Low back pain patients with Modic type 1 changes exhibit distinct bacterial and non-bacterial subtypes

• Published in: Osteoarthritis and cartilage open 2024-03, Vol.6 (1), p.100434, Article 100434
• Main Authors: Heggli, I., Mengis, T., Laux, C.J., Opitz, L., Herger, N., Menghini, D., Schuepbach, R., Farshad-Amacker, N.A., Brunner, F., Fields, A.J., Farshad, M., Distler, O., Dudli, S.
• Format: Article
• Language: English
• Subjects: Autoimmunity; Cutibacterium acnes; Etiology; Low back pain; Modic changes; ORIGINAL PAPER
• ISSN: 2665-9131; 2665-9131
• DOI: 10.1016/j.ocarto.2024.100434

Modic type 1 changes (MC1) are vertebral endplate bone marrow (BM) lesions observed on magnetic resonance images in sub-populations of chronic low back pain (CLBP) patients. The etiopathogenesis remains unknown and treatments that modify the underlying pathomechanisms do not exist. We hypothesized that two biological MC1 subtypes exist: a bacterial and a non-bacterial. This would have important implications for developing treatments targeting the underlying pathomechanisms. Intervertebral disc (IVD) samples adjacent to MC1 (n ​= ​34) and control (n ​= ​11) vertebrae were collected from patients undergoing spinal fusion. Cutibacterium acnes (C.acnes) genome copy numbers (GCNs) were quantified in IVD tissues with 16S qPCR, transcriptomic signatures and cytokine profiles were determined in MC1 and control BM by RNA sequencing and immunoassay. Finally, we assessed if C.acnes GCNs are associated with blood plasma cytokines. IVD tissues from control levels had