Importance of Propionibacterium acnes hemolytic activity in human intervertebral discs: A microbiological study

Manu N. Capoor, Filip Ruzicka, Gurpreet Sandhu, Jess Rollason, Konstantinos Mavrommatis, Fahad S. Ahmed, Jonathan E. Schmitz, Assaf Raz, Holger Bruggemann, Peter A. Lambert, Vincent A. Fischetti, Ondrej Slaby

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Abstract

Most patients with chronic lower back pain (CLBP) exhibit degenerative disc disease. Disc specimens obtained during initial therapeutic discectomies are often infected/colonized with
Propionibacterium acnes, a Gram-positive commensal of the human skin. Although pain associated with infection is typically ascribed to the body’s inflammatory response, the Gram-positive bacterium Staphylococcus aureus was recently observed to directly activate nociceptors by secreting pore-forming α-hemolysins that disrupt neuronal cell membranes. The hemolytic activity of P. acnes in cultured disc specimens obtained during routine therapeutic discectomies was assessed through incubation on sheep-blood agar. The β-hemolysis pattern displayed by P. acnes on sheep-blood agar was variable and phylogroupdependent. Their molecular phylogroups were correlated with their hemolytic patterns. Our findings raise the possibility that pore-forming proteins contribute to the pathogenesis and/ or symptomology of chronic P. acnes disc infections and CLBP, at least in a subset of cases.
Original languageEnglish
Article numbere0208144
Number of pages10
JournalPLoS ONE
Volume13
Issue number11
DOIs
Publication statusPublished - 29 Nov 2018

Bibliographical note

Copyright: © 2018 Capoor et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original
author and source are credited.

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