NEW YORK (Reuters Health) Aug 15 - The upregulation of chemokine B lymphocyte chemoattractant (BLC) in cerebrospinal fluid is strongly associated with Lyme neuroborreliosis, new research indicates.

Lyme neuroborreliosis is typically diagnosed by looking for intrathecal production of Borrelia burgdorferi-specific antibodies. However, because these antibodies may not be present early in the course of the disease and rapid treatment is advantageous, there is a need for other diagnostic markers.

Dr. Hans-Walter Pfister, from Klinikum Grosshadern in Munich, Germany, and colleagues used a cytokine antibody array to characterize the CSF cytokine patterns seen in 11 patients with acute Lyme neuroborreliosis and in 83 patients with other neurologic diseases.

The analysis uncovered BLC as a possible diagnostic marker for Lyme neuroborreliosis. All of the patients with the condition showed an increase in BLC levels, whereas the protein was undetectable with most of the other neurologic disorders. Patients with relapse-remitting multiple sclerosis had detectable, but very low levels of BLC compared with Lyme neuroborreliosis patients.

"Apart from its use in diagnostic testing, the (new) discovery may also illuminate the pathogenic processes underlying Lyme neuroborreliosis," Dr. Benjamin M. Segal and Dr. Eric L. Logigian, from the University of Rochester in New York, comment in a related editorial. In addition, further research is needed to determine if BLC could be a target for immunomodulator therapy.

Neurology 2005;65:351-352,448-450.