title: Tumor necrosis factor-alpha, interleukin-6, and interleukin-8 secretion and the acute-phase response in patients with bacterial and tuberculous osteomyelitis.
abstract: Osteomyelitis, or bone infection, is a major worldwide cause of morbidity. Treatment is frequently unsatisfactory, yet little is known about pathogenesis of infection. Plasma tumor necrosis factor (TNF), interleukin (IL)-6, and IL-8 concentrations were measured before and after lipopolysaccharide stimulation of whole blood from patients with bacterial and tuberculous osteomyelitis and from controls. Patients with bacterial and tuberculous osteomyelitis mounted an acute-phase response and were anemic and febrile. However, plasma IL-6 concentrations were significantly elevated in only tuberculous osteomyelitis patients (vs. controls, P < .05). IL-6 concentrations correlated with erythrocyte sedimentation rate, C-reactive protein level, and plasma albumin concentration, all acute-phase markers. There were no other correlations between cytokine concentrations and clinical data. Following ex vivo stimulation, TNF, IL-6, and IL-8 were secreted equally by patients and controls. In summary, tuberculous osteomyelitis is characterized by elevated systemic IL-6 concentrations associated with an acute-phase response. For further insight into immunopathology of osteomyelitis, studies on infected bone are required.
authors.affiliation: Department of Infectious Diseases, Imperial College School of Medicine, The Hammersmith Hospital, London, United Kingdom.
authors.forename: C A
authors.initials: CA
authors.lastname: Evans
authors.forename: J
authors.initials: J
authors.lastname: Jellis
authors.forename: S P
authors.initials: SP
authors.lastname: Hughes
authors.forename: D G
authors.initials: DG
authors.lastname: Remick
authors.forename: J S
authors.initials: JS
authors.lastname: Friedland
mesh_terms: D000210:Acute-Phase Reaction / Q000276:immunology*; D000328:Adult; D001424:Bacterial Infections / Q000276:immunology*; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood / Q000378:metabolism; D016209:Interleukin-8 / Q000097:blood / Q000378:metabolism; D008297:Male; D010019:Osteomyelitis / Q000276:immunology* / Q000382:microbiology; D014376:Tuberculosis / Q000276:immunology*; D014394:Tuberculosis, Osteoarticular / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha