University of Oulu

Karppinen, J., Koivisto, K., Ketola, J. et al. Serum biomarkers for Modic changes in patients with chronic low back pain. Eur Spine J 30, 1018–1027 (2021).

Serum biomarkers for Modic changes in patients with chronic low back pain

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Author: Karppinen, Jaro1,2,3; Koivisto, Katri1; Ketola, Jukka1;
Organizations: 1Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
2Center for Life Course Health Research, University of Oulu, Oulu, Finland
3Finnish Institute of Occupational Health, Oulu, Finland
4Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
5Research Unit of Biomedicine and Biocenter Oulu, Department of Physiology, University of Oulu, Oulu, Finland
6Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland
7AO Research Institute, Davos, Switzerland
8Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, USA
9Center of Experimental Rheumatology, University Hospital Zurich, Zurich, Switzerland
10Department of Orthopaedic Surgery, RUSH University Medical Center, Suite 204-G, 1611 W. Harrison Street, Orthopaedic BuildingChicago, IL, 60612, USA
11International Spine Research and Innovation Initiative, RUSH University, Chicago, USA
12Northern Finland Laboratory Centre NordLab, Oulu University Hospital, Oulu, Finland
13Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
Persistent link:
Language: English
Published: Springer Nature, 2021
Publish Date: 2022-02-23


Purpose: Lumbar Modic change (MC) can serve as a diagnostic marker as well as an independent source of chronic low back pain (CLBP). This study aimed to test for the existence of serum biomarkers in CLBP patients with MC.

Methods: Age- and sex-matched CLBP patients with confirmed MC on lumbar MRI (n = 40) and pain-free controls (n = 40) were assessed. MC was classified into M1, predominating M1, predominating M2 and M2. MC volumes were calculated. Fasting blood samples were assessed for inflammatory mediators, signalling molecules, growth factors and bone turnover markers. Serum concentrations of 46 biomarkers were measured.

Results: Median concentrations of interleukin (IL)-15 (p < 0.001), IL-8 (p < 0.001), tumour necrosis factor (TNF)-alpha (p < 0.001), Eotaxin-1 (p < 0.05), Eotaxin-3 (p < 0.001), monocyte chemotactic protein (MCP)-1 (p < 0.05), macrophage inflammatory protein (MIP)-1alpha (p < 0.01), TEK receptor tyrosine kinase (Tie)-2 (p < 0.001), vascular cell adhesion molecule (VCAM)-1 (p < 0.001), RANTES (p < 0.001), C telopeptide of type I collagen (CTX)-1 (p < 0.001), vascular endothelial growth factor (VEGF)-C (p < 0.001), VEGF-D (p < 0.05), fms-related tyrosine kinase (Flt)-1 (p < 0.01) and intercellular adhesion molecule (ICAM)-1 (p < 0.01) were significantly higher among controls. IL-1sRII (23.2 vs. 15.5 ng/ml, p < 0.001) and hepatocyte growth factor (HGF)-1 (169 vs. 105 pg/ml, p < 0.01) concentrations were significantly higher among patients. Type or volume of MC was not associated with biomarker concentrations.

Conclusions: This is the first study to assess the blood serum biomarker profile in individuals with CLBP with MC. Several biomarkers were suppressed, while two markers (IL-1sRII and HGF) were elevated among MC patients, irrespective of MC type or size, with CLBP compared with asymptomatic controls.

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Series: European spine journal
ISSN: 0940-6719
ISSN-E: 1432-0932
ISSN-L: 0940-6719
Volume: 30
Pages: 1018 - 1027
DOI: 10.1007/s00586-020-06713-z
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Copyright information: This is a post-peer-review, pre-copyedit version of an article published in Eur Spine J. The final authenticated version is available online at