Interleukin 6 gene polymorphism in patients with degenerative lumbar scoliosis: a cohort study

A study on vertebral refracture and scoliosis after percutaneous kyphoplasty in patients with osteoporotic vertebral compression fractures

PURPOSE

To analyze the association between scoliosis and vertebral refracture after percutaneous kyphoplasty (PKP) in patients with osteoporotic vertebral compression fractures (OVCFs).

METHODS

A retrospective study was conducted on 269 patients meeting the criteria from January 2014 to October 2022. All patients underwent PKP with complete data and were followed-up for > 12 months. First, it was verified that scoliosis was a risk factor in 269 patients. Second, patients with scoliosis were grouped based on the Cobb angle to evaluate the impact of the post-operative angle. The cox proportional hazards regression analysis and survival analysis were used to calculate the hazard ratio and recurrence time.

RESULTS

A total of 56 patients had scoliosis, 18 of whom experienced refractures after PKP. The risk factors for vertebral refractures included a T-score < - 3.0 and presence of scoliosis (both p < 0.001). The results indicated that the vertebral fractured arc (T10 - L4) was highly influential in scoliosis and vertebral fractures. When scoliotic and initially fractured vertebrae were situated within T10 - L4, the risk factors for vertebral refracture included a postoperative Cobb angle of ≥ 20° (p = 0.002) and an increased angle (p = 0.001). The mean recurrence times were 17.2 (10.7 - 23.7) months and 17.6 (7.9 - 27.3) months, respectively.

CONCLUSION

Osteoporosis combined with scoliosis significantly increases the risk of vertebral refractures after PKP in patients with OVCFs. A postoperative Cobb angle of ≥ 20° and an increased angle are significant risk factors for vertebral refractures when scoliotic and initially fractured vertebrae are situated within T10 - L4.

Biological principles of adult degenerative scoliosis

The global aging population has led to an increase in geriatric diseases, including adult degenerative scoliosis (ADS). ADS is a spinal deformity affecting adults, particularly females. It is characterized by asymmetric intervertebral disc and facet joint degeneration, leading to spinal imbalance that can result in severe pain and neurological deficits, thus significantly reducing the quality of life. Despite improved management, molecular mechanisms driving ADS remain unclear. Current literature primarily comprises epidemiological and clinical studies. Here, we investigate the molecular mechanisms underlying ADS, with a focus on angiogenesis, inflammation, extracellular matrix remodeling, osteoporosis, sarcopenia, and biomechanical stress. We discuss current limitations and challenges in the field and highlight potential translational applications that may arise with a better understanding of these mechanisms.

Genetic and serum markers in adult degenerative scoliosis: a literature review

STUDY DESIGN

Literature review.

OBJECTIVE

Adult degenerative scoliosis (ADS) is becoming a more prevalent diagnosis with an increasing elderly population. Our objective is to provide a literature review of genetic and serum markers in ADS.

METHODS

A literature review was conducted in the various databases from their inception to July 2020. Studies that reviewed any genetic or serum markers of ADS whether in detection or progression were selected. Studies that reviewed congenital scoliosis or adolescent idiopathic scoliosis (AIS) were excluded.

RESULTS

A total of 1447 titles were identified of which 14 were included in the final review. Two papers reported on serum markers pertaining to serum cartilage metabolites and pentosidine. Twelve studies reported on genetic markers including gene polymorphisms in estrogen receptors, parathyroid hormone receptors, interleukin 6, cyclooxygenase-2 (COX-2), COL2A1, GPRIN1, TRAIL, GRIN receptor, RIMS, LBX1 as well as copy number variations.

CONCLUSIONS

Serum markers of osteoarthritis and sarcopenia have been found to be significantly elevated in ADS patients as well. Numerous polymorphisms have been found in a variety of genes playing key roles in bone formation and regulation. Further research is needed in validating previous studies as well as identifying other biomarkers for patients at risk for developing ADS.

Associations between IL-6 Variations and Congenital Heart Disease Incidence among Chinese Han People

Background

Our research explored if Interleukin-6 (IL-6) variants held substantial connection to congenital heart disease (CHD) susceptibility among Chinese Han children.

Material/Methods

A total of 102 CHD children were recruited as the case group while 98 healthy persons were recruited as the control group. We used polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) completed genotyping for IL-6 variants rs1800795 and rs1800796. The Hardy-Weinberg equilibrium (HWE) among controls was tested using χ² analysis. Genotype and allele frequencies for variants were compared between groups. Odds ratio (OR) accompanied by 95% confidence interval (CI) reflected the potential link of IL-6 variants to CHD occurrence.

Results

A remarkable increased trend of rs1800795 CC genotype and C allele was detected in the CHD patient group (P<0.05). Individuals carrying rs1800795 CC genotype showed higher risk for CHD (OR=3.763, 95% CI=1.162–12.190). In addition, rs1800795 C allele could increase CHD incidence (OR=1.766, 95% CI=1.101–2.832). No significant differences were detected in IL-6 gene rs1800796 polymorphism in both genotype and allele distributions between the case group and the control group (P>0.05). These associations had no significant alteration after the adjustment of age, gender, maternal smoking history, and maternal history of diabetes.

Conclusions

IL-6 variant rs1800795 exhibited a close relation to CHD susceptibility among Chinese Han people while the mutant C allele promoted CHD incidence. But rs1800796 variant showed no such influence.

Association of the IL-6 -174G > C (rs1800795) Polymorphism with Adolescent Idiopathic Scoliosis: Evidence from a Case-Control Study and Meta-Analysis

Recent epidemiological studies have identified that the -174G > C (rs1800795) polymorphism in the promoter region of the interleukin-6 ( IL-6 ) gene is associated with the risk of developing adolescent idiopathic scoliosis (AIS), but they presented inconsistent and controversial results. Thus, we performed a case-control study and meta-analysis to derive a more precise estimation of the relationship between the IL-6 -174G > C polymorphism and the risk of developing AIS. A total of 80 patients with AIS and 80 matched healthy control subjects were genotyped using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. In addition, all eligible studies published up to June 2018 were identified through a search in the PubMed, EMBASE, Google Scholar, and China National Knowledge Infrastructure (CNKI) databases. We calculated the odds ratios (ORs) and 95% confidence intervals (95%CIs) to assess the association. A total of 10 eligible studies comprising 1,695 AIS cases and 2,097 healthy controls were included in the meta-analysis. The pooled data suggested a significant association between the IL-6 -174G > C polymorphism and the susceptibility to develop AIS, which was demonstrated under 4 genetic models, that is, the allelic (C versus G; OR = 0.671; 95%CI: 0.457–0.985; p  = 0.042), heterozygous (CG versus GG; OR = 0.734; 95%CI: 0.554–0.973; p  = 0.032), dominant (CC + CG versus GG; OR = 0.660; 95%CI: 0.440–0.990; p  = 0.044) and recessive models (CC versus CG + GG; OR = 0.506; 95%CI: 0.264–0.970; p  = 0.040). The stratification analysis by ethnicity revealed an increased risk of developing AIS in Caucasians, but not in Asians. The present meta-analysis, which is inconsistent with the previous meta-analysis, suggests that the IL-6 -174G > C polymorphism may increase the individual susceptibility to develop AIS, especially in Caucasians, and it could serve as a biomarker to predict the population at high risk of developing AIS.

Association of Susceptibility Genes for Adolescent Idiopathic Scoliosis and Intervertebral Disc Degeneration With Adult Spinal Deformity

STUDY DESIGN

Genetic case-control study of single nucleotide polymorphisms (SNPs).

OBJECTIVE

To examine the association of previously reported susceptibility genes for adolescent idiopathic scoliosis (AIS) and intervertebral disc (IVD) degeneration with adult spinal deformity (ASD).

SUMMARY OF BACKGROUND DATA

ASD is a spinal deformity that develops and progresses with age. Its etiology is unclear. Several ASD susceptibility genes were recently reported using a candidate gene approach; however, the sample sizes were small and associations with ASD development were not determined.

METHODS

ASD was defined as structural scoliosis with a Cobb angle more than 15° on standing radiographs, taken of patients at age 40 to 75 years in this study. Subjects in whom scoliosis was diagnosed before age 20 were excluded. We recruited 356 Japanese ASD subjects and 3341 healthy controls for case-control association studies of previously reported SNPs. We genotyped four known AIS-associated SNPs (rs11190870 in LBX1, rs6570507 in GPR126, rs10738445 in BNC2, and rs6137473 in PAX1) and three IVD degeneration-associated SNPs (rs1245582 in CHST3, rs2073711 in CILP, and rs1676486 in COL11A1) by the Invader assay.

RESULTS

Among the AIS-associated SNPs, rs11190870 and rs6137473 showed strong and nominal associations with ASD (P = 1.44 × 10, 1.00 × 10, respectively). Of the IVD degeneration-associated SNPs, rs1245582 and rs2073711 showed no association with ASD, while rs1676486 showed a nominal association (P = 1.10 × 10). In a subgroup analysis, rs11190870 was significantly associated with a Cobb angle more than 20° in the minor thoracic curve (P = 1.44 × 10) and with a left convex lumbar curve (P = 6.70 × 10), and nominally associated with an apical vertebra higher than L1 (P = 1.80 × 10).

CONCLUSION

rs11190870 in LBX1, a strong susceptibility SNP for AIS, may also be a susceptibility SNP for ASD. Thus, ASD and AIS may share a common genetic background.

LEVEL OF EVIDENCE

4.

Significant association of IL-6-572G/C, IL-6-597G/A, and IL-6-174G/C polymorphisms and susceptibility to lumbar degenerative disease: A meta-analysis

OBJECTIVES

To assess and synthesize the current evidence on the association of interleukin-6 (IL-6)-572 G/C, IL-6-597 G/A, and IL-6-174 G/C polymorphisms and risk of lumbar degenerative disease (LDD).

PATIENTS AND METHODS

Five electronic databases including PubMed, EMBASE, Web of Science, CNKI and Wanfang were systematically searched for potential studies previous to August 10, 2018. Summary odds ratio (OR) and corresponding 95% confidence interval (95%CI) were calculated to evaluate the association.

RESULTS

Nine case-control studies comprising 1519 cases and 1887 controls were obtained for the meta-analysis. For IL-6-572 G/C, IL-6-597 G/A, and IL-6-174 G/C polymorphisms, there were seven, six, and seven studies eventually included in the meta-analysis respectively. The findings indicated that the three polymorphisms had significant associations with risk of LDD: for IL-6-572 G/C, G vs. C, OR = 1.37, 95%CI 1.11-1.69, P = 0.004; for IL-6-597 G/A, G vs. A, OR = 1.38, 95 %CI 1.16-1.65, P = 0.000; for IL-6-174 G/C, G vs. C, OR = 1.63, 95%CI 1.15-2.29, P = 0.006.

CONCLUSION

The present meta-analysis found IL-6-572 G/C, IL-6-597 G/A, and IL-6-174 G/C polymorphisms were significantly associated with increased risk of LDD susceptibility.