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The aim of the study was to check whether measurement of TLR-2 in serum or cerebrospinal fluid (CSF) can help differentiate between neuroborreliosis (NB) and tick-borne encephalitis (TBE). Eighty patients with meningitis and meningoencephalitis were divided into two groups: Group I - patients with NB (n = 40) and Group II - patients with TBE (n = 40). Diagnosis was based on the clinical picture, CSF examination and presence of specific antibodies in serum and CSF. The control group (CG) consisted of healthy blood donors (n = 25) and patients in whom inflammatory process in central nervous system was excluded (n = 25). Concentration of TLR-2 was measured using a commercial kit [TLR-2 Elisa Kit (EIAab, China)]. The serum and CSF TLR-2 concentration of NB patients was significantly higher than in CG. The serum and CSF TLR-2 concentration in TBE patients was significantly higher than in the CG. Receiver operating characteristic analysis of the serum TLR-2 concentration showed significant differences between the group of patients with NB and a group of patients with TBE. TLR-2 is involved in the development of inflammatory process in the CNS caused by both tick-borne pathogens: viral and bacterial as TLR-2 concentration in both CSF and serum differentiates these groups from healthy patients. Although TLR-2 cannot be used as a sole and reliable biomarker differentiating NB from TBE, results of our study are a step forward toward discovering such biomarker in the future. [ABSTRACT FROM AUTHOR]

Lyme borreliosis is a multisystem chronic disease caused by Borrelia burgdorferi sensu lato (s.l.) spirochete transmitted by Ixodes. This bacterium has a remarkable ability to survive in tick-vertebrate setup. Its infection causes diagnostic and clinical difficulties. It was distinguished as a separate disease entity over 30 years ago. Observations made by Steere et al. proved to be a milestone since they found correlation between the occurrence of skin and joint lesions with tick bites. Further studies showed that the disease affects not only joints and skin, but also nervous and circulatory systems. Shortly afterwards, an etiological factor was identified – spirochete isolated by W. Burgdorfer (from ticks) as well as Steer and Benach (from blood). Research conducted by other authors confirmed that the spirochete named after its discoverer (Borrelia burgdorferi) is a common etiological factor for disease entities classified as Lyme borreliosis. The high incidence of Lyme borreliosis among the residents of endemic areas, along with diagnostic and therapeutic difficulties, make it a serious academic, clinical and social problem. The present article elaborates on bacterium structure and selected mechanisms facilitating the colonisation of particular hosts. Knowledge of those processes might be useful in understanding complex pathogenesis of lesions occurring in Lyme disease.