Th1 and Th17 but no Th2-related cytokine spectrum in the cerebrospinal fluid of children with Borrelia-related facial nerve palsy.

Background: Chemokines and cytokines in cerebrospinal fluid (CSF) and serum have been extensively studied in adults with neuroborreliosis (NB), whereas there are limited data about the pediatric population. In adults, T helper type 1 (Th1) and Th17-related cytokines were observed during acute NB. In children, the Th2 response is thought to moderate the disease course. The aim of this study was to determine the chemokine-cytokine profile in children with acute NB displaying Borrelia-related peripheral facial nerve palsy (PFNP).

Methods: Luminex multiple bead technology was used for the detection of twelve cytokines and chemokines in the CSF and serum of three groups: 1) children with Borrelia-related PFNP (BPFNP); 2) children with non-borrelial "idiopathic" PFNP (NIPFNP); and 3) age-related controls.

Results: In BPFNP, cytokines-chemokines related to a non-specific pro-inflammatory activity and specific Th1/Th17 responses were detected in CSF, and elevated IL-7 and IL-10 levels were observed in serum and CSF compared to NIPFNP and to controls. In NIPFNP, CSF findings were similar to controls; however, higher levels of IL-7 and MCP-1 were observed in serum. Higher IL-8, IL-15 and MCP-1 levels were detected in CSF compared to serum in all groups. MCP-1 and IL-8 levels in CSF were strikingly higher in BPFNP compared to the other two groups, while IL-15 levels in CSF showed no difference. In addition, in controls, increased IL-4 level was found in CSF compared to serum.

Conclusion: The chemokine-cytokine profile in the CSF of children with acute NB was similar to previous studies in adults. Our data suggests that higher levels of IL-4, IL-15 and MCP-1 levels in CSF compared to serum in controls might represent a potentially protective cytokine milieu in the CNS compartment.