title: Are Modic changes associated with intervertebral disc cytokine profiles?
abstract: Degenerative changes including Modic changes (MCs) are commonly observed in patients with chronic low back pain. Although intervertebral disc (IVD) cytokine expression has been shown to be associated with low back pain, the cytokine profile for degenerative IVD with and without MC has not been compared.
  
  
  
  This study aimed to evaluate the potential association between IVD cytokine expression and MCs.
  
  
  
  A laboratory study was carried out.
  
  
  
  The IVD tissue samples from 10 patients with type II MCs and10 patients without MCs who underwent an anterior lumbar interbody and fusion for significant low back pain were collected. The expression levels of 42 cytokines were determined using a RayBio Human Cytokine Antibody Array 3 (RayBiotech Inc, Norcross, GA, USA) and the results were verified with enzyme-linked immunosorbent assay (ELISA).
  
  
  
  The cytokine array demonstrated a statistically significant increase in the expression of granulocyte-macrophage colony-stimulating factor (GM-CSF) (p=.001) and epithelial-derived neutrophil-activating peptide 78 (ENA-78) (p=.04), and a trend toward an increase in interleukin-1β (IL-1β) (p=.12) and tumor necrosis factor-α (TNF-α) (p=.22) in IVDs associated with type II MCs. These results were validated with ELISA which demonstrated a 3.85-fold increase in the GM-CSF level between IVDs with type II MCs compared with those without MCs (p=.03). Similarly there was a significant increase in the level of both ENA-78 (3.68-fold, p=.02) and IL-1β (2.11-fold, p=.01) in IVDs with type II MCs. Lastly, there was a trend (p=.07) toward an increase in TNF-α in IVDs with type II MCs (4.4-fold).
  
  
  
  Intervertebral discs with type II MCs demonstrate a significant increase in IL-1β, GM-CSF, and ENA-78, and there is a trend toward an increase in TNF-α. These results further strengthen the association between MCs and low back pain.
authors: Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, 925 Chestnut St, Philadelphia, PA, 19107, USA; The Thomas Jefferson University Department of Orthopaedic Surgery, 1025 Walnut St, Fifth Floor, Philadelphia, PA, 19107, USA. Electronic address: gregdschroeder@gmail.com.
authors: Gregory D
authors: GD
authors: Schroeder
authors: The Thomas Jefferson University Department of Orthopaedic Surgery, 1025 Walnut St, Fifth Floor, Philadelphia, PA, 19107, USA.
authors: Dessislava Z
authors: DZ
authors: Markova
authors: Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, 925 Chestnut St, Philadelphia, PA, 19107, USA; The Thomas Jefferson University Department of Orthopaedic Surgery, 1025 Walnut St, Fifth Floor, Philadelphia, PA, 19107, USA.
authors: John D
authors: JD
authors: Koerner
authors: Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, 925 Chestnut St, Philadelphia, PA, 19107, USA; The Thomas Jefferson University Department of Orthopaedic Surgery, 1025 Walnut St, Fifth Floor, Philadelphia, PA, 19107, USA.
authors: Jeffery A
authors: JA
authors: Rihn
authors: Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, 925 Chestnut St, Philadelphia, PA, 19107, USA; The Thomas Jefferson University Department of Orthopaedic Surgery, 1025 Walnut St, Fifth Floor, Philadelphia, PA, 19107, USA.
authors: Alan S
authors: AS
authors: Hilibrand
authors: Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, 925 Chestnut St, Philadelphia, PA, 19107, USA; The Thomas Jefferson University Department of Orthopaedic Surgery, 1025 Walnut St, Fifth Floor, Philadelphia, PA, 19107, USA.
authors: Alexander R
authors: AR
authors: Vaccaro
authors: Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, 925 Chestnut St, Philadelphia, PA, 19107, USA; The Thomas Jefferson University Department of Orthopaedic Surgery, 1025 Walnut St, Fifth Floor, Philadelphia, PA, 19107, USA.
authors: D Greg
authors: DG
authors: Anderson
authors: Department of Orthopaedic Surgery, The Rothman Institute at Thomas Jefferson University, 925 Chestnut St, Philadelphia, PA, 19107, USA; The Thomas Jefferson University Department of Orthopaedic Surgery, 1025 Walnut St, Fifth Floor, Philadelphia, PA, 19107, USA.
authors: Christopher K
authors: CK
authors: Kepler
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D053583:Interleukin-1beta / Q000378:metabolism*; D007403:Intervertebral Disc / Q000378:metabolism* / Q000473:pathology; D055959:Intervertebral Disc Degeneration / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D053583:Interleukin-1beta; D014409:Tumor Necrosis Factor-alpha
keywords: Cytokines; Degenerative discs; Intervertebral disc; Low back pain; Lumbar spine; Modic changes