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Scientists dont exactly know why this reaction happens but suspect that one reason is that the killed spirochetes break down and release toxins, and our immune systems response to this spill is what causes the symptoms of the Jarisch Herxheimer reaction

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According to the supplier, the tissue systems were derived from primary human alveolar epithelial cells and primary pulmonary fibroblasts, both from a same healthy donor (male, 50 years), and pulmonary endothelial cells from another healthy donor (male, 6 years), and THP-1 cell line derived macrophages

Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study