Concentration of TGF-beta1 in the supernatant of peripheral blood mononuclear cells cultures from patients with early disseminated and chronic lyme borreliosis.

PURPOSE: The aberrant inflammatory response is probably involved in the pathogenesis of chronic Lyme borreliosis, including chronic Lyme arthritis and neuroborreliosis. Transforming growth factor-beta 1 (TGF-beta1) is an important anti-inflammatory and immunomodulatory cytokine and its deficient synthesis is linked to exaggerated inflammation and immune response. MATERIAL AND METHODS: Peripheral blood mononuclear cells (PBMC) from 25 patients with Lyme borreliosis and 6 controls were incubated for 7 days with suspension of Borrelia afzeli, B. garinii and B. burgdorferi sensu stricto spirochetes. TGF-beta1 concentration in culture supernatants was measured with ELISA. Results were analyzed according to disease duration (group I--chronic borreliosis, n=20; group II--early borreliosis, n=5) and clinical form (LA--arthritis, NB--neuroborreliosis). RESULTS: TGF-beta1 concentration was increased in supernatants of PBMC cultures of patients with early neuroborreliosis, in comparison with chronic borreliosis and controls. In chronic, but not in early borreliosis, there was a tendency for decrease of TGF-beta1 synthesis under stimulation with B. burgdorferi spirochetes. CONCLUSIONS: Impaired synthesis of TGF-beta1 by mononuclear cells seems to be present in patients with chronic forms of Lyme borreliosis when compared to those with early stage of the disease. It may be a factor contributing to the persistence of inadequate inflammatory response in patients in whom chronic form of the disease develops.

Serum levels of interleukin-18 (IL-18), interleukin-1beta (IL-1beta), its soluble receptor sIL-1RII and C-reactive protein (CRP) in patients with Lyme arthritis.

BACKGROUND: In recent years, the role of pro- and antiinflammatory cytokines in the development of Lyme arthritis (LA) has been widely discussed. The purpose of the present study was to determine the concentration of interleukin-18 (IL-18), interleukin-1beta (IL-beta) and its soluble receptor sIL-1RII in serum of patients with LA as well as the usefulness of serum C-reactive protein (CRP) determination in LA diagnosis and monitoring of its treatment. PATIENTS AND METHODS: The study group consisted of 20 patients with LA. Before and after antibiotic treatment, the serum levels of IL-18, IL-1beta and sIL-1RII were measured immunoenzymatically using standard kits and the CRP level was measured by immunoturbidimetric method. RESULTS: Before treatment, the serum levels of IL-18, IL-1beta and sIL-1RII were significantly higher than in control group and after treatment the concentrations of IL-18, IL-1beta and sIL-1RII decreased significantly, but the level of IL-18 and sIL-1RII still remained higher than in control group. The elevated serum level of CRP was detected only in 6 of 20 patients and in 5 of them it returned to the baseline after treatment. CONCLUSION: The results of our study suggest that IL-18, IL-1beta and sIL-1RII might be involved in the development of LA. CRP may be useful in differential diagnosis in patients with suspicion of Lyme arthritis.

Elevated concentration of the chemokine CCL3 (MIP-1alpha) in cerebrospinal fluid and serum of patients with tick borne encephalitis.

PURPOSE: Chemokines, including a chemoattractant for mononuclear cells CCL3 (MIP-1alpha), are responsible for attracting leukocytes into central nervous system (CNS) and cerebrospinal fluid (CSF) in meningitis and encephalomeningitis. We investigated the possibility of the involvement of CCL3 in tickborne encephalitis (TBE) pathogenesis. MATERIAL AND METHODS: We studied 26 patients with TBE; 13 with meningitis (group I) and 13 with encephalomeningits (group II). Control group included 11 patients without infectious disease of the CNS. CCL3 concentration was measured by ELISA in serum and CSF on admission (examination 1) and after 2 weeks (examination 2) in TBE patients and once in controls. RESULTS: In all control samples CCL3 concentration was below detection limit. In TBE, CCL3 serum concentration was: in group I--10.1 +/- 4.1 (mean +/- SD, ng/ml) in examination 1 and 12.4 +/- 4.8 in examination 2, and in group II--12.5 +/- 3.9 and 13.5 +/- 4.8, respectively. In CSF, CCL3 was detected: in group I in 5 patients in examination 1 (178 +/- 236 pg/ml) and 11 in examination 2 (457 +/- 215), in group II--in 8 (357 +/- 311) and 7 patients (326 +/- 330), respectively. There were no differences between group I and II. The comparison of CCL3 concentration gradient with albumin gradient between serum and CSF supported the possibility of intrathecal synthesis of CCL3. CONCLUSIONS: 1) Synthesis of CCL3, perhaps including intrathecal synthesis, is increased in TBE. 2) CCL3 concentration was much lower in CSF than in serum of the TBE patients, which argues against its significant role as chemoattractant in this condition.

Concentration of interferon-inducible T cell chemoattractant and monocyte chemotactic protein-1 in serum and cerebrospinal fluid of patients with Lyme borreliosis.

PURPOSE: Chronic inflammation in Lyme borreliosis may be sustained by aberrant inflammatory response, characterized by Th1 lymphocyte predominance, which in turn may be determined by chemokines synthesized in inflammatory focus. The aim of the study was to evaluate synthesis of chemokines: interferon-induced T cell chemoattractant (I-TAC--chemoattractant for Th1 lymphocytes), and monocyte chemotactic protein (MCP-1) in Lyme borreliosis. MATERIAL AND METHODS: Study group consisted of 13 patients with erythema migrans, 10 with Lyme arthritis and 6 with neuroborreliosis. Serum, as well as cerebrospinal fluid (CSF) in neuroborreliosis, was obtained before (examination 1) and during (examination 2) antibiotic treatment. Control serum was obtained from 8 healthy volunteers and control csf from 8 patients in whom meningitis and neuroborreliosis was excluded after diagnostic lumbar puncture. The samples were assayed for MCP-1 and I-TAC by ELISA. RESULTS: Serum mean I-TAC concentration in examination 1 was 73.0 pg/ml in erythema migrans, 78.9 pg/ml in Lyme arthritis and 87.3 pg/ml in neuroborreliosis (29.9 pg/ml in controls, difference significant for neuroborreliosis) and did not change significantly in examination 2. MCP-1 serum concentration was significantly increased to 497.5 pg/ml in neuroborreliosis in examination 2. I-TAC concentration in csf remained low, while MCP-1 concentration in examination 1 was increased to 589.1 pg/ml, significantly higher than simultaneously in serum. CONCLUSIONS: I-TAC synthesis is increased in Lyme borreliosis and may be a factor favoring predominance of Th1 lymphocyte subset. MCP-1 creates chemotactic gradient towards central nervous system and may contribute to csf pleocytosis in neuroborreliosis.

Concentrations of macrophage inflammatory proteins MIP-1alpha and MIP-1beta and interleukin 8 (il-8) in lyme borreliosis.

BACKGROUND: Components of the spirochete Borrelia burgdorferi sensu lato ( B. burgdorferi s.l.) do not have chemotactic activity. However, B. burgdorferi s.l. causes a chemotactic response, probably by stimulating synthesis of cytokines of the chemokine family by host cells. Our aim was to confirm that the synthesis of chemokines is increased in Lyme borreliosis and that they may account for leukocyte migration, thus being involved in inflammatory response. MATERIALS AND METHODS: We measured concentrations of chemokines: interleukin 8 (Il-8) and macrophage inflammatory protein 1alpha and 1beta (MIP-1alpha, -1beta) in serum of 20 patients with erythema migrans (early localized infection, group I), of 19 patients with Lyme arthritis (chronic infection, group II), and in serum and cerebrospinal fluid (CSF) of 20 patients with neuroborreliosis (early disseminated infection, group III), before and after 2 weeks of antibiotic therapy (examinations 1 and 2), as well as in the sera of 12 healthy blood donors and CSF of ten patients in whom Lyme borreliosis and meningitis were excluded (control group). Interleukin 1beta (Il-1beta) level in serum and CSF and pleocytosis of CSF were assessed simultaneously. RESULTS: The mean concentrations of all studied chemokines in serum were significantly elevated in all study groups in examination 1 and decreased in examination 2. The concentration of Il-8 in serum was higher in group I and the concentration of MIP-1alpha in group III was higher in comparison with group II. Serum concentrations of all chemokines in group I and III correlated with the concentration of Il-1beta, while in group II this correlation appeared only for Il-8 in examination 2. Concentrations of all chemokines in CSF were significantly increased, but as for MIP-1alpha and 1beta they remained lower than in serum. The concentration of Il-8 in CSF was variable and reached values several fold higher than in the serum in some patients. There was no correlation between chemokine concentrations and CSF pleocytosis. CONCLUSION: The synthesis of chemokines (Il-8, MIP-1alpha and 1beta) is increased in Lyme borreliosis and, at least in the early stages of the disease, is related to the synthesis of Il-1beta. Chemokine concentrations depend on the clinical form of Lyme borreliosis, with a tendency for higher values in early infection (erythema migrans and neuroborreliosis). Of the chemokines studied, Il-8 created a chemotactic gradient towards the inflammation site, and thus might be responsible for leukocyte migration.

Proton MR spectroscopy in neuroborreliosis: a preliminary study.

We report results of a magnetic resonance spectroscopy (MRS) study in 12 patients with neuroborreliosis. We used a PRESS sequence, placing an 8 cm3 voxel in normal-appearing white matter of the frontal lobe. Peaks indicating N-acetylaspartate (NAA), choline (Cho), creatine (Cr), myo-inositol (mI), lipids (Lip) and lactate (Lac) were identified and ratios of NAA/Cr, Cho/Cr, mI/Cr, Lip/Cr, Lac/Cr calculated. Significant increases in Cho/Cr and Lip/Cr were noted. No abnormality was found in mean NAA/Cr and Lac/Cr, but in four patients there was a decreased NAA peak; mI/Cr ratio was slightly increased. Although the spectroscopic profile in patients with neuroborreliosis seems to be nonspecific, MRS might be useful for assessing tissue damage of the central nervous system.

IL-15 in the culture supernatants of PMN and PBMC and the serum of patients with Lyme disease.

PURPOSE: The aim of this study was to estimate the production of interleukin-15 (IL-15) by neutrophils (PMNs) and peripheral blood mononuclear cells (PBMC) confronted with the serum levels of IL-15 in patients with Lyme disease. MATERIAL AND METHODS: PMN and PBMC were isolated from heparinized whole blood of patients. The cells were incubated for 18 hs at 37 degrees C in a humidified incubator with 5% CO2. After 18 hs incubation, supernatant was removed and assessed for IL-15 using ELISA kits. RESULTS: The results obtained showed significant increase in the ability of patient's PMNs and peripheral blood mononuclear cells (PBMC) to release IL-15. Although PBMC produced higher concentrations of IL-15 than PMN, the quantitative dominance of PMN in the peripheral blood suggest a significant role for these cells in the defense reactions controlled by this cytokine. Similar changes in the secretion of IL-15 by PMN and PBMC in patient group may be caused by the same regulatory mechanisms which influence the functional abnormalities of the cells examined. CONCLUSIONS: A change in the ability of PMN and PBMC to release IL-15 may have various implications for the cellular and humoral response to the Borrelia burgdorferi (B.b.) infection in patients with Lyme disease.

Role of reactive oxygen species (ROS) in patients with erythema migrans, an early manifestation of Lyme borreliosis.

BACKGROUND: Lyme borreliosis is a tick-transmitted, chronic, zoogenous disease caused by Borrelia burgdorferi spirochete. The clinical picture of Lyme disease is characterized by the variety of tissue and organ involvement and differing severity of symptoms. One of the pathogenic symptoms of early Lyme disease is a skin lesion called erythema migrans. MATERIAL AND METHODS: The purpose of our research was to estimate the parameters of the antioxidant system and the concentration of lipid peroxidation products in the plasma of patients with erythema migrans (EM). The parameters measured included the activity levels of superoxide dismutase (SOD) according to Sykes, gluthatione reductase (GSSG-R) according to Mize and Langdon, glutathione peroxidase (GSH-Px) according to Paglia and Valentine; the concentrations of malondialdehyde (MDA) were examined by means of a Bioxytech LPO-586 kit. The total sulphydryl groups (-SH) according to Ellman and reduced glutathione (GSH) were measured using a Bioxytech GSH-400 test in plasma samples collected from 20 patients with EM aged from 19 to 50, taken before (examination 1) and after (examination 2) therapy with amoxycycline. The control group consisted of 8 healthy people. RESULTS: The results of our examinations prove that beta-lactamase antibiotic therapy brings non-enzymatic antioxidant parameters to control values, though the treatment causes no change in enzymatic antioxidant parameters, resulting in the further activation of free radicals. CONCLUSIONS: In patients with Erythema migrans, the decreased capability to reduce lipid superoxidants leads to maintaining a high concentration of membrane lipid peroxidation products.

[Tumor necrosis factor alpha and interleukin 1-beta in serum of patients with tick-borne encephalitis]. / Stezenie czynnika martwicy nowotworów alpha i interleukiny 1 beta w surowicy chorych na kleszczowe zapalenie mózgu.

The purpose of this work was to evaluate the changes of IL-1 beta and TNF-alpha serum concentrations among patients with TBE (tick-borne encephalitis) of mild and severe clinical course. The detection of cytokines was performed by immunometric assay twice before and after treatment. There was no significant changes in IL-1 beta serum concentration after treatment in both groups of patients. But concentration of TNF-alpha decreased significantly after treatment in both groups of patients. It seems that changes of TNF-alpha concentration might be helpful in evaluation of efficacy of aseptic central nervous system treatment.

[Incidence of antibody detection against Toxocara canis and clinical symptoms in inhabitants of North-Eastern Poland]. / Czestosc wykrywania przeciwcial przeciwko Toxocara canis i objawy kliniczne u mieszkanców pólnocno-wschodniej Polski.

The purpose of this work was to evaluate the the level of exposition of humans on Toxocara eggs in North Eastern Poland on a base of serological tests and epidemiological and clinical data. 1025 inhabitants of North Eastern region of Poland were examine to detect antibodies against Toxocara antigens. 214 (20.7%) showed presence of antibodies against Toxocara. They were mostly males (71%) and country inhabitants (58.9%). No abnormalities in laboratory tests were found among these people. Some of them had complaints like joint pains (19.6%), temporary skin rash 2.3%).

Concentration of soluble CD4, CD8 and CD25 receptors in early localized and early disseminated Lyme borreliosis.

BACKGROUND: The aim of this study was to evaluate the concentrations of soluble CD4, CD8 and CD25 antigens in the serum of patients with early LocaLized, (group I, n = 22 patients) and early disseminated Lyme borreliosis (group II n = 23 patients), before and after antibiotic therapy compared with controls (group III n = 7 healthy persons). MATERIALS AND METHODS: The diagnosis of Lyme borreliosis based on clinical features was confirmed by ELISA and Western blot. The assays of sCD4, sCD8 and sCD25 concentrations were performed using Endogen (USA) kits. RESULTS: In group I the sCD4 level decreased in examination 2 (p < 0.001) compared to examination 1. The mean concentration of sCD8 in initial examination 1 in group II was higher than in controls (p < 0.0001); it decreased in examination 2 but was still higher (p < 0.01) than in controls (p < 0.006). Prior to treatment mean sCD25 concentration in group II was higher compared to controls (p < 0.0008) like in examination 2 after treatment (p < 0.02) and this persisted. The mean value of sCD8 in initial examination 1 before treatment in group II was higher than in group I (p < 0.00001). CONCLUSION: Increased initial concentrations of sCD8 and sCD25 indicate the activation of CD8 and CD25 lymphocytes and their role in immunopathogenesis of Lyme disease. Elevated levels of sCD8 in group II before and after treatment suggest a significant involvement of CD8 lymphocytes, indicating the role of long-lasting cellular response in this stage of Lyme disease.

First cases of acute human granulocytic ehrlichiosis in Poland.

The first three cases of acute human granulocytic ehrlichiosis in Poland are described. Blood samples were tested by an indirect immunofluorescence method to detect specific serum antibodies, and the polymerase chain reaction was used to detect ehrlichial DNA. Additionally, peripheral blood smears were examined for the presence of morulae. According to criteria of the Centers for Disease Control and Prevention, all three cases can be classified as confirmed granulocytic ehrlichiosis. Using the criteria recommended by a consensus group, however, two cases can be classified as confirmed granulocytic ehrlichiosis and one case as probable granulocytic ehrlichiosis.

[Chemokines in meningitis of different etiologies]. / Chemokiny w zapaleniach opon mózgowo-rdzeniowych o róznej etiologii.

Chemokines constitute a group of cytokines with strong chemotactic activity towards different populations of leukocytes, playing significant role in the pathogenesis of inflammatory responses. The chemokines of the alpha subfamily act mainly on neutrophiles, while beta subfamily chemokines attract primarily monocytes and lymphocytes. Research conducted within the last few years suggests chemokines to be the main factors responsible for the attraction of leukocytes to the cerebrospinal fluid (CSF) in the course of both bacterial and viral meningitis. In cerebrospinal fluid from patients with meningitis of different etiologies significant concentrations of both alpha and beta chemokines were observed, which tended to decrease after the introduction of the treatment, with the relationship to the clinical improvement. It was also confirmed in in vitro experiments that the chemotactic properties of the inflammatory CSF mainly depend on the presence of chemokines. The most important chemokines in the pathophysiology of the meningitis in humans are probably interleukin 8 (IL-8), monocyte chemoattractant protein (MCP-1) and INF-gamma inducible protein (IP-10). They seem to be responsible for the attraction to the cns of, respectively, neutrophiles, monocytes and activated T lymphocytes. Differences between the chemokine profiles observed in meningitides of different etiologies are to some degree relevant to coexisting differences in type and extent of pleocytosis. In future, measurements of concentrations of certain chemokines may become of some importance in diagnostics of meningitis and monitoring its clinical course.

[Estimation of platelet counts and their morphological parameters in patients infected by borrelia burgdorferi]. / Ocena liczby plytek i ich parametrów morfologicznych u chorych zakazonych Borrelia burgdorferi.

Platelet counts and their morphologic parameters in patients with Lyme borreliosis before and after antibiotic therapy (4 weeks of treatment) were estimated. 30 patients aged 17-60, x = 41 were evaluated: 7 with Erythema migrans, 3 patients with neuroborreliosis in the from Lymphocytic meningitis and 20 ones with Lyme arthritis. Control group consisted of 19 healthy persons aged 34-52, x = 43. Hematologic analyser Coulter MAXM was used for testing PLT, MPV, PCT and PDW. The results indicated that patients with Lyme boreliosis have decreasing platelet count with simultaneously increasing their volume in comparison with healthy control. It may result from the involement of platelets in defense mechanisms of infected host. The decrease of platelet count after the antibiotic treatment in comparison with the control group may be the reflection of influence of antibiotic treatment on thrombopoesis.

[Epidemiologic aspect of lyme borreliosis among the inhabitants of Podlasie Province]. / Wybrane aspekty epidemiologiczne boreliozy z Lyme wsród mieszkanców województwa podlaskiego.

UNLABELLED: The aim of this study was to evaluate Lyme borreliosis morbidity among the inhabitants of Podlasie Province in the years of 1996-2000. MATERIAL AND METHODS: The new cases of Lyme borreliosis reported in the years of 1996-2000 in Podlasie Province were analyzed. The analysis included the data from Mz-56 and Mz-57 forms and the information from epidemiologic investigations sent to Regional Sanitary and Epidemiologic Station in Bialystok. In 1996-2000, screening examinations were carried out in the same group of 358 forestry workers including 44 (12.29%) females and 314 (87.71%) males aged from 21 to 64 (x = 41.2) years. Immunoenzymatic test of ELISA Borrelia recombinant IgM and IgG by Biomedica firm (Austria) were used to detect B. burgdorferi antibodies. RESULTS: In 1996-2000, 4933 of borreliosis cases were registered in Poland including 1377 (27.91%) in Podlasie Province. The morbidity rate in Podlasie province ranged from 15.05% in 1996 year to 21.29% in 2000 year of the whole country morbidity. At the same time, the incidence rate in Podlasie Province ranged from 9.09 in 1996 to 32.2 in 2000 year and was 6.72-fold higher than the incidence rate in the whole country. In Eastern and Central region of the province, 80.54% of cases were registered whereas, 14.09% by the Lakeside of Augustów and Suwalki only 5.37% in the western region of the province. It was proved that the morbidity increased in proportion to the age of patients (41.39% of patients were at the age of 30-49) and it decreased only above the age of 60. Thus, Lyme borreliosis affects mainly people at working age. The increase in B. burgdorferi antibody detectability was noticed in the population of forestry workers; it was detected in 38.55% in 1995 and in 2000 in 43.56% of the examined. Interestingly, 81 people infected with B.b in 1995-2000 included 74 men and only 7 women, supporting the statement that B.b infection affects mainly working professionals and the risk increases with the practice. CONCLUSIONS: Our studies indicate that Lyme borreliosis is a serious health problem among the inhabitants of Podlasie Province which is an endemic area for Ixodes ricinus ticks infected with B. burgdorferi spirochete.

[Neuroborreliosis: CT and MRI findings in 14 cases. Preliminary communication]. / Neuroborelioza: badania obrazowe OUN (CT i MR) u 14 chorych. Doniesienie wstepne.

Since 1987 when Januszkiewicz and Kieda first described borreliosis, it is commonly recognized as infection of the nervous system in Poland, especially in north-east region. The diagnosis of the disease is mainly based on typical clinical signs, supported by serological testing. In 14 patients with clinical symptoms of neuroborreliosis CT and MR were performed to evaluate CNS changes. MR examinations were abnormal in 36%. Most patients (60%) presented cerebral atrophy. In 2 cases areas of abnormal signal were identified within cerebral white matter as well as within the brain stem. In the first case it was, recognized as demyelination focus, in second one MR showed evidence of or were suggestive of vascular involvement. In one case symmetrical calcifications were also found in internal capsules. Neuroradiological signs in Lyme disease are not specific. Neuroborreliosis has to be considered when patients present foci of hyperintense signal (T2-weighted images) in white matter and brain stem.

[Proinflammatory cytokines in humoral immune response]. / Cytokiny prozapalne w odpowiedzi humoralnej.

Proinflammatory cytokines secreted by cells involved in inflammatory process play a key role in the regulation of immune responses, both cellular and humoral immune response. Through their influence on T-helper lymphocytes and antigen presenting cells including lymphocytes B, they induce secretion of secondary cytokines and, in cooperation with them, promote activation and proliferation of lymphocytes B and production of variety of classes of immunoglobulins. Cytokines interact with their specific receptors which usually occur both in membrane bound and soluble form. The purpose of this article was to evaluate the relationships between primary cytokines such as interleukin-1 (IL-1) and tumor necrosis factor-alpha (TNF-alpha) and other cytokines, lymphocytes T-helper and lymphocytes B in the light of current opinions regarding this matter.

[Bactericidal properties of neutrophils from peripheral blood (PMN)of patients with Lyme borreliosis]. / Bakteriobójcze wlasciwosci granulocytów obojetnochlonnych (PMN) krwi obwodowej u chorych z borelioza z Lyme.

In recent years in Poland, the interest has increased in studies about tick borne diseases, mainly Lyme borreliosis. Immune response and genotype of pathogen play an important role in the course of this disease. Phagocytic cells, especially PMN are dominant in defence mechanisms against bacterial infections. The main feature of PMN is their ability to destroy pathogenic microorganisms by phagocytosis. The aim of this study was to estimate the phagocytic activity of PMN connected with intracellular respiratory burst in patients with Lyme borreliosis. The PMN activity tests completed were: phagocytosis, spontaneous and reduced of nitrotetralizate blue test (NBT). Decreased phagocytic activity and oxygen metabolism of PMN from patients with borreliosis in comparison with values of controls were found. Normalization of these parameters after treatment was observed. Changed phagocytic activity connected with intracellular oxygen metabolism during the course of therapy was the main observation. Depression of phagocytic activity of PMN connected with oxygen metabolism can influence defence reactions in patients with Lyme borreliosis. It is suggested that changes observed are acquired and associated with Borrelia burgdorferi presence.

[Assessment of selected parameters of non-specific cellular response in patients with tick borne encephalitis (TBE)]. / Ocena wybranych parametrów odpornosci komórkowej nieswoistej u chorych z kleszczowym zapaleniem mózgu (KZM).

The aim of this study was the assessment of certain PMN functions involving migration, chemotaxis, phagocytic activity and intracellular oxygen-dependent killing in patients with TBE. The examination involved 47 persons treated in the Department of Infectious and Neuroinfectious Diseases Medical Academy in Bialystok. Two examinations were done: before and just after treatment. Control group contained 29 healthy persons. Migration and chemotaxis were assessed by agarose method of Nelson and al. and Glaser and al. Phagocytic activity was examined by microscopic method and intracellular oxygen-dependent killing by reduction test of NBT by Parks method. Analysis of results showed a decrease of all examined parameters both before and after treatment. It indicates a depression of non-specific cellular response in patients with Lyme meningoencephalitis.