Cerebrospinal fluid interleukins, immunoglobulins, and fibronectin in neuroborreliosis
M. Weller, A. Stevens, N. Sommer, H. Wietholter and J. Dichgans
Department of Neurology, University of Tubingen, Federal Republic of Germany.
Intrathecal synthesis of IgM and IgG, oligoclonal immunoglobulin bands, and
the levels of fibronectin, soluble interleukin 2 receptor, interleukin 6,
and tumor necrosis factor alpha were investigated with the use of
enzyme-linked immunosorbent assay in 46 paired cerebrospinal fluid and
serum samples from 32 patients with meningopolyradiculoneuritis due to
Borrelia burgdorferi (Lyme borreliosis stage 2). Cerebrospinal fluid and
serum interleukin 6, although not specific for neuroborreliosis, were good
indicators of disease activity, while the serum soluble interleukin 2
receptor level was only mildly elevated. Tumor necrosis factor alpha was
never detected in cerebrospinal fluid or serum specimens, and cerebrospinal
fluid IgM, IgM index, and cerebrospinal fluid IgM/cerebrospinal fluid IgG
ratios were significantly higher than in all other neuroimmunologic
disorders evaluated and may be valuable diagnostic indicators for
neuroborreliosis. The estimation of intrathecally synthesized IgG and IgM
fractions for the differential diagnosis of neuroimmunologic disorders did
not add to IgG and IgM index calculations.
