title: Local and systemic concentrations of tumour necrosis factor-alpha, interleukin-6 and interleukin-8 in bacterial osteomyelitis.
abstract: Osteomyelitis is a major cause of morbidity worldwide but there are few data investigating pathogenesis of infection and no investigations into local secretion of proinflammatory cytokines in patients. Tumour necrosis factor-alpha (TNF), interleukin (IL)-6 and IL-8 concentrations were measured in pus of infected bone from 30 Zambian patients with chronic osteomyelitis (principally caused by Staphylococcus aureus), in plasma, and after lipopolysaccharide stimulation of whole-blood leucocytes. Patients had reduced body mass index compared to controls (P = 0.025) and an acute-phase response. Elevated concentrations of proinflammatory cytokines were detected in bone compared to plasma (all P < 0.0002). Bone IL-8 concentrations were greater than IL-8 levels after lipopolysaccharide stimulation of whole blood (P < 0.01). In contrast, systemic and ex-vivo-stimulated concentrations of proinflammatory cytokine were similar in patients and controls, despite differences in body mass index and an acute-phase response. In summary, we observed marked local TNF, IL-6 and IL-8 secretion in established bacterial osteomyelitis without systemic cytokine release.
authors.affiliation: Department of Orthopaedic, Imperial College of Science, Technology and Medicine, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Fullilove
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: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism*; D016209:Interleukin-8 / Q000378:metabolism*; D008297:Male; D010019:Osteomyelitis / Q000378:metabolism* / Q000382:microbiology; D012480:Salmonella Infections / Q000150:complications / Q000378:metabolism; D013203:Staphylococcal Infections / Q000378:metabolism; D013492:Suppuration / Q000382:microbiology; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha