Vertebral osteomyelitis is characterised by increased RANK/OPG and RANKL/OPG expression ratios in vertebral bodies...

Area of Science:

• Orthopedics
• Infectious Diseases
• Molecular Biology

Background:

• Vertebral osteomyelitis (VO) is a spinal infection with poorly understood mechanisms of intervertebral disc (IVD) and vertebral body (VB) destruction.
• Investigating the link between infection and bone/disc metabolism is crucial for understanding VO pathogenesis.

Purpose of the Study:

• To investigate the connection between infection and bone/disc metabolism in patients with vertebral osteomyelitis.
• To compare gene expression patterns in infected spinal tissues versus non-infected controls.

Main Methods:

• Prospective study of 14 VO patients and 14 control patients with spinal burst fractures.
• Analysis of mRNA expression levels of 18 target genes (chemokines, adipokines, bone metabolism genes) in IVD and VB tissue biopsies using RT-qPCR.

Main Results:

• A significantly elevated receptor activator of NF-κB/osteoprotegerin (RANK/OPG) expression ratio was observed in both VBs and IVDs of the infection group.
• Increased expression of genes in the prostaglandin-E2 system, IL-8, and CCL-20, indicating induced tissue degradation pathways.
• Differential expression of adipokines: higher leptin in infected IVDs, lower omentin and resistin in infected VBs.

Conclusions:

• Common immuno-metabolic pathways, including pro-inflammatory cytokines and pro-osteoclastogenic factors, are implicated in the tissue degradation of VBs and IVDs during VO.
• The findings suggest a shared molecular mechanism underlying bone and disc destruction in vertebral osteomyelitis.