ISSLS PRIZE IN CLINICAL SCIENCE 2017: Is infection the possible initiator of disc disease? An insight from proteomic analysis

Rajasekaran, S.; Tangavel, Chitraa; Aiyer, Siddharth N.; Nayagam, Sharon Miracle; Raveendran, M.; Demonte, Naveen Luke; Subbaiah, Pramela; Kanna, Rishi Mugesh; Shetty, Ajoy Prasad; Dharmalingam, K.

doi:10.1007/s00586-017-4972-3

Cited by 55 publications

(57 citation statements)

References 70 publications

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“…Host IVD cells can be sensitized by chronic inflammatory signals and by the increased presence of macrophages that remain in proinflammatory and remodeling states and do not revert to anti‐inflammatory healing states . Clinical evidence also supports the hypothesis that bacterial infection and low‐grade discitis is a potential contributor to IVD degeneration . Interestingly, endplate changes, recorded as modic changes on MRI, are commonly thought to involve fibrogenic and proinflammatory cross‐talk between bone marrow and adjacent IVDs .…”

Section: Cellular Responses To Injurymentioning

confidence: 85%

“…126 Clinical evidence also supports the hypothesis that bacterial infection and lowgrade discitis is a potential contributor to IVD degeneration. [128][129][130] Interestingly, endplate changes, recorded as modic changes on MRI, are commonly thought to involve fibrogenic and proinflammatory cross-talk between bone marrow and adjacent IVDs. 131 Regardless of what the initiator of IVD degeneration is, this inflammatory response, which is required for healing, can become chronic in the IVD, resulting in a frustrated healing state that may predispose the tissue to degeneration and painful conditions.…”

Section: Cellular Responses To Injurymentioning

confidence: 99%

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Annulus fibrosus cell phenotypes in homeostasis and injury: implications for regenerative strategies

Torre

Mroz

Bartelstein

et al. 2018

Annals of the New York Academy of Sciences

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Despite considerable efforts to develop cellular, molecular, and structural repair strategies and restore intervertebral disk function after injury, the basic biology underlying intervertebral disk healing remains poorly understood. Remarkably, little is known about the origins of cell populations residing within the annulus fibrosus, or their phenotypes, heterogeneity, and roles during healing. This review focuses on recent literature highlighting the intrinsic and extrinsic cell types of the annulus fibrosus in the context of the injury and healing environment. Spatial, morphological, functional, and transcriptional signatures of annulus fibrosus cells are reviewed, including inner and outer annulus fibrosus cells, which we propose to be referred to as annulocytes. The annulus also contains peripheral cells, interlamellar cells, and potential resident stem/progenitor cells, as well as macrophages, T lymphocytes, and mast cells following injury. Phases of annulus fibrosus healing include inflammation and recruitment of immune cells, cell proliferation, granulation tissue formation, and matrix remodeling. However, annulus fibrosus healing commonly involves limited remodeling, with granulation tissues remaining, and the development of chronic inflammatory states. Identifying annulus fibrosus cell phenotypes during health, injury, and degeneration will inform reparative regeneration strategies aimed at improving annulus fibrosus healing.

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Section: Cellular Responses To Injurymentioning

confidence: 85%

Section: Cellular Responses To Injurymentioning

confidence: 99%

Annulus fibrosus cell phenotypes in homeostasis and injury: implications for regenerative strategies

Torre

Mroz

Bartelstein

et al. 2018

Annals of the New York Academy of Sciences

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“…Although the culture result is controversial, many other methods like HE and modified Brown-Brenn staining [7], confocal scanning laser microscopy [14], fluorescence in situ hybridization [35], liquid chromatography-tandem mass spectrometry (LC-MS/MS) [36] and PCR assay [12,15,36,37] have provided the evidence for the presence of bacteria. Studies have also demonstrated the differences between genotypes of P. acnes from intervertebral discs and skin.…”

Section: Discussionmentioning

confidence: 99%

The bacteria-positive proportion in the disc tissue samples from surgery: a systematic review and meta-analysis

et al. 2019

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Purpose The role of bacteria, especially Propionibacterium acnes (P. acnes), in human intervertebral disc diseases has raised attention in recent years. However, limited sample size of these studies and diverse bacteria-positive proportion made this topic still controversial. We aimed to review related articles and summarize the bacteria-positive proportion in these studies. Methods We searched the PubMed, Cochrane Library, Embase for related literature from January 2001 to May 2018, and the reference articles were also searched. The random effects or fixed effects meta-analysis was used to pool the overall positive proportion or odds ratio of these studies. ResultsWe found 16 relevant articles and 2084 cases of the bacteria culture from surgery. Within the 16 included studies, 12 studies' results supported the infection in the discs. The pooled bacterial infection rate was 25.3%. The pooled P. acnes infection rate was 15.5%. The overall pooled P. acnes proportion in bacteria-positive discs was 56.4%. We also found that the presence of bacteria may contribute to the development of Modic change with the odds ratio as 1.27 (95% CI: 0.44-3.64), but this result is not significant due to heterogeneity, so further study is needed. Conclusion The existence of bacteria in the intervertebral discs was proved by many studies. However, the variety in sample collecting and culture methods is still obvious and the positive rate also fluctuated within the studies. Standardized and reliable methods should be taken to promote the study in the future. Graphic abstractThese slides can be retrieved under Electronic Supplementary Material.

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“…Clinical and animal-based follow-ups are now corroborating the initial findings showing that local P. acnes proliferation causes upregulation of inflammatory markers and disk degeneration consistent with Modic changes (Aghazadeh et al, 2016; Dudli et al, 2016). There is now even first clinical evidence to suggest that bacterial infection of the intervertebral disk with P. acnes and/or Staphylococcus epidermidis may actually precede all other issues as the root cause of disk herniation and associated pathological changes (Rajasekaran et al, 2017). …”

Section: Spondylodiscitis and Back Painmentioning

confidence: 99%

P. acnes-Driven Disease Pathology: Current Knowledge and Future Directions

Leheste

Ruvolo

Chrostowski

et al. 2017

Front. Cell. Infect. Microbiol.

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This review discusses the biology and behavior of Propionibacterium acnes (P. acnes), a dominant bacterium species of the skin biogeography thought to be associated with transmission, recurrence and severity of disease. More specifically, we discuss the ability of P. acnes to invade and persist in epithelial cells and circulating macrophages to subsequently induce bouts of sarcoidosis, low-grade inflammation and metastatic cell growth in the prostate gland. Finally, we discuss the possibility of P. acnes infiltrating the brain parenchyma to indirectly contribute to pathogenic processes in neurodegenerative disorders such as those observed in Parkinson's disease (PD).

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ISSLS PRIZE IN CLINICAL SCIENCE 2017: Is infection the possible initiator of disc disease? An insight from proteomic analysis

Abstract: Our study demonstrates bacterial specific proteins and host defence proteins to infection which strengthen the hypothesis of infection as a possible initiator of disc disease. These results can lead to a paradigm shift in our understanding and management of disc disorders.

Cited by 55 publications

References 70 publications

Annulus fibrosus cell phenotypes in homeostasis and injury: implications for regenerative strategies

Annulus fibrosus cell phenotypes in homeostasis and injury: implications for regenerative strategies

The bacteria-positive proportion in the disc tissue samples from surgery: a systematic review and meta-analysis

P. acnes-Driven Disease Pathology: Current Knowledge and Future Directions

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