Is IL-1β Further Evidence for the Role of Propionibacterium acnes in Degenerative Disc Disease? Lessons From the Study of the Inflammatory Skin Condition Acne Vulgaris

Slabý, Ondřej; McDowell, Andrew; Brüggemann, Holger; Raz, Assaf; Demir‐Deviren, Sibel; Freemont, Anthony J.; Lambert, Peter A.; Capoor, Manu N.

doi:10.3389/fcimb.2018.00272

Cited by 15 publications

(15 citation statements)

References 41 publications

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“…Because correlations among clinical symptoms, radiological signs of disc degeneration, and treatment outcomes are not satisfactory, the selection of treatment options is difficult and the options employed often yield less than satisfactory results. Clearly, a more detailed understanding of the causes and development of DDD is needed so patients can be stratified for tailored or personalized treatments where possible (21). IDD advancing.…”

Section: Discussionmentioning

confidence: 99%

“…The infection may therefore result in local tissue inflammation with edema, and due to production of cytokines known to affect the bone; this is leading to MC type 1 in the vertebral endplates and subchondral bone marrow (26). The identification of Propionibacterium acnes biofilms in intervertebral disc tissue obtained from patients who have undergone microdiscectomy, combined with previous studies demonstrating the success of antibiotic treatment for patients with CLBP , has led to the suggestion that P. acnes infection of the intervertebral disc may be another important causative factor for the development of DDD (21). Ozone (O3) gas, discovered in the mid-nineteenth century, is a molecule consisting of three atoms of oxygen.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of Degenerative Disc Disease associated with Modic changes, with ozone therapy. A new therapeutic proposal.

Grangeat

Erario

2021

J Ozone Ther.

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Introduction. Modic Changes (MCs) represent signal changes in the vertebral endplate and subchondral bone region visualized on T1 and T2 weighted magnetic resonance images (MRI). Three types of MCs It have been identified (Types 1 to 3). Modic changes are commonly associated with low-back pain (LBP). In the last few years scientific papers have shown that one of the causes of MCs (fundamentally, the MCs type 1) is the infection caused by an anaerobic bacterium of very low virulence: Propionibacterium acnes (P. acnes). This bacterium resides on the human skin, oral cavity, intestinal tract, and external ear canal as normal flora. As a consequence of tooth brushing and endodontic-therapy, could invade the blood stream leading to transient bacteremia. The authors propose a treatment which consists of Amoxicillin-clavulanate (500 mg/125 mg) three times a day, at 8-hour intervals, for 90 days/100 days. Objectives. Ozone therapy could be the gold standard therapy for MC1 because ozone is a powerful anti-microbial, anti-inflammatory and analgesic agent, which regulates oxidative stress, immune system and oxygen metabolism. Materials and Methods Patients with LBP lasting 6 months or more and MC1 confirmed by MRI of lumbar spine L3/L4 or L4/L5 or L5/S1 and who responded with 5 or more points on the VAS scale were treated with three intradiscal sessions of ozone therapy and ten paravertebral sessions. Results. Patients who were treated with ozone therapy according to our treatment proposal showed a substantial improvement on VAS comparing the beginning and the end of the treatment. They show a significant difference in pain, and general condition. However, these results were not reflected on ODI scale, neither on the MRI but we could notice certain improvements.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Treatment of Degenerative Disc Disease associated with Modic changes, with ozone therapy. A new therapeutic proposal.

Grangeat

Erario

2021

J Ozone Ther.

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“…Nevertheless, our data It should furthermore be noted that the high data variability within the two degeneration groups for all targets indicates that HYAL expression and activity is not only affected by the grade of degeneration, but also by other factors that were not controlled for due to the small sample size. Possible examples include, but are not limited to, diabetic conditions [48], P. acnes infection [49] and tissue loading patterns [50,51]. Higher number of samples will be needed to better identify trends and statistically significant differences in future studies.…”

Section: Discussionmentioning

confidence: 99%

Expression and activity of hyaluronidases HYAL-1, HYAL-2 and HYAL-3 in the human intervertebral disc

Krupková

Greutert

Boos³

et al. 2019

Eur Spine J

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Purpose Hyaluronic acid plays an essential role in water retention of the intervertebral disc (IVD) and thus provides flexibility and shock absorbance in the spine. Hyaluronic acid gets degraded by hyaluronidases (HYALs), and some of the resulting fragments were previously shown to induce an inflammatory and catabolic response in human IVD cells. However, no data currently exist on the expression and activity of HYALs in IVD health and disease. Methods Gene expression, protein expression and activity of HYALs were determined in human IVD biopsies with different degrees of degeneration (n = 50 total). Furthermore, freshly isolated human IVD cells (n = 23 total) were stimulated with IL-1β, TNF-α or H 2 O 2 , followed by analysis of HYAL-1, HYAL-2 and HYAL-3 gene expression. Results Gene expression of HYAL-1 and protein expression of HYAL-2 significantly increased in moderate/severe disc samples when compared to samples with no or low IVD degeneration. HYAL activity was not significantly increased due to high donor-donor variation, but seemed overall higher in the moderate/severe group. An inflammatory environment, as seen during IVD disease, did not affect HYAL-1, HYAL-2 or HYAL-3 expression, whereas exposure to oxidative stress (100 µM H 2 O 2) upregulated HYAL-2 expression relative to untreated controls. Conclusion Although HYAL-1, HYAL-2 and HYAL-3 are all expressed in the IVD, HYAL-2 seems to have the highest pathophysiological relevance. Nonetheless, further studies will be needed to comprehensively elucidate its significance and to determine its potential as a therapeutic target.

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“…It has been a point of controversy as to whether they are true infections or intraoperative contamination, due to these bacteria are skin colonizing bacteria and the most common pathogens of implant-associated infections in the beginning. However, recent evidence suggested that bacteria are present in the disc before acquisition of disc tissue [ 4 ]. The detection of bacteria in degenerated cervical IVDs has been discussed in our study previously, and both bacteria were found to be predominant, but S. epidermidis was more common than P. acnes [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Different responses of cervical intervertebral disc caused by low and high virulence bacterial infection: a comparative study in rats

Chen

et al. 2022

Bioengineered

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The aims of this study were to investigate the outcomes of low- and high-virulence bacterial cervical intervertebral discs (IVDs) infection and its association with cervical IVDs degeneration in rats. A total of 75 clean grade male rats were used to establish the corresponding animal models of low and high virulent bacterial cervical disc infection via an anterior cervical approach, with injection of Propionibacterium acnes (P. acnes) and Staphylococcus epidermidis (S. epidermidis) with a 29 G needle to cervical IVDs. Specimens were collected for evaluation of Blood routine (Blood-RT), histological staining, and gene expression assays after a magnetic resonance imaging (MRI) scan. There were no statistical differences in all groups in white blood cells (WBC) at 2 and 6 weeks postoperatively (P = 0.136). The highest percentage of neutrophils was found in the S. epidermidis group at 2 weeks postoperatively (P = 0.043). MRI and histology showed that at 6 weeks postoperatively, the puncture group and P. acnes group had similar disc degeneration. In the S. epidermidis group, the disc and subchondral bone structure had been destroyed and bony fusion had occurred after the discitis. The upregulation of pro-inflammatory factor expression had the strongest effect of S. epidermidis on the early stage, while the upregulation in the puncture and P. acnes groups was more persistent. P. acnes infection of the cervical IVDs can lead to degenerative changes, whereas S. epidermidis infection leads to the manifestation of septic discitis. The correlation between P. acnes infection and cervical IVDs degeneration found in clinical studies was confirmed.

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Is IL-1β Further Evidence for the Role of Propionibacterium acnes in Degenerative Disc Disease? Lessons From the Study of the Inflammatory Skin Condition Acne Vulgaris

Cited by 15 publications

References 41 publications

Treatment of Degenerative Disc Disease associated with Modic changes, with ozone therapy. A new therapeutic proposal.

Treatment of Degenerative Disc Disease associated with Modic changes, with ozone therapy. A new therapeutic proposal.

Expression and activity of hyaluronidases HYAL-1, HYAL-2 and HYAL-3 in the human intervertebral disc

Different responses of cervical intervertebral disc caused by low and high virulence bacterial infection: a comparative study in rats

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