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

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Abstract

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.

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Funding

National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases, Grant # R21AR079679; Thomas J. Coogan Sr. MD Endowment.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Rush Medical College, 1611 W. Harrison St, Chicago, IL, 60612, USA

    Khaled Aboushaala, Ana V. Chee, Sheila J. Toro, Rajko Vucicevic, Catherine Yuh, Jake Dourdourekas, Ishani K. Patel, Alejandro Espinoza-Orias, Chundo Oh, Edward J. Goldberg, Frank M. Phillips, Matthew Colman, Frances M. K. Williams, Howard S. An & Dino Samartzis

  2. Department of Microbial Pathogens and Immunity, Rush Medical College, Chicago, IL, USA

    Lena Al-Harthi

  3. Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland

    Jaro Karppinen

  4. Department of Twins Research and Genetic Epidemiology, King’s College, London, UK

    Frances M. K. Williams

  5. Departments of Anatomy & Cell Biology and Pathology, Rush Medical College, Chicago, IL, USA

    Jeffrey A. Borgia

  6. Department of Internal Medicine, Rush Medical College, Chicago, IL, USA

    Stefan Green & Christopher Forsyth

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  1. Khaled Aboushaala
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Correspondence to Ana V. Chee or Dino Samartzis.

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Aboushaala, K., Chee, A.V., Toro, S.J. et al. Discovery of circulating blood biomarkers in patients with and without Modic changes of the lumbar spine: a preliminary analysis. Eur Spine J 33, 1398–1406 (2024). https://doi.org/10.1007/s00586-024-08192-y

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