Correlation between gene expression and MRI STIR signals in patients with chronic low back pain and Modic changes indicates immune involvement

Author:

Vigeland Maria Dehli,Flåm Siri Tennebø,Vigeland Magnus Dehli,Espeland Ansgar,Kristoffersen Per Martin,Vetti Nils,Wigemyr Monica,Bråten Lars Christian Haugli,Gjefsen Elisabeth,Schistad Elina Iordanova,Haugen Anne Julsrud,Froholdt Anne,Skouen Jan Sture,Zwart John-Anker,Storheim Kjersti,Pedersen Linda Margareth,Lie Benedicte Alexandra,Anke Audny,Winsvold Bendik Slagsvold,Lurud Britt Elin,Hellum Christian,Andersen Erling,Granvigen Fredrik,Marchand Gunn Hege,Kjos Guro,Andersen Hege,Presberg Hilde,Østhus Ida Beate,Brox Jens Ivar,Aßmus Jörg,Gammelsrud Karianne Wiger,Huneide Knut Morten,Grøvle Lars,Rolfsen Mads Peder,Wilhelmsen Maja,Grotle Margreth,Thorsø Marianne,Lutro Olav,Nygaard Øystein Petter,Randen Sigrun,Claussen Siv Krüger,Fors Terese,Kadar Thomas Istvan,Holmgard Thor Einar,Sørensen Veronica,Rao Vidar,

Abstract

AbstractDisability and distress caused by chronic low back pain (LBP) lacking clear pathoanatomical explanations cause huge problems both for patients and society. A subgroup of patients has Modic changes (MC), identifiable by MRI as vertebral bone marrow lesions. The cause of such changes and their relationship to pain are not yet understood. We explored the pathobiology of these lesions using profiling of gene expression in blood, coupled with an edema-sensitive MRI technique known as short tau inversion recovery (STIR) imaging. STIR images and total RNA from blood were collected from 96 patients with chronic LBP and MC type I, the most inflammatory MC state. We found the expression of 37 genes significantly associated with STIR signal volume, ten genes with edema abundancy (a constructed combination of STIR signal volume, height, and intensity), and one gene with expression levels significantly associated with maximum STIR signal intensity. Gene sets related to interferon signaling, mitochondrial metabolism and defense response to virus were identified as significantly enriched among the upregulated genes in all three analyses. Our results point to inflammation and immunological defense as important players in MC biology in patients with chronic LBP.

Funder

Helse Sør-Øst RHF

Helse Vest

Publisher

Springer Science and Business Media LLC

Subject

Multidisciplinary

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