Immunological Differentiation Between Neuroborreliosis and Multiple Sclerosis

Overview

Journal J Neurol

Specialty Neurology

Date 1990 Dec 1

PMID 2074447

Citations 4

Authors

J Heller

G Holzer

K Schimrigk

Affiliations

Soon will be listed here.

Abstract

Neuroborreliosis, a tick-borne spirochaetosis of the central nervous system, is diagnosed by the presence of intrathecally synthesized Borrelia burgdorferi-specific antibodies. Multiple sclerosis and neuroborreliosis can show similarities in clinical symptoms as well as lymphocytic cell reactions and oligoclonal bands in the isoelectric focusing of cerebrospinal fluid. To differentiate between multiple sclerosis and neuroborreliosis we tested intrathecally synthesized IgM and virus antibodies. The IgM indices were higher for most of the neuroborreliosis patients studied than for those with multiple sclerosis, and cell counts were also significantly higher in the acute stage of the disease. In 84% of multiple sclerosis patients we were able to demonstrate intrathecal antibody production against measles, rubella or mumps virus. Neuroborreliosis patients had no intrathecal virus antibody synthesis. The specification of oligoclonal bands resulting from isoelectric focusing of cerebrospinal fluid with an ELISA for B. burgdorferi can further substantiate the diagnosis of neuroborreliosis or help to rule it out in multiple sclerosis patients with positive borrelia-specific serology.

Citing Articles

The Probable Infectious Origin of Multiple Sclerosis.

Landry R, Embers M NeuroSci. 2024; 4(3):211-234.

PMID: 39483197 PMC: 11523707. DOI: 10.3390/neurosci4030019.

A case of chronic progressive lyme encephalitis as a manifestation of late lyme neuroborreliosis.

Verma V, Roman M, Shah D, Zaretskaya M, Yassin M Infect Dis Rep. 2015; 6(4):5496.

PMID: 25568755 PMC: 4274401. DOI: 10.4081/idr.2014.5496.

[Neuroborreliosis].

Kaiser R, Fingerle V Nervenarzt. 2009; 80(10):1239-51.

PMID: 19536517 DOI: 10.1007/s00115-009-2788-z.

Molecular approach to find target(s) for oligoclonal bands in multiple sclerosis.

Rand K, Houck H, Denslow N, Heilman K J Neurol Neurosurg Psychiatry. 1998; 65(1):48-55.

PMID: 9667560 PMC: 2170146. DOI: 10.1136/jnnp.65.1.48.

References

Schmutzhard E, Pohl P, Stanek G . Borrelia burgdorferi antibodies in patients with relapsing/remitting form and chronic progressive form of multiple sclerosis. J Neurol Neurosurg Psychiatry. 1988; 51(9):1215-8. PMC: 1033030. DOI: 10.1136/jnnp.51.9.1215. View

Brouwer J . Estimation of IgM in cerebrospinal fluid by enzyme immunoassay. Clin Chim Acta. 1983; 131(3):337-42. DOI: 10.1016/0009-8981(83)90104-3. View

Ukkonen P, Granstrom M, Rasanen J, Salonen E, Penttinen K . Local production of mumps IgG and IgM antibodies in the cerebrospinal fluid of meningitis patients. J Med Virol. 1981; 8(4):257-65. DOI: 10.1002/jmv.1890080406. View

Norrby E . Viral antibodies in multiple sclerosis. Prog Med Virol. 1978; 24:1-39. View

Coyle P . Borrelia burgdorferi antibodies in multiple sclerosis patients. Neurology. 1989; 39(6):760-1. DOI: 10.1212/wnl.39.6.760. View

FELGENHAUER K, Schadlich H, Nekic M, Ackermann R . Cerebrospinal fluid virus antibodies. A diagnostic indicator for multiple sclerosis?. J Neurol Sci. 1985; 71(2-3):291-9. DOI: 10.1016/0022-510x(85)90067-x. View

Kruger H, Reuss K, Pulz M, Rohrbach E, Pflughaupt K, Martin R . Meningoradiculitis and encephalomyelitis due to Borrelia burgdorferi: a follow-up study of 72 patients over 27 years. J Neurol. 1989; 236(6):322-8. DOI: 10.1007/BF00314373. View

Reiber H . The discrimination between different blood-CSF barrier dysfunctions and inflammatory reactions of the CNS by a recent evaluation graph for the protein profile of cerebrospinal fluid. J Neurol. 1980; 224(2):89-99. DOI: 10.1007/BF00313347. View

Schmutzhard E, Stanek G, Pohl P . Polyneuritis cranialis associated with Borrelia burgdorferi. J Neurol Neurosurg Psychiatry. 1985; 48(11):1182-4. PMC: 1028583. DOI: 10.1136/jnnp.48.11.1182. View

10.

Reiber H, FELGENHAUER K . Protein transfer at the blood cerebrospinal fluid barrier and the quantitation of the humoral immune response within the central nervous system. Clin Chim Acta. 1987; 163(3):319-28. DOI: 10.1016/0009-8981(87)90250-6. View

11.

FELGENHAUER K, Schadlich H . The compartmental IgM and IgA response within the central nervous system. J Neurol Sci. 1987; 77(2-3):125-35. DOI: 10.1016/0022-510x(87)90115-8. View

12.

Martin R, Martens U, Dorries R, Kruger H . Persistent intrathecal secretion of oligoclonal, Borrelia burgdorferi-specific IgG in chronic meningoradiculomyelitis. J Neurol. 1988; 235(4):229-33. PMC: 7088014. DOI: 10.1007/BF00314352. View

13.

Murray N, Kristoferitsch W, Stanek G, Steck A . Specificity of CSF antibodies against components of Borrelia burgdorferi in patients with meningopolyneuritis Garin-Bujadoux-Bannwarth. J Neurol. 1986; 233(4):224-7. DOI: 10.1007/BF00314024. View

14.

Ryberg B . A longitudinal study of antibrain antibodies in multiple sclerosis. J Neurol Sci. 1982; 54(2):263-70. DOI: 10.1016/0022-510x(82)90186-1. View

15.

Salmi A, Reunanen M, Ilonen J, Panelius M . Intrathecal antibody synthesis to virus antigens in multiple sclerosis. Clin Exp Immunol. 1983; 52(2):241-9. PMC: 1535858. View

16.

Schadlich H, Karenberg A, Nekic M, FELGENHAUER K . Acute encephalitis with intrathecal synthesis of measles antibodies. J Neurol. 1988; 235(4):248-51. DOI: 10.1007/BF00314358. View

17.

Halperin J, Luft B, Anand A, Roque C, Alvarez O, Volkman D . Lyme neuroborreliosis: central nervous system manifestations. Neurology. 1989; 39(6):753-9. DOI: 10.1212/wnl.39.6.753. View

18.

Wilske B, Preac-Mursic V, SCHIERZ G, Busch K . Immunochemical and immunological analysis of European Borrelia burgdorferi strains. Zentralbl Bakteriol Mikrobiol Hyg A. 1986; 263(1-2):92-102. DOI: 10.1016/s0176-6724(86)80108-0. View

19.

Wilske B, SCHIERZ G, Preac-Mursic V, von Busch K, Kuhbeck R, Pfister H . Intrathecal production of specific antibodies against Borrelia burgdorferi in patients with lymphocytic meningoradiculitis (Bannwarth's syndrome). J Infect Dis. 1986; 153(2):304-14. DOI: 10.1093/infdis/153.2.304. View

20.

Vandvik B, Norrby E, Nordal H, DeGre M . Oligoclonal measles virus-specific IgG antibodies isolated from cerebrospinal fluids, brain extracts, and sera from patients with subacute sclerosing panencephalitis and multiple sclerosis. Scand J Immunol. 1976; 5(8):979-92. DOI: 10.1111/j.1365-3083.1976.tb03050.x. View