Discovery of circulating blood biomarkers in patients with and without Modic changes of the lumbar spine: a preliminary analysis

• Published in: European spine journal Vol. 33; no. 4; pp. 1398 - 1406
• Main Authors: Aboushaala, Khaled, Chee, Ana V., Toro, Sheila J., Vucicevic, Rajko, Yuh, Catherine, Dourdourekas, Jake, Patel, Ishani K., Espinoza-Orias, Alejandro, Oh, Chundo, Al-Harthi, Lena, Karppinen, Jaro, Goldberg, Edward J., Phillips, Frank M., Colman, Matthew, Williams, Frances M. K., Borgia, Jeffrey A., Green, Stefan, Forsyth, Christopher, An, Howard S., Samartzis, Dino
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2024; Springer Nature B.V
• Subjects: Biomarkers; Body mass index; Chemokines; Cross-Sectional Studies; Decompression; Degeneration; Degenerative disc disease; Galectin-3; Humans; Intervertebral Disc Degeneration; Intervertebral Disc Displacement - surgery; Intervertebral discs; Leukocyte migration; Ligands; Lumbar Vertebrae - surgery; Macrophage migration inhibitory factor; Magnetic Resonance Imaging; Medicine; Medicine & Public Health; Neurosurgery; Original Article; Pentraxins; Phenotypes; Prospective Studies; RANTES; Spine (lumbar); Statistical analysis; Surgical Orthopedics; Changes; Disc degeneration; MRI; Imaging; Biomarkers; Disc herniation; Endplate; Modic
• ISSN: 0940-6719; 1432-0932; 1432-0932
• DOI: 10.1007/s00586-024-08192-y

Purpose The following study aimed to determine the existence of blood biomarkers in symptomatic patients with or without lumbar Modic changes (MC). Methods A cross-sectional sub-analyses of a prospective cohort was performed. Fasting blood samples were collected from patients with and without lumbar MC who had undergone spinal fusion or microdiscectomy. An 80-plex panel and CCL5/RANTES were used to assess preoperative plasma cytokine concentrations. Patient demographics and imaging phenotypes were also assessed. Results Thirty-one subjects were analysed ( n  = 18 no MC; n  = 13 MC). No significant differences were found in age, sex, body mass index, smoking and alcohol history, and surgical procedure (i.e. fusion, decompression) between the two groups ( p  > 0.05). Several statistically significant blood biomarkers in MC patients were identified, including elevated levels of C–C Motif Chemokine Ligand 5 (CCL5, p  = 0.0006), while Macrophage Migration Inhibitory Factor (MIF) was significantly lower ( p  = 0.009). Additionally, C-X-C Motif Chemokine Ligand 5 (CXCL5, p  = 0.052), Pentraxin 3 (PTX3, p  = 0.06) and Galectin-3 (Gal-3, p  = 0.07) showed potential relevance. Moreover, MC patients exhibited significantly higher levels of disc degeneration ( p  = 0.0001) and displacement severity ( p  = 0.020). Based on multivariate analyses and controlling for disc degeneration/displacement, CCL5 (OR 1.02; 95% CI 1.002–1.033; p  = 0.028) and MIF (OR 0.60; 95% CI 0.382–0.951; p  = 0.030) were independently associated with MC patients. Conclusion This “proof-of-concept” study is the first to identify specific and significantly circulating blood biomarkers associated with symptomatic patients with lumbar MC, independent of disc alterations of degeneration and/or bulges/herniations. Specifically, differences in CCL5 and MIF protein levels were significantly noted in MC patients compared to those without MC.