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Serum biomarkers for Modic changes in patients with chronic low back pain

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Abstract

Purpose

Lumbar Modic change (MC) can serve as a diagnostic marker as well as an independent source of chronic low back pain (CLBP). This study aimed to test for the existence of serum biomarkers in CLBP patients with MC.

Methods

Age- and sex-matched CLBP patients with confirmed MC on lumbar MRI (n = 40) and pain-free controls (n = 40) were assessed. MC was classified into M1, predominating M1, predominating M2 and M2. MC volumes were calculated. Fasting blood samples were assessed for inflammatory mediators, signalling molecules, growth factors and bone turnover markers. Serum concentrations of 46 biomarkers were measured.

Results

Median concentrations of interleukin (IL)-15 (p < 0.001), IL-8 (p < 0.001), tumour necrosis factor (TNF)-alpha (p < 0.001), Eotaxin-1 (p < 0.05), Eotaxin-3 (p < 0.001), monocyte chemotactic protein (MCP)-1 (p < 0.05), macrophage inflammatory protein (MIP)-1alpha (p < 0.01), TEK receptor tyrosine kinase (Tie)-2 (p < 0.001), vascular cell adhesion molecule (VCAM)-1 (p < 0.001), RANTES (p < 0.001), C telopeptide of type I collagen (CTX)-1 (p < 0.001), vascular endothelial growth factor (VEGF)-C (p < 0.001), VEGF-D (p < 0.05), fms-related tyrosine kinase (Flt)-1 (p < 0.01) and intercellular adhesion molecule (ICAM)-1 (p < 0.01) were significantly higher among controls. IL-1sRII (23.2 vs. 15.5 ng/ml, p < 0.001) and hepatocyte growth factor (HGF)-1 (169 vs. 105 pg/ml, p < 0.01) concentrations were significantly higher among patients. Type or volume of MC was not associated with biomarker concentrations.

Conclusions

This is the first study to assess the blood serum biomarker profile in individuals with CLBP with MC. Several biomarkers were suppressed, while two markers (IL-1sRII and HGF) were elevated among MC patients, irrespective of MC type or size, with CLBP compared with asymptomatic controls.

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Authors and Affiliations

  1. Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland

    Jaro Karppinen, Katri Koivisto, Jukka Ketola, Marianne Haapea, Markus Paananen, Karl-Heinz Herzig, Marja-Leena Majuri, Eero Kyllönen & Jaakko Niinimäki

  2. Center for Life Course Health Research, University of Oulu, Oulu, Finland

    Jaro Karppinen & Marianne Haapea

  3. Finnish Institute of Occupational Health, Oulu, Finland

    Jaro Karppinen

  4. Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland

    Marianne Haapea, Jyri Järvinen & Jaakko Niinimäki

  5. Research Unit of Biomedicine and Biocenter Oulu, Department of Physiology, University of Oulu, Oulu, Finland

    Karl-Heinz Herzig

  6. Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland

    Karl-Heinz Herzig

  7. AO Research Institute, Davos, Switzerland

    Mauro Alini & Sibylle Grad

  8. Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, USA

    Jeffrey Lotz

  9. Center of Experimental Rheumatology, University Hospital Zurich, Zurich, Switzerland

    Stefan Dudli

  10. Department of Orthopaedic Surgery, RUSH University Medical Center, Suite 204-G, 1611 W. Harrison Street, Orthopaedic BuildingChicago, IL, 60612, USA

    Dino Samartzis

  11. International Spine Research and Innovation Initiative, RUSH University, Chicago, USA

    Dino Samartzis

  12. Northern Finland Laboratory Centre NordLab, Oulu University Hospital, Oulu, Finland

    Juha Risteli

  13. Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden

    Harri Alenius

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  1. Jaro Karppinen
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  2. Katri Koivisto
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Correspondence to Dino Samartzis.

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Karppinen, J., Koivisto, K., Ketola, J. et al. Serum biomarkers for Modic changes in patients with chronic low back pain. Eur Spine J 30, 1018–1027 (2021). https://doi.org/10.1007/s00586-020-06713-z

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  • DOI: https://doi.org/10.1007/s00586-020-06713-z

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