Division of Clinical Neuroscience, Department of Research, Innovation and Education, Oslo University Hospital, Oslo, Norway.
Faculty of Medicine, University of Oslo, Oslo, Norway.
Sci Rep. 2022 Jan 7;12(1):215. doi: 10.1038/s41598-021-04189-5.
Disability and distress caused by chronic low back pain (LBP) lacking clear pathoanatomical explanations cause huge problems both for patients and society. A subgroup of patients has Modic changes (MC), identifiable by MRI as vertebral bone marrow lesions. The cause of such changes and their relationship to pain are not yet understood. We explored the pathobiology of these lesions using profiling of gene expression in blood, coupled with an edema-sensitive MRI technique known as short tau inversion recovery (STIR) imaging. STIR images and total RNA from blood were collected from 96 patients with chronic LBP and MC type I, the most inflammatory MC state. We found the expression of 37 genes significantly associated with STIR signal volume, ten genes with edema abundancy (a constructed combination of STIR signal volume, height, and intensity), and one gene with expression levels significantly associated with maximum STIR signal intensity. Gene sets related to interferon signaling, mitochondrial metabolism and defense response to virus were identified as significantly enriched among the upregulated genes in all three analyses. Our results point to inflammation and immunological defense as important players in MC biology in patients with chronic LBP.
慢性下腰痛（LBP）缺乏明确的病理解剖学解释所导致的残疾和痛苦给患者和社会都带来了巨大的问题。患者中有一小部分存在 Modic 改变（MC），可通过 MRI 识别为椎骨髓病变。这些变化的原因及其与疼痛的关系尚不清楚。我们使用血液中的基因表达谱分析，结合一种称为短 tau 反转恢复（STIR）的水肿敏感 MRI 技术，来探索这些病变的病理生物学。从 96 例慢性 LBP 和 MC Ⅰ型（最具炎症性的 MC 状态）患者中收集了 STIR 图像和血液中的总 RNA。我们发现 37 个基因的表达与 STIR 信号体积显著相关，10 个基因与水肿丰度相关（STIR 信号体积、高度和强度的构建组合），1 个基因与最大 STIR 信号强度的表达水平显著相关。在所有三种分析中，与干扰素信号、线粒体代谢和对病毒的防御反应相关的基因集被确定为上调基因中显著富集的基因。我们的研究结果表明，炎症和免疫防御是慢性 LBP 患者 MC 生物学中的重要因素。
