Association between Type 1 Modic Changes and <i>Propionibacterium Acnes</i> Infection in the Cervical Spine: An Observational Study

Georgy, Mark; Vaida, Florin; Stern, Mark A.; Murphy, Kieran J.

doi:10.3174/ajnr.a5741

Cited by 19 publications

(14 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We also see similar induction of inflammatory responses in keratinocytes by C. acnes activation of TLR signalling [ 42 , 43 ]. None of the small number of retrieved tissue samples analysed displayed any evidence of prior infection, indicating that the cells were likely C. acnes naive; the absence in 7/8 patients of type I Modic changes, which have been described as predictive of a C. acnes -positive culture [ 44 ], was also consistent with our microbiology results. Host responses to infection were variable and depended on the patient, gene target, MOI and time course.…”

Section: Discussionsupporting

confidence: 87%

Pro-Inflammatory and Neurotrophic Factor Responses of Cells Derived from Degenerative Human Intervertebral Discs to the Opportunistic Pathogen Cutibacterium acnes

Capoor

Konieczna

McDowell

et al. 2021

IJMS

View full text Add to dashboard Cite

Previously, we proposed the hypothesis that similarities in the inflammatory response observed in acne vulgaris and degenerative disc disease (DDD), especially the central role of interleukin (IL)-1β, may be further evidence of the role of the anaerobic bacterium Cutibacterium (previously Propionibacterium) acnes in the underlying aetiology of disc degeneration. To investigate this, we examined the upregulation of IL-1β, and other known IL-1β-induced inflammatory markers and neurotrophic factors, from nucleus-pulposus-derived disc cells infected in vitro with C. acnes for up to 48 h. Upon infection, significant upregulation of IL-1β, alongside IL-6, IL-8, chemokine (C-C motif) ligand 3 (CCL3), chemokine (C-C motif) ligand 4 (CCL4), nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF), was observed with cells isolated from the degenerative discs of eight patients versus non-infected controls. Expression levels did, however, depend on gene target, multiplicity and period of infection and, notably, donor response. Pre-treatment of cells with clindamycin prior to infection significantly reduced the production of pro-inflammatory mediators. This study confirms that C. acnes can stimulate the expression of IL-1β and other host molecules previously associated with pathological changes in disc tissue, including neo-innervation. While still controversial, the role of C. acnes in DDD remains biologically credible, and its ability to cause disease likely reflects a combination of factors, particularly individualised response to infection.

show abstract

Section: Discussionsupporting

confidence: 87%

Pro-Inflammatory and Neurotrophic Factor Responses of Cells Derived from Degenerative Human Intervertebral Discs to the Opportunistic Pathogen Cutibacterium acnes

Capoor

Konieczna

McDowell

et al. 2021

IJMS

View full text Add to dashboard Cite

show abstract

“…MC1 adjacent discs have been proffered as inflammatory and most vulnerable to occult infection [14]; however, only study showed MC1 was associated with increased rates of disc bacterial growth [35]. MC specimens have been reported more infective than MC-free specimens [36][37][38][39] as have MC2 samples [41,42].…”

Section: Discussionmentioning

confidence: 99%

Evidence for infection in intervertebral disc degeneration: a systematic review

et al. 2021

View full text Add to dashboard Cite

Purpose Back pain is a major problem worldwide and is linked to intervertebral disc degeneration and Modic change. Several studies report growth of bacteria following extraction of degenerate discs at spine surgery. A pathophysiological role for infection in back pain has been proposed. Method We conducted a PRISMA systematic review. MEDLINE, PubMed, Scopus and Web of Science were searched with the terms Modic change, intervertebral dis*, bacteria, microb*, and infect*. Date limits of 2001–2021 were set. Human studies investigating the role of bacteria in disc degeneration or Modic change in vertebrae were included. Results Thirty-six articles from 34 research investigations relating to bacteria in human degenerate discs were found. Cutibacterium acnes was identified in pathological disc material. A ‘candidate bacterium’ approach has been repeatedly adopted which may have biased results to find species a priori, with disc microbial evidence heavily weighted to find C. acnes. Conclusion Evidence to date implicates C. acnes identified through culture, microscopy and sequencing, with some suggestion of diverse bacterial colonisation in the disc. This review found studies which used culture methods and conventional PCR for bacterial detection. Further agnostic investigation using newer methods should be undertaken.

show abstract

“…C. acnes has been observed in IVDs with a biofilm-like morphology that precludes it presence in such samples due to surgical contamination [ 23 , 24 ]. It has also been reported that human IVDs associated with C. acnes are more likely to be characterised by type I modic changes (MC) in the endplates on magnetic resonance imaging (MRI) scans [ 25 , 26 , 27 ]. Animal studies have also shown that C. acnes infection of rabbit discs induces degeneration and inflammation of the endplate region, presenting as MCs [ 28 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

Sheep as a Potential Model of Intradiscal Infection by the Bacterium Cutibacterium acnes

Coscia

Abutaleb

Hostetter³

et al. 2021

Veterinary Sciences

View full text Add to dashboard Cite

The anaerobic bacterium Cutibacterium acnes has been increasingly linked to the development of degenerative disc disease (DDD), although causality is yet to be conclusively proven. To better study how this organism could contribute to the aetiology of DDD, improved animal models that are more reflective of human disc anatomy, biology and mechanical properties are required. Against this background, our proof-of concept study aimed to be the first demonstration that C. acnes could be safely administered percutaneously into sheep intervertebral discs (IVDs) for in vivo study. Following our protocol, two sheep were successfully injected with a strain of C. acnes (8.3 × 106 CFU/disc) previously recovered from a human degenerative disc. No adverse reactions were noted, and at one-month post inoculation all triplicate infected discs in our first animal grew C. acnes, albeit at a reduced load (5.12 × 104 to 6.67 × 104 CFU/disc). At six months, no growth was detected in discs from our second animal indicating bacterial clearance. This pilot study has demonstrated the feasibility of safe percutaneous injection of C. acnes into sheep IVDs under fluoroscopic guidance. The design of follow-up sheep studies to investigate the potential of C. acnes to drive pathological changes within infected discs should now be pursued.

show abstract

Association between Type 1 Modic Changes and Propionibacterium Acnes Infection in the Cervical Spine: An Observational Study

Cited by 19 publications

References 20 publications

Pro-Inflammatory and Neurotrophic Factor Responses of Cells Derived from Degenerative Human Intervertebral Discs to the Opportunistic Pathogen Cutibacterium acnes

Pro-Inflammatory and Neurotrophic Factor Responses of Cells Derived from Degenerative Human Intervertebral Discs to the Opportunistic Pathogen Cutibacterium acnes

Evidence for infection in intervertebral disc degeneration: a systematic review

Sheep as a Potential Model of Intradiscal Infection by the Bacterium Cutibacterium acnes

Contact Info

Product

Resources

About