Lyme neuroborreliosis. Pathophysiological and diagnosis aspects
Lyme neuroborreliosis is the neurological complication of Borrelia burgdorferi infection. The main mechanism involved is acute inflammation (direct infectious or indirect autoimmune) leading to degeneration of the central and peripheral nervous system structures. Several cell populations are involve...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Amaltea Medical Publishing House
2009-03-01
|
| Series: | Romanian Journal of Neurology |
| Subjects: | |
| Online Access: | https://rjn.com.ro/articles/2009.1/RJN_2009_1_Art-03.pdf |
| _version_ | 1797985856416382976 |
|---|---|
| author | Andreea Barsan Brandusa Tilea Alexandru G. Schiopu Adina Stoian Alexandru A. Schiopu |
| author_facet | Andreea Barsan Brandusa Tilea Alexandru G. Schiopu Adina Stoian Alexandru A. Schiopu |
| author_sort | Andreea Barsan |
| collection | DOAJ |
| description | Lyme neuroborreliosis is the neurological complication of Borrelia burgdorferi infection. The main mechanism involved is acute inflammation (direct infectious or indirect autoimmune) leading to degeneration of the central and peripheral nervous system structures. Several cell populations are involved in mediating the inflammatory response: endothelial cells modify the function of the blood-brain barrier; the microglia and the astrocytes act as immune cells as they present antigens to T cells and secrete prostaglandins, and the dendritic cells which can determine disease relapse or transformation into a chronic condition. All these cells secrete cytokines (interleukins, interferons, TNF), prostaglandins and complement components.
The permeabilization of the blood-brain barrier through inflammation leads to cerebral edema, associated with characteristic CSF modifications which can be detected by specific laboratory tests. Serologic analysis and CSF analysis are the most useful tests for Lyme disease diagnosis. CSF analysis is mandatory in patients with neurological symptoms in the absence of skin manifestations and involves detection of intrathecal antibodies and pro-inflammatory cytokines by ELISA, FIA and Western Blotting. PCR for detecting Borrelia burgdorferi, DNA and Flow Cytometry are important in the later, chronic stages of the disease.
Lyme neuroborreliosis is a disease with complex manifestations which can induce difficulties in diagnosis, especially in the early stages. False positive diagnosis can occur in patients considered to be at high risk for this disease (endemic zones, certain professions). Therefore collaboration between neurologist, infectionist and laboratory doctor is essential for an early and correct diagnosis; it allows for effective treatment of the disease, with a favourable prognostic. |
| first_indexed | 2024-04-11T07:23:38Z |
| format | Article |
| id | doaj.art-ccd779b12f4b443989d17d9225dbc122 |
| institution | Directory Open Access Journal |
| issn | 1843-8148 2069-6094 |
| language | English |
| last_indexed | 2024-04-11T07:23:38Z |
| publishDate | 2009-03-01 |
| publisher | Amaltea Medical Publishing House |
| record_format | Article |
| series | Romanian Journal of Neurology |
| spelling | doaj.art-ccd779b12f4b443989d17d9225dbc1222022-12-22T04:37:07ZengAmaltea Medical Publishing HouseRomanian Journal of Neurology1843-81482069-60942009-03-0181182310.37897/RJN.2009.1.3Lyme neuroborreliosis. Pathophysiological and diagnosis aspectsAndreea Barsan0Brandusa Tilea1Alexandru G. Schiopu2Adina Stoian3Alexandru A. Schiopu4Neurology Clinic, Medicine and Farmacy University, Targu Mures, RomaniaClinical of Infectious Diseases, Medicine and Farmacy University, Targu Mures, RomaniaPhysiopathology Discipline, Medicine and Farmacy University, Targu Mures, RomaniaPhysiopathology Discipline, Medicine and Farmacy University, Targu Mures, RomaniaTransplant Research Group Departament, Oxford UniversityLyme neuroborreliosis is the neurological complication of Borrelia burgdorferi infection. The main mechanism involved is acute inflammation (direct infectious or indirect autoimmune) leading to degeneration of the central and peripheral nervous system structures. Several cell populations are involved in mediating the inflammatory response: endothelial cells modify the function of the blood-brain barrier; the microglia and the astrocytes act as immune cells as they present antigens to T cells and secrete prostaglandins, and the dendritic cells which can determine disease relapse or transformation into a chronic condition. All these cells secrete cytokines (interleukins, interferons, TNF), prostaglandins and complement components. The permeabilization of the blood-brain barrier through inflammation leads to cerebral edema, associated with characteristic CSF modifications which can be detected by specific laboratory tests. Serologic analysis and CSF analysis are the most useful tests for Lyme disease diagnosis. CSF analysis is mandatory in patients with neurological symptoms in the absence of skin manifestations and involves detection of intrathecal antibodies and pro-inflammatory cytokines by ELISA, FIA and Western Blotting. PCR for detecting Borrelia burgdorferi, DNA and Flow Cytometry are important in the later, chronic stages of the disease. Lyme neuroborreliosis is a disease with complex manifestations which can induce difficulties in diagnosis, especially in the early stages. False positive diagnosis can occur in patients considered to be at high risk for this disease (endemic zones, certain professions). Therefore collaboration between neurologist, infectionist and laboratory doctor is essential for an early and correct diagnosis; it allows for effective treatment of the disease, with a favourable prognostic.https://rjn.com.ro/articles/2009.1/RJN_2009_1_Art-03.pdfinflammationcnslyme diseasecsfserologic analysis |
| spellingShingle | Andreea Barsan Brandusa Tilea Alexandru G. Schiopu Adina Stoian Alexandru A. Schiopu Lyme neuroborreliosis. Pathophysiological and diagnosis aspects Romanian Journal of Neurology inflammation cns lyme disease csf serologic analysis |
| title | Lyme neuroborreliosis. Pathophysiological and diagnosis aspects |
| title_full | Lyme neuroborreliosis. Pathophysiological and diagnosis aspects |
| title_fullStr | Lyme neuroborreliosis. Pathophysiological and diagnosis aspects |
| title_full_unstemmed | Lyme neuroborreliosis. Pathophysiological and diagnosis aspects |
| title_short | Lyme neuroborreliosis. Pathophysiological and diagnosis aspects |
| title_sort | lyme neuroborreliosis pathophysiological and diagnosis aspects |
| topic | inflammation cns lyme disease csf serologic analysis |
| url | https://rjn.com.ro/articles/2009.1/RJN_2009_1_Art-03.pdf |
| work_keys_str_mv | AT andreeabarsan lymeneuroborreliosispathophysiologicalanddiagnosisaspects AT brandusatilea lymeneuroborreliosispathophysiologicalanddiagnosisaspects AT alexandrugschiopu lymeneuroborreliosispathophysiologicalanddiagnosisaspects AT adinastoian lymeneuroborreliosispathophysiologicalanddiagnosisaspects AT alexandruaschiopu lymeneuroborreliosispathophysiologicalanddiagnosisaspects |