Fullilove S, Jellis J, Hughes S P, Remick D G, Friedland J S
Department of Orthopaedic, Imperial College of Science, Technology and Medicine, London, UK.
Trans R Soc Trop Med Hyg. 2000 Mar-Apr;94(2):221-4. doi: 10.1016/s0035-9203(00)90284-0.
Osteomyelitis is a major cause of morbidity worldwide but there are few data investigating pathogenesis of infection and no investigations into local secretion of proinflammatory cytokines in patients. Tumour necrosis factor-alpha (TNF), interleukin (IL)-6 and IL-8 concentrations were measured in pus of infected bone from 30 Zambian patients with chronic osteomyelitis (principally caused by Staphylococcus aureus), in plasma, and after lipopolysaccharide stimulation of whole-blood leucocytes. Patients had reduced body mass index compared to controls (P = 0.025) and an acute-phase response. Elevated concentrations of proinflammatory cytokines were detected in bone compared to plasma (all P < 0.0002). Bone IL-8 concentrations were greater than IL-8 levels after lipopolysaccharide stimulation of whole blood (P < 0.01). In contrast, systemic and ex-vivo-stimulated concentrations of proinflammatory cytokine were similar in patients and controls, despite differences in body mass index and an acute-phase response. In summary, we observed marked local TNF, IL-6 and IL-8 secretion in established bacterial osteomyelitis without systemic cytokine release.
骨髓炎是全球发病的主要原因，但关于感染发病机制的研究数据较少，且尚无针对患者促炎细胞因子局部分泌情况的研究。对30名赞比亚慢性骨髓炎患者（主要由金黄色葡萄球菌引起）感染骨的脓液、血浆以及脂多糖刺激全血白细胞后，测量了肿瘤坏死因子-α（TNF）、白细胞介素（IL）-6和IL-8的浓度。与对照组相比，患者的体重指数降低（P = 0.025）且有急性期反应。与血浆相比，在骨中检测到促炎细胞因子浓度升高（所有P < 0.0002）。骨IL-8浓度高于脂多糖刺激全血后的IL-8水平（P < 0.01）。相比之下，尽管体重指数和急性期反应存在差异，但患者和对照组中促炎细胞因子的全身和体外刺激浓度相似。总之，我们观察到在已确诊的细菌性骨髓炎中存在明显的局部TNF、IL-6和IL-8分泌，而无全身细胞因子释放。
