Department of Orthopedic Surgery, Rush Medical College, 1611 W. Harrison St, Chicago, IL, 60612, USA.
Department of Microbial Pathogens and Immunity, Rush Medical College, Chicago, IL, USA.
Eur Spine J. 2024 Apr;33(4):1398-1406. doi: 10.1007/s00586-024-08192-y. Epub 2024 Mar 7.
The following study aimed to determine the existence of blood biomarkers in symptomatic patients with or without lumbar Modic changes (MC).
A cross-sectional sub-analyses of a prospective cohort was performed. Fasting blood samples were collected from patients with and without lumbar MC who had undergone spinal fusion or microdiscectomy. An 80-plex panel and CCL5/RANTES were used to assess preoperative plasma cytokine concentrations. Patient demographics and imaging phenotypes were also assessed.
Thirty-one subjects were analysed (n = 18 no MC; n = 13 MC). No significant differences were found in age, sex, body mass index, smoking and alcohol history, and surgical procedure (i.e. fusion, decompression) between the two groups (p > 0.05). Several statistically significant blood biomarkers in MC patients were identified, including elevated levels of C-C Motif Chemokine Ligand 5 (CCL5, p = 0.0006), while Macrophage Migration Inhibitory Factor (MIF) was significantly lower (p = 0.009). Additionally, C-X-C Motif Chemokine Ligand 5 (CXCL5, p = 0.052), Pentraxin 3 (PTX3, p = 0.06) and Galectin-3 (Gal-3, p = 0.07) showed potential relevance. Moreover, MC patients exhibited significantly higher levels of disc degeneration (p = 0.0001) and displacement severity (p = 0.020). Based on multivariate analyses and controlling for disc degeneration/displacement, CCL5 (OR 1.02; 95% CI 1.002-1.033; p = 0.028) and MIF (OR 0.60; 95% CI 0.382-0.951; p = 0.030) were independently associated with MC patients.
This "proof-of-concept" study is the first to identify specific and significantly circulating blood biomarkers associated with symptomatic patients with lumbar MC, independent of disc alterations of degeneration and/or bulges/herniations. Specifically, differences in CCL5 and MIF protein levels were significantly noted in MC patients compared to those without MC.
本研究旨在确定有症状的腰椎 Modic 改变（MC）患者和无症状的腰椎 MC 患者中是否存在血液生物标志物。
对前瞻性队列的一项横断面亚分析进行了研究。对接受脊柱融合或显微椎间盘切除术的有症状的腰椎 MC 患者和无症状的腰椎 MC 患者采集空腹血样。使用 80 聚体试剂盒和 CCL5/RANTES 评估术前血浆细胞因子浓度。还评估了患者的人口统计学特征和影像学表型。
分析了 31 名受试者（无 MC 患者 18 名，MC 患者 13 名）。两组患者的年龄、性别、体重指数、吸烟和饮酒史以及手术方式（融合术、减压术）均无显著差异（p>0.05）。在 MC 患者中发现了几个具有统计学意义的血液生物标志物，包括 C-C 基序趋化因子配体 5（CCL5，p=0.0006）水平升高，而巨噬细胞移动抑制因子（MIF）水平显著降低（p=0.009）。此外，C-X-C 基序趋化因子配体 5（CXCL5，p=0.052）、Pentraxin 3（PTX3，p=0.06）和半乳糖凝集素 3（Gal-3，p=0.07）也显示出潜在的相关性。此外，MC 患者的椎间盘退变（p=0.0001）和位移严重程度（p=0.020）显著更高。基于多变量分析并控制椎间盘退变/位移，CCL5（OR 1.02；95%CI 1.002-1.033；p=0.028）和 MIF（OR 0.60；95%CI 0.382-0.951；p=0.030）与 MC 患者独立相关。
这项“概念验证”研究首次确定了与有症状的腰椎 MC 患者相关的特定且显著的循环血液生物标志物，与椎间盘退变和/或膨出/突出无关。具体而言，与无 MC 患者相比，MC 患者的 CCL5 和 MIF 蛋白水平存在显著差异。
