Involvement of cytolytic immune cells in human Lyme borreliosis - indication of intracellular persistance of the Borrelia spirochete?

Ekerfelt, Christina (1); Jarefors, Sara (1); Tynngård, Nahreen (2); Hedlund, Michael (1); Sander, Birgitta (3); Bergström, Sven (4); Forsberg, Pia (2); Ernerudh, Jan (1)

(1) Dept Clinical Immunology, Univ Linköping, Sweden; (2) Dept Infectious Diseases, Univ Linköping, Sweden:
(3) Dept Pathology, Karolinska Institute, Stockholm, Sweden
(4) Dept Microbiology, Univ Umeå, Sweden

The immuno-pathogenetic mechanisms underlying chronic Lyme neuroborreliosis are mainly unknown. Human Borrelia burgdorferi (Bb) infection is associated with Bb-specific secretion of interferon-g (IFN-g), which may be important for elimination of Bb, but this may also cause tissue injury. In order to increase the understanding of the pathogenic mechanisms in chronic neuroborreliosis we investigated which cell types that secrete IFN-g. Blood mononuclear cells from 13 patients with neuroborreliosis and/or acrodermatitis chronicum atrophicans were stimulated with Bb antigen and the phenotypes of the induced IFN-g- secreting cells were analyzed with three different approaches. Cells expressing CD8 or TCRgd, which both have cytolytic properties, were the main phenotypes of IFN-g-secreting cells, indicating that tissue injury in chronic neuroborreliosis may be mediated by cytotoxic cells. Furthermore, the finding of Borrelia-specific cytolytic cells may indicate an intracellular localization of Bb.

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