Studies on the humoral immune response in nervous system infections with special reference of facial palsy and lyme borreliosis

• This thesis is mainly based on studies of the humoral immune response in subjects with neurological infections with special reference to facial palsy and Lyme borreliosis. Cerebrospinal fluid and/or serum samples from a total of 281 patients were investigated. Two hundred twenty-three of the subjects had a diagnosis of idiopathic peripheral facial palsy at the start of the investigations. Sixteen subjects (11 %) from the prospective studies and 15 (20%) from a retrospective study were found to exhibit elevated antibodies against Borrelia burgdorferi. These Borrelia burgdoiferi antibody positive patients were found to have a less favourable outcome of the palsy compared to other diagnostic groups.Seven patients out of 147 (5%) in the prospective studies and three out of twelve (25%) in the retrospective study of facial palsy showed intrathecal Borrelia burgdorferi IgG antibody synthesis compatible with a past or present Lyme neuroborreliosis.Three of the papers describe the immunoglobulin A (IgA) response in subjects with peripheral facial palsy, Lyme borreliosis, herpes simplex virus encephalitis, herpes zoster and mumps meningitis. The intrathecal IgA immune response was present in the viral infections but was less pronounced in Lyme borreliosis determined by an indirect ELISA method. By applying Western blot analysis, the IgA antibody response was detected against Borrelia burgdoiferi and was found to differ from the corresponding IgG antibody response. The specific IgG and IgA avidity was investigated in subjects with herpes simplex virus encephalitis, herpes zoster and Lyme borreliosis. Specific IgG antibodies were of lower avidity in serum than in CSF from all subjects with herpes simplex encephalitis; this is in contrast to the finding in herpes zoster patients. The serum-cerebrospinal fluid differences in IgG avidity decreased in the convalescence. A similar, but not significant, trend was seen for IgA antibodies. In comparison, IgG antibodies from subjects with Lyme neuroborreliosis were of low avidity.

Nyckelord

MEDICINE

MEDICIN

Publikations- och innehållstyp

vet (ämneskategori)

dok (ämneskategori)