Propionibacterium acnes Incubation in the Discs Can Result in Time-Dependent Modic Changes A Long-Term Rabbit Model
Propionibacterium acnes Incubation in the Discs Can Result in Time-Dependent Modic Changes A Long-Term Rabbit Model
复制标题
痤疮丙酸杆菌在椎间盘中的孵化可导致随时间变化的 Modic 变化（长期兔子模型）
DOI：
10.1097/brs.0000000000002192
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发表时间：
2017
期刊：
影响因子：
3
通讯作者：
Zhao Fengdong
中科院分区：
文献类型：
--
作者：
Shan Zhi;Zhang Xuyang;Li Shengyun;Yu Tianming;Liu Junhui;Zhao Fengdong
Study Design.A case-control study of animal model of Modic changes (MCs) on rabbits.Objective.To evaluate the feasibility of inducing of MCs by injection of Propionibacterium acne (P. acnes) into the lumbar intervertebral discs of rabbits.Summary of Background Data.MCs have been widely observed, and assume to be closely associated with low back pain and P. acnes, but there are few animal models showing the progression of MCs.Methods.Ten rabbits were used for the study. The L3–4 and L4–5 discs of all rabbits were injected with 100 μL P. acnes (1.6× 10 7 CFU/mL) as P. acnes group, L2–3 disc were injected with 100 μL normal saline as vehicle, and L5–6 disc was untreated (blank). MCs were investigated by magnetic resonance imaging before operation and at 2 weeks, 1, 3, 4.5, 6, and 9 months postoperatively. Following sacrifice, histological analysis, blood test and micro-computed tomography were performed. Cytokine expression in nucleus and endplate tissues was quantified using real-time polymerase chain reaction.Results.From 3 months postoperatively, the P. acnes group showed significantly decreased T1-weighted signal intensity, whereas the T2-weighted signal was significantly higher at 3 and 4.5 months, and then decreased remarkably at 6 and 9 months. Eleven of 20 inferior endplates were identified as type I MCs at 4.5 months, and 9 of 20 were identified as type II MCs at 9 months. Real-time polymerase chain reaction showed that expression of interleukin-1β, tumor necrosis factor α, interferon-γ, matrix metalloproteinase-9, and thrombospondin motifs-5 in the nucleus pulposus, and interleukin-1β, tumor necrosis factor α, and thrombospondin motifs-5 in the endplates, were significantly upregulated after injection of P. acnes. Histological slices of discs injected with P. acnes showed disc degeneration, endplate abnormalities, and inflammatory response, with micro-computed tomography confirming bone resorption.Conclusion.P. acnes infection of the disc can induce degeneration of the disc and an inflammatory response in the endplate region, presenting as MCs type I and II time dependently.Level of Evidence: N/ALow back pain (LBP), the world's most common and disabling condition, 1 affects more than 60% of adults and 30% of adolescents. 2 Although LBP is considered to be correlated to degenerative changes during the process of aging and other pathological conditions, 3 recent work has shown it particularly close associated with vertebral bone lesions, or Modic changes (MCs). Patients with LBP with MCs have a longer duration of episodes, higher frequency of occurrence, and poorer outcomes. 4–6
