TUMOR-NECROSIS-FACTOR-ALPHA, INTERLEUKIN-6, AND INTERLEUKIN-8 SECRETION AND THE ACUTE-PHASE RESPONSE IN PATIENTS WITH BACTERIAL AND TUBERCULOUS OSTEOMYELITIS

Osteomyelitis, or bone infection, is a major worldwide cause of morbid ity. Treatment is frequently unsatisfactory, yet little is known about pathogenesis of infection. Plasma tumor necrosis factor (TNF), interl eukin (IL)-6, and IL-8 concentrations mere measured before and after l ipopolysaccharide stimulation of whole blood from patients with bacter ial and tuberculous osteomyelitis and from controls. Patients with bac terial and tuberculous osteomyelitis mounted an acute-phase response a nd were anemic and febrile. However, plasma IL-6 concentrations were s ignificantly elevated in only tuberculous osteomyelitis patients (vs. controls, P < .05). IL-6 concentrations correlated with erythrocyte se dimentation rate, C-reactive protein level, and plasma albumin concent ration, all acute-phase markers. There were no other correlations betw een cytokine concentrations and clinical data. Following ex vivo stimu lation, TNF, IL-6, and IL-8 were secreted equally by patients and cont rols. Ln summary, tuberculous osteomyelitis is characterized by elevat ed systemic IL-6 concentrations associated with an acute-phase respons e. For further insight into immunopathology of osteomyelitis, studies on infected bone are required.