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Spine

PILOT ANALYSIS OF ASSOCIATION BETWEEN GUT MICROBIOME AND MODIC CHANGES

The Society for Back Pain Research (SBPR) Annual General Meeting 2019, ‘From Bench to Bedside’. Sheffield, England, 5–6 September 2019.



Abstract

Objective

Modic changes (MC) is a form of intervertebral disc degeneration visible as subchondral and vertebral bone marrow changes on spine magnetic resonance (MR). Their etiology is not understood, but microbial infection may be involved for some subtypes. This study set out to test for an association between MC and gut microbiome in a population sample.

Methods

Presence of MC was evaluated in lumbar MR images and gut microbiome assessed using 16S sequencing in TwinsUK dataset (N=309). Cases were identified by the presence of MC of any type, while controls were those without MC. Amplicon sequence variants (ASVs) have been obtained for 16S sequences followed by relative abundance calculation and centred log-ratio transformation. Linear mixed-effects models were applied to test for association between the ASVs at different taxon levels and MC adjusting for technical covariates and demographics.

Results

Nominally significant (p<0.05) associations with MC were obtained for 6 ASVs annotated to species level (min p = 0.0016 for Sanguibacteroides justesenii), 8 ASVs annotated to genus level (min p = 0.0091 for Syntrophomonas), and 2 ASVs annotated to family level (min p = 0.0099 for Syntrophomonadaceae). None of the associations were significant after correction for multiple testing. Also, no statistically significant difference in microbial diversity was found between MC cases and controls.

Conclusions

The results of this pilot study provide limited evidence of association between MC and gut microbiome. Further studies including MC stratified by subtype are warranted as well as studies based on advanced metagenome sequencing rather than 16S approach.

No conflicts of interest

The study was supported by Versus Arthritis grant # 21227


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