Borrelia burgdorferi specific serum and cerebrospinal fluid antibodies in Lyme neuroborreliosis

We used definite Lyme neuroborreliosis (LNB) adult patient acute and convalescent phase serum (n = 63 and 61, respectively) and cerebrospinal fluid (CSF; acute n = 63,3 weeks timepoint n = 41) samples to character-ize Borrelia burgdorferi specific antibody responses in patient subgroups categorized by demographics, infec-tion manifestation and phase, infecting B. burgdorferi genospecies, received antibiotic treatments, and treatment outcome. B. burgdorferi antibodies were analyzed using 4 different assays incorporating a large array of antigens. We observed that B. burgdorferi specific serum antibodies show a universal, antigen inde-pendent declining trend after antibiotic treatment of LNB at 1 year. Antibodies declined similarly among women and men over time, and the decline was independent of patient age. The antibody responses were independent of the predominant LNB manifestation, treatment received by the patient, infecting B. burgdor-feri genospecies, or the subjective improvement experienced by the patients. Finally, the antibody specific-ities in CSF reflected the specificities observed in serum samples.(c) 2022 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)