, a strong B-cell response is mounted in the CNS. In these patients, PBs occur only in the acute phase of disease.…”

Section: Discussionmentioning

confidence: 99%

Viral load determines the B‐cell response in the cerebrospinal fluid during human immunodeficiency virus infection

Cepok

Geldern

Nolting

et al. 2007

Annals of Neurology

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“…High concentrations of interleukin 6 (IL-6), IL-8, IL-12, IL-18, gamma interferon (IFN-␥), and CXCL13 have been found in the CSF samples of patients suffering from Lyme neuroborreliosis (7)(8)(9)(10)(11). Interleukin 6 induces the final maturation of B cells into plasma cells, IL-8 is a chemotactic factor for immune cells, IL-12 induces the Th1 response, which results in a strong inflammatory reaction caused by IFN-␥ and tumor necrosis factor beta (TNF-␤), and IL-18 is an important regulator of the immune response, which in synergy with IL-12 increases the secretion of IFN-␥ (7,8). CXCL13 is produced by stromal cells and influences the migration of B cells (12).…”

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confidence: 99%

Diagnostic Value of Cytokines and Chemokines in Lyme Neuroborreliosis

Cerar

Ogrinc

Lotrič‐Furlan

et al. 2013

Clin. Vaccine Immunol.

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The aims of the present study were to assess the concentrations of different cytokines and chemokines in blood serum and cerebrospinal fluid (CSF) samples of patients with Lyme neuroborreliosis and to identify the possible marker(s) that would enable a distinction between clinically evident and suspected Lyme neuroborreliosis, as well as between Lyme neuroborreliosis and tickborne encephalitis (TBE). Our additional interest was to evaluate the relationship between cytokine and chemokine concentrations and Borrelia burgdorferi sensu lato isolation from CSF, as well as intrathecal synthesis of specific borrelial antibodies. We found that higher concentrations of CXCL13 and lower concentrations of interleukin 10 (IL-10) in serum were associated with higher odds for clinically evident Lyme neuroborreliosis compared to suspected Lyme neuroborreliosis, as well as to TBE. The concentrations of IL-2, IL-5, IL-6, IL-10, and CXCL13 in the CSF were higher in patients with evident Lyme neuroborreliosis than in those who were only suspected to have the disease. A comparison of CSF cytokine and chemokine levels in patients with and without intrathecal synthesis of specific borrelial antibodies revealed that CXCL13 CSF concentration is significantly associated with intrathecal synthesis of borrelial antibodies. A comparison of the cytokine and chemokine CSF concentrations in patients with clinically evident Lyme neuroborreliosis according to CSF culture results revealed that higher concentrations of gamma interferon (IFN-␥) were associated with lower odds of Borrelia isolation. Although several differences in the blood serum and CSF concentrations of various cytokines and chemokines between the groups were found, the distinctive power of the majority of these findings is low. Further research on well-defined groups of patients is needed to appraise the potential diagnostic usefulness of these concentrations.

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The Immune Response at Onset and During Recovery From Borrelia burgdorferi Meningoradiculitis

Cited by 71 publications

References 29 publications

CSF B – lymphocyte chemoattractant (CXCL13) in the early diagnosis of acute Lyme neuroborreliosis

CSF B – lymphocyte chemoattractant (CXCL13) in the early diagnosis of acute Lyme neuroborreliosis

Viral load determines the B‐cell response in the cerebrospinal fluid during human immunodeficiency virus infection

Diagnostic Value of Cytokines and Chemokines in Lyme Neuroborreliosis

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