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Propensity to excessive proinflammatory response in chronic Lyme borreliosis.

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The clinical course of
Lyme borreliosis is extremely variable. However, all the clinical manifestations, acute or chronic, are characterized by strong inflammation. Borrelia burgdorferi can induce the production of several proinflammatory and anti-inflammatory cytokines. The aim of our study was to find out whether the balance between inflammatory and regulatory mechanisms is important in determining the course of
Lyme borreliosis. 13 patients with early
Lyme borreliosis, 8 patients with chronic
Lyme disease with neurological or joint manifestations, and 15 age- and sex-matched healthy controls were studied. Chronic forms of
Lyme borreliosis were characterized by stronger TNF-alpha response by monocytes to lipopolysaccharide as well as to borrelia antigen compared to early
Lyme borreliosis and the healthy state. The percentage of IL-10-secreting monocytes in response to borrelia lysate was lower in the
Lyme borreliosis patients than in healthy controls. The percentage of CD4(+) CTLA-4(+) regulatory T cells showed the highest values in early
Lyme borreliosis. We conclude that chronic forms of
Lyme borreliosis can evolve due to an aberrant innate proinflammatory response.

APMIS. 2007 Feb;115(2):134-41. Research Support, Non-U.S. Gov’t

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