Different phylotypes of Cutibacterium acnes cause different modic changes in intervertebral disc degeneration

Abstract

Background The contribution of Cutibacterium acnes (C. acnes) infection to intervertebral disc degeneration (IDD) and the antibiotic therapy has evoked several controversies in recent years. While some microbiology studies report bacterial disc infection within IDD patients, others attribute the positive results to contamination during prolonged cultures. In addition to the clinical controversy, little was known about the mechanism of C. acnes-caused Modic changes (MCs) if C. acnes was the pathogenic factor. Objectives This study aimed to investigate the inflammatory mechanism of MCs induced by different phylotypes of C. acnes in patients with IDD. Methods Specimens from sixty patients undergoing microdiscectomy for disc herniation were included, C. acnes were identified by anaerobic culture, followed by biochemical and PCR-based methods. The identified species of C. acnes were respectively inoculated into the intervertebral discs of rabbits. MRI and histological change were observed. Additionally, we detected MMP expression in the rabbit model using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Results Of the 60 cases, 18 (30%) specimens were positive for C. acnes, and we identified 4 of 6 defined phylogroups: IA, IB, II and III. The rabbits that received Type IB or II strains of C. acnes showed significantly decreased T1WI and higher T2WI at eighth weeks, while strain III C. acnes resulted in hypointense signals on both T1WI and T2WI. Histological examination results showed that all of the three types of C. acnes could cause disc degeneration and endplates rupture. Moreover, endplate degeneration induced by type IB or II strains of C. acnes is related with MMP13 expression. Meanwhile, strain III C. acnes might upregulated the level of MMP3. Conclusion This study suggested that C. acnes is widespread in herniated disc tissues. Different types of C. acnes could induce different MCs by increasing MMP expression.

Would Cutibacterium acnes Be the Villain for the Chronicity of Low Back Pain in Degenerative Disc Disease? Preliminary Results of an Analytical Cohort

“…acnes has different and distinct evolutionary lineages, with the designated phylotypes IA1, IA2, IB, IC, II, and III being based on Multilocus Sequence Typing and Whole Genome Sequencing [38]. Each phylotype has a specific pathogenicity mechanism and produces virulence factors that, depending on the tissue they are colonizing, can trigger an inflammatory response or remain inert to the host's immune system [34,39]. Rollason et al highlighted the high proportion of phylotype II among positive IVD cultures from patients with LDD [40]; this phylotype produces the enzyme hyaluronate lyase (HYL), which degrades hyaluronic acid, an important component of ECM in IVDs, by contributing to its degeneration [41].…”

“…HYL has two variants, with the HYL-IB/II variant, which is found in phylotypes IB and II, being the most active [41,43]; phylotypes IB and II also secrete the cytotoxin CAMP-1 (Christie-Atkins-Munch-Petersen factor), which has a strong interaction with Toll-like receptor 2, amplifying the inflammatory response in the IVD microenvironment [33,44]. In an animal model study, Lan et al demonstrated a positive effect of phylotypes IB and II on the expression of MMP-13 (Matrix Metallopeptidase 13), which is active in the degradation of collagen, an important component of the annulus fibrosus in IVDs [34]. Our preliminary results demonstrate a high frequency of phylotypes IB and II, which were isolated in association in 42.9% of the positive samples.…”

“…Capoor et al demonstrated the positive effect of C. acnes in IVD cell cultures on the expression of IL-1β and other host defense molecules related to the neo-innervation of the annulus fibrosus and the degradation of the extracellular matrix (ECM) of IVDs [31]. Other authors have indicated that such responses were conditioned by the immune profile of the host and the virulence mechanisms of the C. acnes strain; some biofilm-producing phylotypes use this feature to remain inert to defense cells within IVDs, while others produce ECM degradation enzymes in IVDs and activate inflammatory cascades through the Toll-like receptor system [31][32][33][34][35][36].…”

Development and Evaluation of Topical Zinc Oxide Nanogels Formulation Using Dendrobium anosmum and Its Effect on Acne Vulgaris

“…The Columbia agar w/5% sheep blood is a highly nutritious medium for cultivating and isolating difficult-to-grow microorganisms and is less porous than the MH agar, leading to a lower diffusion rate [71]. Studies on anti-acne efficacy suggested the possible cultivation of CBA and MH agar under aerobic conditions; however, no growth was observed after a cultivation period of 2 weeks with consistent checking [40,72]. G-ZnO NPs exhibit a distinctive zone of inhibition against S. aureus of 19 ± 1 mm.…”

Degenerative Intervertebral Disc Disease: Difficulties in Definition of the Concept and Epidemiology of the Phenomenon. Brief Communication

“…Такі зміни, за популяційної поширеності для поперекового відділу хребта на рівні ~6 % [52], гіпотетично так чи інакше пов'язані з патологією міжхребцевих дисків (див. [3,30,65]), можливо і через запальну ланку, обумовлену колонізацією ушкодженого міжхребцевого диску коменсальною бактерією Cutibacterium acnes [3,4,18,30,33,44,53,62,63] (дискусія: [9,16,47,65], [25] і [32], [10] і [31]). У якості можливого додаткового фактору ризику болю у спині розглядають поширені серед дорослих дефекти добре іннервованих замикальних пластинок хребців (англ.…”