Neuroactive kynurenines in Lyme borreliasis

  title={Neuroactive kynurenines in Lyme borreliasis},
  author={John J Halperin and Melvyn P. Heyes},
  pages={43 - 43}
Although neurologic dysfunction occurs frequently in patients with Lyme borreliosis, it is rarely possible to demonstrate the causative organism within the neuraxis. This discordance could arise if neurologic symptoms were actually due to soluble neuromodulators produced in response to infection. Since immune stimulation is associated with the production of quinolinic acid (QUIN), an excitotoxin and N-methyl-D-aspartate (NMDA) agonist, we measured levels of CSF and serum QUIN, and lymphokines… 

Neuroimmunomodulators in Neuroborreliosis and Lyme Encephalopathy

CSF CXCL13 is a sensitive and specific marker of neuroborreliosis in individuals with Borrelia-specific intrathecal antibody production, however, it does not distinguish individuals strongly suspected of having neurobor Reliosis, but lacking confirmatory intrathe CAL antibodies, from those with other neuroinflammatory conditions.

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Although patients ill with Lyme disease may have concomitant cognitive or memory difficulty, these symptoms are not specific to neuroborreliosis and, when present in isolation, should not be viewed as suggestive of this diagnosis.

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Nervous system Lyme disease.

  • J. Halperin
  • Medicine, Biology
    Handbook of clinical neurology
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Nervous System Involvement in Lyme Borreliosis

Lyme neuroborreliosis (involvement of the central and/or peripheral nervous system due to infection with B. burgdorferi sensu lato) is the second most frequent manifestation of Lyme borreliosis in

Neuro‐ophthalmic Manifestations of Lyme Disease

In the author‘ experience, the incorrect diagnosis of Lyme disease initially has been made in patients with allergic conjunctivitis, keratoconus, morning glory syndrome, carniopharyngiomas, meningioma, CNS lymphoma, paraneoplastic syndrome, multiple sclerosis, sarcoid, syphilis, and functional illness.

Nervous System Lyme Disease: Diagnosis and Treatment

  • J. Halperin
  • Medicine, Biology
    Current Treatment Options in Neurology
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The encephalopathy that can be seen in some patients with active infection represents the same phenomenon that occurs in patients with many other inflammatory disorders, is not evidence of central nervous system (CNS) infection, and does not require any different, more prolonged, or more intensive treatment.

Successful treatment of Lyme encephalopathy with intravenous ceftriaxone.

It is concluded that Lyme encephalopathy can be treated successfully with ceftriaxone and all 18 patients rated themselves as back to normal or improved.

Quinolinic acid and kynurenine pathway metabolism in inflammatory and non-inflammatory neurological disease.

It is concluded that inflammatory diseases are associated with accumulation of QUIN, kynurenic acid and L-kynurenine within the central nervous system, but that the available data do not support a role for QUIN in the aetiology of Huntington's disease or Alzheimer's disease.



Lyme borreliosis‐associated encephalopathy

CSF is studied in 73 patients referred for presumed CNS Lyme to conclude that CNS infection with B burgdorferi does occur in a small proportion of seropositive patients with this confusional state but is extremely uncommon among seronegative individuals with this clinical presentation.

Lyme neuroborreliosis. Peripheral nervous system manifestations.

It is concluded that reversible PNS abnormalities occur in one-third of patients with late Lyme borreliosis, and the pattern of electrophysiological abnormalities is the same in all and is indicative of widespread axonal damage, suggesting that these different presentations reflect varying manifestations of the same pathological process.

Immunologic reactivity against Borrelia burgdorferi in patients with motor neuron disease.

There appears to be a statistically significant association between ALS and immunoreactivity to B burgdorferi, at least among men living in hyperendemic areas.

Evaluation of the intrathecal antibody response to Borrelia burgdorferi as a diagnostic test for Lyme neuroborreliosis.

Intrathecal antibody determinations are the most specific diagnostic test currently available for Lyme neuroborreliosis, but local antibody production in CSF is an inconsistent finding in American patients with late neurologic manifestations of the disorder.

CNS‐borreliosis selectively affecting central motor neurons

D diagnosis was based on elevated B. burgdorferi IgG antibody titers in cerebrospinal fluid and titer normalization at clinical recovery, favouring the hypothesis of the presence of the organism within the CNS.

[Progressive Borrelia encephalomyelitis. Chronic manifestation of erythema chronicum migrans disease of the nervous system].

This progressive encephalomyelitis differs from the common and spontaneously healing meningo-polyneuritis, the usual manifestation of erythema chronicum migrans of the nervous system, in its progressive nature, its invasion of the CNS and the possible long lasting severe damage when not specifically treated.

Increased Cerebrospinal Fluid Quinolinic Acid, Kynurenic Acid, and L‐Kynurenine in Acute Septicemia

Although it is probable that the marked increases in CSF quinolinic acid and kynurenic acid concentrations are reflected in the extracellular fluid space of brain, it remains to be determined whether the magnitude of such increases influences the activity of excitatory amino acid receptors in brain to produce excitotoxic pathology or noncytolytic disruption of functions mediated by exciteatory amino Acid receptors.

Seronegative Lyme disease. Dissociation of specific T- and B-lymphocyte responses to Borrelia burgdorferi.

It is concluded that the presence of chronic Lyme disease cannot be excluded by the absence of antibodies against B. burgdorferi and that a specific T-cell blastogenic response to the spirochete is evidence of infection in seronegative patients with clinical indications of Chronic Lyme disease.

Cerebrospinal fluid neopterin in human immunodeficiency virus type 1 infection

CSF neopterin, although not disease‐specific, may be useful as a surrogate marker for the presence of AIDS dementia complex and its response to antiviral therapy.