Evans C A, Jellis J, Hughes S P, Remick D G, Friedland J S
Department of Infectious Diseases, Imperial College School of Medicine, The Hammersmith Hospital, London, United Kingdom.
J Infect Dis. 1998 Jun;177(6):1582-7. doi: 10.1086/515313.
Osteomyelitis, or bone infection, is a major worldwide cause of morbidity. Treatment is frequently unsatisfactory, yet little is known about pathogenesis of infection. Plasma tumor necrosis factor (TNF), interleukin (IL)-6, and IL-8 concentrations were measured before and after lipopolysaccharide stimulation of whole blood from patients with bacterial and tuberculous osteomyelitis and from controls. Patients with bacterial and tuberculous osteomyelitis mounted an acute-phase response and were anemic and febrile. However, plasma IL-6 concentrations were significantly elevated in only tuberculous osteomyelitis patients (vs. controls, P < .05). IL-6 concentrations correlated with erythrocyte sedimentation rate, C-reactive protein level, and plasma albumin concentration, all acute-phase markers. There were no other correlations between cytokine concentrations and clinical data. Following ex vivo stimulation, TNF, IL-6, and IL-8 were secreted equally by patients and controls. In summary, tuberculous osteomyelitis is characterized by elevated systemic IL-6 concentrations associated with an acute-phase response. For further insight into immunopathology of osteomyelitis, studies on infected bone are required.
骨髓炎，即骨感染，是全球范围内发病的主要原因。其治疗效果常常不尽人意，然而对于感染的发病机制却知之甚少。对患有细菌性和结核性骨髓炎的患者以及对照组患者的全血进行脂多糖刺激前后，分别测定血浆肿瘤坏死因子（TNF）、白细胞介素（IL）-6和IL-8的浓度。患有细菌性和结核性骨髓炎的患者出现急性期反应，并有贫血和发热症状。然而，仅结核性骨髓炎患者的血浆IL-6浓度显著升高（与对照组相比，P <.05）。IL-6浓度与红细胞沉降率、C反应蛋白水平和血浆白蛋白浓度相关，这些均为急性期标志物。细胞因子浓度与临床数据之间无其他相关性。体外刺激后，患者和对照组分泌TNF、IL-6和IL-8的情况相同。总之，结核性骨髓炎的特征是全身IL-6浓度升高并伴有急性期反应。为了进一步深入了解骨髓炎的免疫病理学，需要对感染的骨骼进行研究。
