Cytokines in Lyme borreliosis: lack of early tumour necrosis factor-α and transforming growth factor-β(1) responses are associated with chronic neuroborreliosis

The clinical outcome of the tick born infection Lyme borreliosis seems to be influenced by the type of immune response mounted during the disease, as suggested by various animal models. Here we report the serum and cerebrospinal fluid levels of tumour necrosis factor-α (TNF-α), transforming growth factor β(1) (TGF-β(1)) and interleukin-6 (IL-6) in samples drawn at different disease intervals during the course of non-chronic neuroborreliosis (n = 10), chronic neuroborreliosis (n = 15), erythema migrans (n = 8, serum only) and controls (n = 7). When comparing early neuroborreliosis cerebrospinal fluid samples, significantly higher levels of TNF-α were found in non-chronic patients than in chronic patients (P < 0·05). Moreover, TGF-β(1) was increased in the early serum samples of non-chronic patients, as compared to chronic patients (P < 0·01). Elevated serum levels of TGF-β(1) were also found in erythema migrans as compared to neuroborreliosis and controls (P < 0·05). The high TNF-α levels noted in early cerebrospinal fluid samples of non-chronic patients only, possibly reflects an ongoing pro-inflammatory immune response in the central nervous system, which could be beneficial in eliminating disease. High serum levels of TGF-β(1) probably mirror an anti-inflammatory response, which might play a role in controlling the systemic immune response