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Inflammatory response of disc cells against Propionibacterium acnes depends on the presence of lumbar Modic changes

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Abstract

Purpose

Intervertebral disc with Propionibacterium acnes (P. acnes) is suggested to be an etiology of Modic type I changes in the adjacent bone marrow. However it is unknown if disc cells can respond to P. acnes and if bone marrow cells respond to bacterial and disc metabolites draining from infected discs.

Methods

Human disc cells (n = 10) were co-cultured with 10- and 100-fold excess of P. acnes over disc cells for 3 h and 24 h. Lipopolysaccharide was used as positive control. Expression of IL1, IL6, IL8, and CCL2 by disc cells was quantified by quantitative PCR. Lipase activity was measured in culture supernatants (n = 6). Human vertebral bone marrow mononuclear cells (BMNCs) (n = 2) were cultured in conditioned media from disc cell/P. acnes co-cultures and expression of IL1, IL6, IL8, and CCL2 was measured after 24 h.

Results

All disc cells responded to lipopolysaccharide but only 6/10 responded to P. acnes with increased cytokine expression. Cytokine increase was time- but not P. acnes concentration-dependent. Disc cell responsiveness was associated with the presence of lumbar Modic changes in the donor. Lipase activity was increased independent of disc cell responsiveness. BMNCs responded with inflammatory activity only when cultured in supernatants from responsive disc cell lines.

Conclusion

Disc cell responsiveness to P. acnes associates with the presence of lumbar Modic changes. Furthermore, bone marrow cells had an inflammatory response to the cocktail of disc cytokines and P. acnes metabolites. These data indicate that low virulent P. acnes infection of the disc is a potential exacerbating factor to Modic changes.

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Acknowledgements

This study was supported by the Swiss National Science Foundation Grant 145961, 158792, and 164726 as well as the National Institutes of Health Grant AR063705.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of California San Francisco, 513 Parnassus Ave, S-1164, San Francisco, CA, 94143, USA

    Stefan Dudli & J. C. Lotz

  2. Center of Experimental Rheumatology, University Hospital Zurich, Lengghalde 5, 8008, Zurich, Switzerland

    Stefan Dudli

  3. Department of Laboratory Medicine, University of California San Francisco, 185 Berry St, Suite 290, San Francisco, CA, 94107, USA

    S. Miller

  4. Department of Orthopaedic Surgery, University of California San Francisco, 1500 Owens Street, San Francisco, CA, 94158, USA

    S. Demir-Deviren

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  1. Stefan Dudli
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  2. S. Miller
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  3. S. Demir-Deviren
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  4. J. C. Lotz
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Corresponding author

Correspondence to Stefan Dudli.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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The authors declare that they have no conflict of interest.

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Dudli, S., Miller, S., Demir-Deviren, S. et al. Inflammatory response of disc cells against Propionibacterium acnes depends on the presence of lumbar Modic changes. Eur Spine J 27, 1013–1020 (2018). https://doi.org/10.1007/s00586-017-5291-4

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  • DOI: https://doi.org/10.1007/s00586-017-5291-4

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