Modic type 1 changes (MC1) are vertebral bone marrow lesions and associate with low back pain. Increased serum C-reactive protein (CRP) has inconsistently been associated with MC1. We aimed to provide evidence for the role of CRP in the tissue pathophysiology of MC1 bone marrow. From 13 MC1 patients undergoing spinal fusion at MC1 levels, vertebral bone marrow aspirates from MC1 and intrapatient control bone marrow were taken. Bone marrow CRP, interleukin (IL)-1, and IL-6 were measured with enzyme-linked immunosorbent assays; lactate dehydrogenase (LDH) was measured with a colorimetric assay. CRP, IL-1, and IL-6 were compared between MC1 and control bone marrow. Bone marrow CRP was correlated with blood CRP and with bone marrow IL-1, IL-6, and LDH. CRP expression by marrow cells was measured with a polymerase chain reaction. Increased CRP in MC1 bone marrow (mean difference: +0.22 mg CRP/g, 95% confidence interval [CI] [−0.04, 0.47], p = 0.088) correlated with blood CRP (r = 0.69, p = 0.018), with bone marrow IL-1β (ρ = 0.52, p = 0.029) and IL-6 (ρ = 0.51, p = 0.031). Marrow cells did not express CRP. Increased LDH in MC1 bone marrow (143.1%, 95% CI [110.7%, 175.4%], p = 0.014) indicated necrosis. A blood CRP threshold of 3.2 mg/L detected with 100% accuracy increased CRP in MC1 bone marrow. In conclusion, the association of CRP with inflammatory and necrotic changes in MC1 bone marrow provides evidence for a pathophysiological role of CRP in MC1 bone marrow.

中文翻译：

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C反应蛋白在Modic 1型骨髓改变中的作用


Modic 1 型改变 (MC1) 是椎骨骨髓病变，与腰痛相关。血清 C 反应蛋白 (CRP) 升高与 MC1 的相关性不一致。我们的目的是为 CRP 在 MC1 骨髓组织病理生理学中的作用提供证据。从 13 名接受 MC1 水平脊柱融合的 MC1 患者中，抽取 MC1 椎体骨髓抽吸物和患者体内对照骨髓。采用酶联免疫吸附测定法测定骨髓CRP、白细胞介素(IL)-1和IL-6；用比色法测定乳酸脱氢酶（LDH）。比较 MC1 和对照骨髓之间的 CRP、IL-1 和 IL-6。骨髓 CRP 与血液 CRP 以及骨髓 IL-1、IL-6 和 LDH 相关。通过聚合酶链式反应测量骨髓细胞的 CRP 表达。 MC1 骨髓中 CRP 升高（平均差：+0.22 mg CRP/g，95% 置信区间 [CI] [−0.04, 0.47]， p = 0.088）与血液 CRP 相关（ r = 0.69， p = 0.018），骨髓 IL-1β（ ρ = 0.52， p = 0.029）和 IL-6（ ρ = 0.51， p = 0.031）。骨髓细胞不表达CRP。 MC1 骨髓中 LDH 增加（143.1%，95% CI [110.7%，175.4%]， p = 0.014）表明坏死。检测到的血液 CRP 阈值为 3.2 mg/L，准确度为 100%，MC1 骨髓中的 CRP 会升高。总之，CRP 与 MC1 骨髓炎症和坏死变化的关联为 CRP 在 MC1 骨髓中的病理生理学作用提供了证据。