Summary:
In 88 patients with the diagnosis of Lyme neuroborreliosis the intrathecal synthesis of antiborrelial
IgG antibodies was assessed by two independent methods: a) assessment of antigen non-specific and
specific oligoclonal immunoglobulins G by the qualitative method of isoelectric focusing with sub-
sequent immunoblotting, b) by a quantitative method using calculation of the specific antibody index
from the titres assessed in serum and cerebrospinal fluid by the ELISA method. The diagno sis was
assessed on the basis of manifestations of the nervous affection and evidence of specific antiborrelial
antibodies in the cerebrospinal fluid by the ELISA test. In 74 patients antibodies class IgG were found,
in 14 patients antibodies class IgM. Non-specific oligoclonal immunoglobulins G were detected in 33
patients of 74, incl. 31 patients where it proved possible to detect also antigenic specificity. Of 72 patients
with concurrently detected antiborrelial IgG antibodies in blood and cerebrospinal fluid in 39 intrat-
hecal synthesis of specific antibodies calculated by means of the antibody index were found. The results
indicate a greater sensitivity of the assessment of the antibody index (54.1 %) for e vidence of intrathecal
secretion as compared with assessment of specific oligoclonal immunoglobulins G (38.8 %). In 16
patients serologically infection with the virus of Central European tick-borne encephalitis was proved,
however 12 of them had an increased permeability of the blood-brain barrier. Only in four patients
a positive antiborrelial antibody index was found which suggested dual viral and borrelial infection.
Key words:
intrathecal synthesis of IgG antibodies, neuroborreliosis, non-specific oligoclonal IgG
|