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Asymptomatic Borrelia‐seropositive individuals display the same incidence of Borrelia‐specific interferon‐gamma (IFN‐γ)‐secreting cells in blood as patients with clinical Borrelia infection

Lyme disease is a complex disorder that sometimes becomes chronic. There are contradictory reports of experimental Borrelia infections regarding which type of T cell cytokine responses, i.e. Th1 or Th2, are needed to eradicate the Borrelia spirochaetes. In human borreliosis a predominance of Borrelia‐specific Th1‐like responses has been shown. In this study, spontaneous, as well as Borrelia‐specific, secretion of IFN‐γ (Th1) and IL‐4 (Th2) in Borrelia‐seropositive healthy asymptomatic individuals (n = 17) was investigated in peripheral blood by a sensitive ELISPOT assay, and compared with previously reported responses in patients with clinical Borrelia infection (n = 25). The seropositive asymptomatic individuals displayed the same predominance of Borrelia‐specific IFN‐γ‐secreting cells as the patients with clinical Borrelia infection. Interestingly, the proportion of spontaneously IL‐4‐secreting cells, reflecting the unstimulated in vivo secretion, was lower in the seropositive asymptomatic individuals compared with patients with chronic Borrelia infections (n = 13, P = 0.02), whereas no such difference was found compared with subacute Borrelia infections (n = 12). These findings indicate that IFN‐γ secretion alone is not sufficient to eliminate Borrelia spirochaetes in humans, although IFN‐γ may still have a beneficial role in borreliosis acting in concert with other mechanisms.