BACKGROUND Modic changes (MCs), vertebral end plate and bone marrow damage observed by magnetic resonance imaging, are an independent risk factor for low back pain. The compositions of and interaction between microbiota and metabolites in the lumbar cartilaginous end plates (LCEPs) of patients with MCs have not been identified. METHODS Patients with lumbar disc degeneration who were undergoing lumbar spinal fusion surgery were recruited between April 2020 and April 2021. LCEPs were collected for 16S rRNA sequencing and liquid chromatography-mass spectrometry (LC/MS)-based targeted metabolomic profiling. Of the 54 patients recruited, 24 had no MCs and 30 had changes classified as Modic type 2 or 3. The primary goal was to identify specific genera of microbiota associated with MCs, and secondary goals included investigating differences in metabolites between patients with and without MCs and exploring the correlation between these metabolites and microorganisms. RESULTS Investigation of the microbiota community structure revealed that both alpha diversity and beta diversity were significantly different between patients with and without MCs, and the abundances of 26 genera were significantly different between these 2 groups. Metabolomic analysis revealed that 26 metabolites were significantly different between the 2 groups. The unsaturated fatty acid pathway was found to be the main pathway related to MCs. Multiomic correlation analysis suggested that Caulobacteraceae (unclassified) and Mycobacterium, Clostridium, Blautia, and Bifidobacterium at the genus level were linked to dysregulation of fatty acid metabolism, contributing to the pathogenesis of MCs. CONCLUSIONS Our study represents a foundational effort to examine the landscape of the microbiota and metabolites in patients with MCs, informing future studies on the pathogenesis of and targeted therapy for MCs. LEVEL OF EVIDENCE Prognostic Level II . See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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Modic 变化患者的腰软骨终板微生物群和代谢物景观。


背景 磁共振成像观察到的 Modic 变化 （MCs）、椎末板和骨髓损伤是腰痛的独立危险因素。MCs 患者腰软骨终板 （LCEPs） 中微生物群和代谢物的组成和相互作用尚未确定。方法 招募了 2020 年 4 月至 2021 年 4 月期间接受腰椎融合手术的腰椎间盘退变性患者。收集 LCEPs 用于 16S rRNA 测序和基于液相色谱-质谱 （LC/MS） 的靶向代谢组学分析。在招募的 54 名患者中，24 名没有 MC，30 名的变化被归类为 Modic 2 型或 3 型。主要目标是确定与 MCs 相关的微生物群的特定属，次要目标包括调查有和没有 MCs 的患者之间代谢物的差异，并探索这些代谢物与微生物之间的相关性。结果 微生物群落结构调查显示，有和无 MCs 患者的 α 多样性和 β 多样性均存在显著差异，26 个属的丰度在这两组之间存在显著差异。代谢组学分析显示，2 组间 26 种代谢物差异显著。多组学相关性分析表明，Caulobacteraceae （unclassified） 和属水平的分枝杆菌属、梭状芽胞杆菌属、Blautia 和双歧杆菌属与脂肪酸代谢失调有关，有助于 MCs 的发病机制。 结论 我们的研究代表了检查 MCs 患者微生物群和代谢物景观的基础工作，为未来关于 MCs 发病机制和靶向治疗的研究提供信息。证据水平 预后 II 级。有关证据级别的完整描述，请参阅作者说明。