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Tumor Necrosis Factor‐α, Interleukin‐6, and Interleukin‐8 Secretion and the Acute‐Phase Response in Patients with Bacterial and Tuberculous Osteomyelitis

1998; Oxford University Press; Volume: 177; Issue: 6 Linguagem: Inglês

10.1086/515313

1537-6613

Carlton A. Evans, John E. Jellis, Sean Hughes, Daniel G. Remick, Jon S. Friedland,

Hematological disorders and diagnostics

Osteomyelitis, or bone infection, is a major worldwide cause of morbidity. Treatment is frequently unsatisfactory, yet little is known about pathogenesis of infection. Plasma tumor necrosis factor (TNF), interleukin (IL)-6, and IL-8 concentrations were measured before and after lipopolysaccharide stimulation of whole blood from patients with bacterial and tuberculous osteomyelitis and from controls. Patients with bacterial and tuberculous osteomyelitis mounted an acute-phase response and were anemic and febrile. However, plasma IL-6 concentrations were significantly elevated in only tuberculous osteomyelitis patients (vs. controls, P <.05). IL-6 concentrations correlated with erythrocyte sedimentation rate, C-reactive protein level, and plasma albumin concentration, all acute-phase markers. There were no other correlations between cytokine concentrations and clinical data. Following ex vivo stimulation, TNF, IL-6, and IL-8 were secreted equally by patients and controls. In summary, tuberculous osteomyelitis is characterized by elevated systemic IL-6 concentrations associated with an acute-phase response. For further insight into immunopathology of osteomyelitis, studies on infected bone are required.