Different responses of cervical intervertebral disc caused by low and high virulence bacterial infection: a comparative study in rats

Bioengineered. 2022 May;13(5):12446-12461. doi: 10.1080/21655979.2022.2075305.

Abstract

The aims of this study were to investigate the outcomes of low- and high-virulence bacterial cervical intervertebral discs (IVDs) infection and its association with cervical IVDs degeneration in rats. A total of 75 clean grade male rats were used to establish the corresponding animal models of low and high virulent bacterial cervical disc infection via an anterior cervical approach, with injection of Propionibacterium acnes (P. acnes) and Staphylococcus epidermidis (S. epidermidis) with a 29 G needle to cervical IVDs. Specimens were collected for evaluation of Blood routine (Blood-RT), histological staining, and gene expression assays after a magnetic resonance imaging (MRI) scan. There were no statistical differences in all groups in white blood cells (WBC) at 2 and 6 weeks postoperatively (P = 0.136). The highest percentage of neutrophils was found in the S. epidermidis group at 2 weeks postoperatively (P = 0.043). MRI and histology showed that at 6 weeks postoperatively, the puncture group and P. acnes group had similar disc degeneration. In the S. epidermidis group, the disc and subchondral bone structure had been destroyed and bony fusion had occurred after the discitis. The upregulation of pro-inflammatory factor expression had the strongest effect of S. epidermidis on the early stage, while the upregulation in the puncture and P. acnes groups was more persistent. P. acnes infection of the cervical IVDs can lead to degenerative changes, whereas S. epidermidis infection leads to the manifestation of septic discitis. The correlation between P. acnes infection and cervical IVDs degeneration found in clinical studies was confirmed.

Keywords: Cervical intervertebral discs; Propionibacterium acnes; disc low virulent bacterial infections; discitis staphylococcus.

MeSH terms

  • Animals
  • Discitis* / complications
  • Discitis* / diagnostic imaging
  • Discitis* / pathology
  • Gram-Positive Bacterial Infections* / complications
  • Gram-Positive Bacterial Infections* / microbiology
  • Gram-Positive Bacterial Infections* / pathology
  • Intervertebral Disc Degeneration* / diagnostic imaging
  • Intervertebral Disc* / diagnostic imaging
  • Intervertebral Disc* / microbiology
  • Intervertebral Disc* / pathology
  • Male
  • Propionibacterium acnes / physiology
  • Rats
  • Virulence

Grants and funding

This study was supported by National Natural Science Foundation of China (project number 81871796 and 81802192). Zhejiang Provincial Natural Science Foundation of China (project number LGF19H180016). Ningbo Natural Science Foundation (project number 202003N4279)