Expression and significance of cytokines in peripheral blood and bone microenvironment in Kummell's disease, osteoporotic vertebral compression fractures and nonosteoporotic patients.

Objective: To analyze the expression and determine the significance of cytokines in peripheral blood and vertebral blood in the bone microenvironment of patients with osteoporotic vertebral compression fractures (OVCFs) and Kummell's disease (KD).

Methods: From October 2022 to April 2023, 16 patients with osteoporotic vertebral compression fracture (OVCF), 14 patients with Kummell (KD) disease, and 19 patients with lumbar degenerative disease were included in the study. The patients were divided into the OVCF group, KD group and control group. The levels of interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and transforming growth factor-β (TGF-β) in peripheral blood and vertebral blood in the bone microenvironment were detected by enzyme-linked immunosorbent assay. Receiver operating characteristic (ROC) curve analysis was used to determine the correlation between cytokines and the occurrence of OVCF and KD.

Results: The levels of IL-1, IL-6, TGF-β and TNF-α in vertebral blood in the bone microenvironment of the KD group were significantly higher than those in peripheral blood (p = 0.001, p < 0.001, p = 0.017, p < 0.001). Compared with the control group, the OVCF displayed a marked increase in the expression of IL-1, IL-6, and TNF-α and a significant reduction in the expression of TGF-β (p < 0.001). In addition, compared with the vertebral blood in the bone microenvironment of the control group, the levels of IL-1, IL-6 and TNF-α in the vertebral blood in the bone microenvironment of the KD group were significantly increased (p < 0.001). and compared with the vertebral blood in the bone microenvironment of OVCF group, the levels of IL-1, IL-6 and TNF-α in the vertebral blood in the bone microenvironment of the KD group were significantly increased (p = 0.014, p = 0.020, p = 0.006). Moreover, Compared to peripheral blood, the vertebral blood within the bone microenvironment demonstrated increased area under the curve (AUC) values for the associations of IL-1, IL-6, and TNF-α with OVCF and Kummell's disease KD.

Conclusions: The expression levels of IL-1, IL-6 and TNF-α in OVCFs and KD were increased, but that of TGF-β was decreased. The levels of IL-1, IL-6 and TNF-α in the vertebral blood of KD patients were significantly increased, which can promote vertebral osteonecrosis and bone nonunion in KD patients. Alterations in the expression levels of these proinflammatory cytokines maybe demonstrate a significant correlation with the pathogenesis of OVCF and KD.