Patients who have Lyme neuroborreliosis (LNB) might experience lingering symptoms that persist despite antibiotic drug therapy. We tested whether those symptoms are caused by maladaptive immune responses by measuring 20 immune mediators in serum and cerebrospinal fluid (CSF) in 79 LNB patients followed for 1 year. At study entry, most mediators were highly concentrated in CSF, the site of the infection. Those responses resolved with antibiotic therapy, and associations between CSF cytokines and signs and symptoms of LNB were no longer observed. In contrast, subjective symptoms that persisted after use of antibiotics were associated with increased levels of serum interferon-α (IFN-α), which were already observed at study entry, and remained increased at each subsequent timepoint. Highest IFN-α levels corresponded with severe disease. Although the infection serves as the initial trigger, sequelae after antibiotic therapy are associated with unremitting systemic IFN-α levels, consistent with the pathogenic role of this cytokine in interferonopathies in other conditions.
Keywords: Bogovič P; IFN-α; Kastrin A; Korva M; Lyme disease; Lyme neuroborreliosis; Ogrinc K; Rojko T; Slovenia; Suggested citation for this article: Hernández SA; United States; blood; et al. Association of persistent symptoms after Lyme neuroborreliosis and increased levels of interferon-α in blood. Emerg Infect Dis. 2023 Jun [date cited]. https://doi.org/10.3201/eid2906.221685; immune response; increased levels; inflammation; interferon-alpha; persistent symptoms; post‒Lyme disease symptoms; tick-borne infections; vector-borne infections; zoonoses.