Circulating inflammatory proteins and osteomyelitis: A bidirectional Mendelian randomization and colocalization
Tianxuan Feng1,2, Peisheng Chen2, Fengfei Lin1,2
1Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
Medicine
|November 5, 2025
Summary
This study used Mendelian randomization to investigate the causal links between circulating inflammatory proteins and osteomyelitis (OM). Findings suggest tumor necrosis factor-beta (TNF-β), osteoprotegerin, and adenosine deaminase may play causal roles in OM development.
Area of Science:
- Immunology
- Genetics
- Orthopedics
Background:
- Circulating inflammatory proteins (CIPs) are linked to osteomyelitis (OM) progression, but their causal role is uncertain.
- Understanding these relationships is crucial for developing effective treatments for OM.
Purpose of the Study:
- To investigate the potential causal relationships between CIPs and OM using a bidirectional 2-sample Mendelian randomization (MR) approach.
- To identify specific CIPs that may be causal factors in OM development.
Main Methods:
- Utilized genome-wide association study summary statistics for 91 inflammation-related proteins and OM.
- Employed inverse variance weighted (IVW) as the primary MR method, with sensitivity analyses including MR-Egger and weighted median.
- Conducted colocalization and pathway enrichment analyses to identify shared causal variants and biological mechanisms.
Main Results:
- Elevated tumor necrosis factor-beta (TNF-β) levels were associated with increased OM risk (OR=1.132).
- Decreased osteoprotegerin (OR=0.772) and adenosine deaminase (OR=0.811) levels were linked to higher OM risk.
- Reverse MR identified several other inflammatory proteins, including interleukin-10 (IL10), associated with OM susceptibility.
Conclusions:
- Identified TNF-β, osteoprotegerin, and adenosine deaminase as potentially causal factors in osteomyelitis development.
- Highlighted the involvement of Toll-like receptor signaling and T-helper 17 cell differentiation pathways.
- Suggests these CIPs represent promising targets for future immunomodulatory therapies for OM.

