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Local and systemic concentrations of tumour necrosis factor-alpha, interleukin-6 and interleukin-8 in bacterial

S Fullilove1, J Jellis, S P Hughes

  • 1Department of Orthopaedic, Imperial College of Science, Technology and Medicine, London, UK.

Transactions of the Royal Society of Tropical Medicine and Hygiene
|July 18, 2000
PubMed

Insights

This study found high levels of local inflammatory cytokines in bone infections (osteomyelitis) but not in the blood. This suggests targeted treatment strategies are needed for bone infections.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Orthopedics

Background:

  • Osteomyelitis is a significant global health issue with limited understanding of its pathogenesis.
  • Previous research has not investigated the local secretion of pro-inflammatory cytokines in osteomyelitis patients.

Purpose of the Study:

  • To investigate the concentrations of tumor necrosis factor-alpha (TNF), interleukin-6 (IL-6), and interleukin-8 (IL-8) in the pus of infected bone in patients with chronic osteomyelitis.
  • To compare local cytokine levels with plasma concentrations and ex-vivo lipopolysaccharide-stimulated whole-blood leucocyte responses.

Main Methods:

  • Measurement of TNF, IL-6, and IL-8 concentrations in bone pus, plasma, and lipopolysaccharide-stimulated whole-blood leucocytes from 30 Zambian patients with chronic osteomyelitis.
  • Comparison of cytokine levels between patients and controls, considering body mass index and acute-phase response.

Main Results:

  • Patients exhibited reduced body mass index and an acute-phase response compared to controls.
  • Significantly elevated concentrations of pro-inflammatory cytokines (TNF, IL-6, IL-8) were detected in bone pus compared to plasma.
  • Bone IL-8 levels were higher than those observed after ex-vivo lipopolysaccharide stimulation, while systemic and stimulated cytokine levels were similar between patients and controls.

Conclusions:

  • Established bacterial osteomyelitis is characterized by marked local secretion of TNF, IL-6, and IL-8 within the infected bone.
  • There is a lack of systemic cytokine release in these patients, despite local inflammation.
  • Findings highlight localized inflammatory processes in osteomyelitis, suggesting potential for targeted therapeutic interventions.

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