Is IL-1β Further Evidence for the Role of in Degenerative Disc Disease? Lessons From the Study of the Inflammatory Skin Condition Acne Vulgaris.

The pathogenesis of degenerative disc disease is a complex and multifactorial process in which genetics, mechanical trauma, altered loading and nutrition present significant etiological factors. Infection of the intervertebral disc with the anaerobic bacterium is now also emerging as a potentially new etiological factor. This human commensal bacterium is well known for its long association with the inflammatory skin condition acne vulgaris. A key component of inflammatory responses to in acne appears to be interleukin (IL)-1β. Similarly, in degenerative disc disease (DDD) there is compelling evidence for the fundamental roles of IL-1β in its pathology. We therefore propose that involvement in DDD is biologically very plausible, and that IL-1β is the key inflammatory mechanism driving the host response to infection. Since there is a solid theoretical basis for this phenomenon, we further propose that the relationship between infection and DDD is causal.