Abstract
Purpose
There is considerable controversy on the role of genetics, mechanical and environmental factors, and, recently, on subclinical infection in triggering inflammaging leading to disk degeneration. The present study investigated sequential molecular events in the host, analyzing proteome level changes that will reveal triggering factors of inflammaging and degeneration.
Methods
Ten MRI normal disks (ND) from braindead organ donors and 17 degenerated disks (DD) from surgery were subjected to in-gel-based label-free ESI-LC–MS/MS analysis. Bacterial-responsive host-defense response proteins/pathways leading to Inflammaging were identified and compared between ND and DD.
Results
Out of the 263 well-established host-defense response proteins (HDRPs), 243 proteins were identified, and 64 abundantly expressed HDRPs were analyzed further. Among the 21 HDRPs common to both ND and DD, complement factor 3 (C3) and heparan sulfate proteoglycan 2 (HSPG2) were significantly upregulated, and lysozyme (LYZ), superoxide dismutase 3 (SOD3), phospholipase-A2 (PLA2G2A), and tissue inhibitor of metalloproteinases 3 (TIMP-3) were downregulated in DD. Forty-two specific HDRPs mainly, complement proteins, apolipoproteins, and antimicrobial proteins involved in the complement cascade, neutrophil degranulation, and oxidative-stress regulation pathways representing an ongoing host response to subclinical infection and uncontrolled inflammation were identified in DD. Protein–Protein interaction analysis revealed cross talk between most of the expressed HDRPs, adding evidence to bacterial presence and stimulation of these defense pathways.
Conclusions
The predominance of HDRPs involved in complement cascades, neutrophil degranulation, and oxidative-stress regulation indicated an ongoing infection mediated inflammatory process in DD. Our study has documented increasing evidence for bacteria’s role in triggering the innate immune system leading to chronic inflammation and degenerative disk disease.
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Abbreviations
- A1BG:
-
Alpha 1b glycoprotein
- AMPs:
-
Antimicrobial proteins
- ANIMO:
-
Analysis of Networks with Interactive MOdeling
- APCS:
-
Serum amyloid P component
- ARHGAP5:
-
Rho GTPase activating protein 5
- AZU1:
-
Azurocidin
- BRAF:
-
Proto-oncogene-B-rapidly accelerated fibrosarcoma
- C3:
-
Complement component C3
- C5:
-
Complement component C5
- CA2:
-
Carbonic Anhydrase 2
- CAMP:
-
Cathelicidin–antimicrobial–peptide
- CAT:
-
Catalase
- CFD:
-
Complement factor D
- CFH:
-
Complement factor H
- CHI3L1:
-
Chitinase–3–like–protein–1
- CLR:
-
C-type lectin receptors
- CLU:
-
Clusterin
- CTSG:
-
Cathepsin G
- DAMPs:
-
Disease-associated molecular patterns
- DCD:
-
Dermcidin
- DD:
-
Degenerated disks
- DDD:
-
Degenerative disk disease
- DEFA1:
-
Defensin–Alpha 1
- ECM:
-
Extracellular matrix
- ESI:
-
Electrospray ionization
- GOnet:
-
Interactive tool for gene ontology analysis
- HDRP:
-
Host-defense response proteins
- HP:
-
Haptoglobin
- HSPA8:
-
Heat shock 70 kDa protein A8
- HSPG2:
-
Heparan sulfate proteoglycan 2/perlecan
- ICMR:
-
Indian Council of Medical Research
- IFN-γ:
-
Interferon gamma
- IGHM:
-
Immunoglobulin heavy constant mu
- IL-6:
-
Interleukin 6
- IRB:
-
Institutional review Board
- LC:
-
Liquid chromatography
- LCN2:
-
Lipocalin 2
- LGALS8:
-
Galectin 8
- LL-37:
-
Active Form of CAMP precursor
- LPS:
-
Lipopolysaccharide
- LTA:
-
Lipoteichoic acid
- LTF:
-
Lactotransferrin
- LYZ:
-
Lysozyme
- MAC:
-
Membrane attack complex
- MAPK:
-
Mitogen–Activated protein kinase
- MCP1:
-
Monocyte chemoattractant protein-1
- MCP3:
-
Monocyte chemotactic protein 3
- MPO:
-
Myeloperoxidase
- MRI:
-
Magnetic resonance imaging
- MS/MS:
-
Tandem mass spectrometry
- ND:
-
Normal disks
- NK cells:
-
Natural killer cells
- NLR:
-
NOD-like receptors
- NOD:
-
Nucleotide–binding oligomerization domain
- PAMPs:
-
Pathogen-associated molecular patterns
- PANTHER:
-
Protein annotation through evolutionary relationship
- PGN:
-
Peptidoglycan
- PLA2G2A:
-
Synovial phospholipase A2
- PPI:
-
Protein–protein interaction
- PRDX1:
-
Peroxiredoxin 1
- PRDX2:
-
Peroxiredoxin 2
- PRDX6:
-
Peroxiredoxin 6
- PRR:
-
Pattern recognition receptors
- PSM:
-
Peptide spectral match
- RAF:
-
Rapidly accelerated fibrosarcoma
- RAS:
-
Rat sarcoma
- Reactome:
-
A database of reactions, pathways and biological processes
- RLR:
-
Retinoic acid-inducible gene 1 like receptors
- SOD3:
-
Extracellular superoxide dismutase
- STRING:
-
Search tool for the retrieval of interacting genes/proteins
- TCC:
-
Terminal complement complex
- TIMP3:
-
Tissue inhibitor of metalloproteinase 3
- TLR:
-
Toll–Like receptors
- TNC:
-
Tenascin C
- TNFAIP6:
-
Tumor necrosis factor-inducible gene 6 protein
- TNFα:
-
Tumor necrosis factor alpha or cachexin, or cachectin
- UPPAAL:
-
Tool for interactive modeling
References
Rajasekaran S, Tangavel C, KS, SVA et al (2020) Inflammaging determines health and disease in lumbar discs-evidence from differing proteomic signatures of healthy, aging, and degenerating discs. Spine J Off J North Am Spine Soc 20:48–59. https://doi.org/10.1016/j.spinee.2019.04.023
Sadowska A, Touli E, Hitzl W et al (2018) Inflammaging in cervical and lumbar degenerated intervertebral discs: analysis of proinflammatory cytokine and TRP channel expression. Eur Spine J Off PublEur Spine SocEur Spinal Deform SocEur Sect Cerv Spine Res Soc 27:564–577. https://doi.org/10.1007/s00586-017-5360-8
Capoor MN, Birkenmaier C, Wang JC et al (2019) A review of microscopy-based evidence for the association of propionibacterium acnes biofilms in degenerative disc disease and other diseased human tissue. Eur Spine J 28:2951–2971. https://doi.org/10.1007/s00586-019-06086-y
Ohrt-Nissen S, Fritz BG, Walbom J et al (2018) Bacterial biofilms: a possible mechanism for chronic infection in patients with lumbar disc herniation—a prospective proof-of-concept study using fluorescence in situ hybridization. APMIS 126:440–447. https://doi.org/10.1111/apm.12841
Urquhart DM, Zheng Y, Cheng AC et al (2015) Could low grade bacterial infection contribute to low back pain? A syst rev BMC Med 13:13. https://doi.org/10.1186/s12916-015-0267-x
Rajasekaran S, Tangavel C, Aiyer SN et al (2017) ISSLS PRIZE IN CLINICAL SCIENCE 2017: is infection the possible initiator of disc disease? An insight from proteomic analysis. Eur Spine J OffPublEur Spine SocEur Spinal Deform SocEur Sect Cerv Spine Res Soc 26:1384–1400. https://doi.org/10.1007/s00586-017-4972-3
Lin Y, Tang G, Jiao Y et al (2018) Propionibacterium acnes Induces intervertebral disc degeneration by promoting iNOS/NO and COX-2/PGE2 activation via the ROS-dependent NF-κB pathway. Oxid Med Cell Longev. https://doi.org/10.1155/2018/3692752
Rao PJ, Maharaj M, Chau C et al (2020) Degenerate-disc infection study with contaminant control (DISC): a multicenter prospective case-control trial. Spine J Off J North Am Spine Soc 20:1544–1553. https://doi.org/10.1016/j.spinee.2020.03.013
Fritzell P, Welinder-Olsson C, Jönsson B et al (2019) Bacteria: back pain, leg pain and Modic sign-a surgical multicentre comparative study. Eur Spine J Off PublEur Spine SocEur Spinal Deform SocEur Sect Cerv Spine Res Soc 28:2981–2989. https://doi.org/10.1007/s00586-019-06164-1
Rajasekaran S, Soundararajan DCR, Tangavel C et al (2020) Human intervertebral discs harbour a unique microbiome and dysbiosis determines health and disease. Eur Spine J Off PublEur Spine SocEur Spinal Deform SocEur Sect Cerv Spine Res Soc 29:1621–1640. https://doi.org/10.1007/s00586-020-06446-z
Zybailov B, Mosley AL, Sardiu ME et al (2006) Statistical analysis of membrane proteome expression changes in saccharomyces cerevisiae. J Proteome Res 5:2339–2347. https://doi.org/10.1021/pr060161n
Beck WHJ, Adams CP, Biglang-awa IM et al (2013) Apolipoprotein A-I binding to anionic vesicles and lipopolysaccharides: Role for lysine residues in antimicrobial properties. BiochimBiophysActa BBA - Biomembr 1828:1503–1510. https://doi.org/10.1016/j.bbamem.2013.02.009
Onat A, Hergenç G, Ayhan E et al (2009) Impaired anti-inflammatory function of apolipoprotein A-II concentrations predicts metabolic syndrome and diabetes at 4 years follow-up in elderly Turks. ClinChem Lab Med 47:1389–1394. https://doi.org/10.1515/CCLM.2009.310
Sturm E, Roula D, Theiler A et al (2019) Apolipoprotein A-IV is reduced in serum of allergic patients and acts as an endogenous anti-inflammatory protein. EurRespir J. https://doi.org/10.1183/13993003.congress-2019.OA1625
Gaglione R, Cesaro A, Dell’Olmo E et al (2019) Effects of human antimicrobial cryptides identified in apolipoprotein B depend on specific features of bacterial strains. Sci Rep 9:6728. https://doi.org/10.1038/s41598-019-43063-3
Lee JY, Kang MJ, Choi JY et al (2018) Apolipoprotein B binds to enolase-1 and aggravates inflammation in rheumatoid arthritis. Ann Rheum Dis 77:1480–1489. https://doi.org/10.1136/annrheumdis-2018-213444
Crespo-Sanjuán J, Zamora-Gonzalez N, Calvo-Nieves M, Andres-Ledesma C (2017) Apolipoprotein D
Zhang H, Wu L-M, Wu J (2011) Cross-Talk between Apolipoprotein E and Cytokines. In: Mediators Inflamm. https://www.hindawi.com/journals/mi/2011/949072/. Accessed 16 Oct 2020
Kloske CM, Wilcock DM (2020) The important interface between apolipoprotein E and Neuroinflammation in Alzheimer’s Disease. Front Immunol. https://doi.org/10.3389/fimmu.2020.00754
Tschopp J, Chonn A, Hertig S, French LE (1993) Clusterin, the human apolipoprotein and complement inhibitor, binds to complement C7, C8 beta, and the b domain of C9. J Immunol 151:2159–2165
Vanwalleghem G, Fontaine F, Lecordier L et al (2015) Coupling of lysosomal and mitochondrial membrane permeabilization in trypanolysis by APOL1. Nat Commun 6:8078. https://doi.org/10.1038/ncomms9078
Viennois E, Baker MT, Xiao B et al (2015) Longitudinal study of circulating protein biomarkers in inflammatory bowel disease. J Proteomics 112:166–179. https://doi.org/10.1016/j.jprot.2014.09.002
Liu C-C, Ahearn JM (2005) Chapter 10—acute-phase proteins and inflammation: immunological and clinical implications. In: Lotze MT, Thomson AW (eds) Measuring Immunity. Academic Press, London, pp 131–143
Huang B, Chen J, Zhang X et al (2019) Alpha 2-macroglobulin as dual regulator for both anabolism and catabolism in the cartilaginous endplate of Intervertebral Disc. Spine 44:E338–E347. https://doi.org/10.1097/BRS.0000000000002852
Yang Y, Liu G, He Q et al (2019) A Promising Candidate: Heparin-Binding Protein Steps onto the Stage of Sepsis Prediction. In: J. Immunol. Res. https://www.hindawi.com/journals/jir/2019/7515346/. Accessed 16 Oct 2020.
Gao S, Zhu H, Zuo X, LUO H (2018) Cathepsin G and Its role in inflammation and autoimmune diseases. Arch Rheumatol 33:498–504. https://doi.org/10.5606/ArchRheumatol.2018.6595
Liu PT, Stenger S, Li H et al (2006) Toll-Like receptor triggering of a vitamin D-Mediated human antimicrobial response. Science 311:1770–1773. https://doi.org/10.1126/science.1123933
Ghosh S, Stepicheva N, Yazdankhah M et al (2020) The role of lipocalin-2 in age-related macular degeneration (AMD). Cell Mol Life Sci 77:835–851. https://doi.org/10.1007/s00018-019-03423-8
Teixeira GQ, Yong Z, Goncalves RM et al (2020) Terminal complement complex formation is associated with intervertebral disc degeneration. Eur Spine J. https://doi.org/10.1007/s00586-020-06592-4
Catalase Enhances Viability of Human Chondrocytes in Culture by Reducing Reactive Oxygen Species and Counteracting Tumor Necrosis Factor-α-Induced Apoptosis—PubMed. https://pubmed.ncbi.nlm.nih.gov/30261500/. Accessed 17 Oct 2020
Sly WS, Hewett-Emmett D, Whyte MP et al (1983) Carbonic anhydrase II deficiency identified as the primary defect in the autosomal recessive syndrome of osteopetrosis with renal tubular acidosis and cerebral calcification. ProcNatlAcadSci 80:2752–2756. https://doi.org/10.1073/pnas.80.9.2752
Chandramohanadas R, Davis PH, Beiting DP et al (2009) Apicomplexan parasites co-opt host calpains to facilitate their escape from infected cells. Science 324:794–797. https://doi.org/10.1126/science.1171085
Akhatib B, Önnerfjord P, Gawri R et al (2013) Chondroadherin fragmentation mediated by the protease HTRA1 distinguishes human intervertebral disc degeneration from normal aging. J BiolChem 288:19280–19287. https://doi.org/10.1074/jbc.M112.443010
Kim JY, Han Y, Lee JE, Yenari MA (2018) The 70-kDa heat shock protein (Hsp70) as a therapeutic target for stroke. Expert OpinTher Targets 22:191–199. https://doi.org/10.1080/14728222.2018.1439477
Rosenzweig SD, Holland SM (2016) 11 - Defects of Innate immunity. In: Leung DYM, Szefler SJ, Bonilla FA et al (eds) Pediatric Allergy: Principles and Practice, 3rd edn. Elsevier, London, pp 101-111.e3
Ding C, Fan X, Wu G (2017) Peroxiredoxin 1 – an antioxidant enzyme in cancer. J Cell Mol Med 21:193–202. https://doi.org/10.1111/jcmm.12955
Salzano S, Checconi P, Hanschmann E-M et al (2014) Linkage of inflammation and oxidative stress via release of glutathionylated peroxiredoxin-2, which acts as a danger signal. ProcNatlAcadSci U S A 111:12157–12162. https://doi.org/10.1073/pnas.1401712111
Arevalo JA, Vázquez-Medina JP (2018) The role of Peroxiredoxin 6 in cell signaling. Antioxidants. https://doi.org/10.3390/antiox7120172
Feng C, Yang M, Lan M, et al (2017) ROS: Crucial Intermediators in the Pathogenesis of Intervertebral Disc Degeneration. In: Oxid. Med. Cell. Longev. https://www.hindawi.com/journals/omcl/2017/5601593/. Accessed 28 Sep 2020.
Wang S, Song R, Wang Z et al (2018) S100A8/A9 in inflammation. Front Immunol. https://doi.org/10.3389/fimmu.2018.01298
Muñoz L, Borrero M-J, Úbeda M et al (2019) Intestinal immune dysregulation driven by dysbiosis promotes barrier disruption and bacterial translocation in rats with cirrhosis. HepatolBaltimMd 70:925–938. https://doi.org/10.1002/hep.30349
Franceschi C, Campisi J (2014) Chronic inflammation (inflammaging) and its potential contribution to age-associated diseases. J GerontolABiolSci Med Sci 69(Suppl 1):S4-9. https://doi.org/10.1093/gerona/glu057
van Dijk A, Hedegaard CJ, Haagsman HP, Heegaard PMH (2018) The potential for immunoglobulins and host defense peptides (HDPs) to reduce the use of antibiotics in animal production. Vet Res 49:68. https://doi.org/10.1186/s13567-018-0558-2
Tang D, Kang R, Coyne CB et al (2012) PAMPs and DAMPs: signal 0s that spur autophagy and immunity. Immunol Rev 249:158–175. https://doi.org/10.1111/j.1600-065X.2012.01146.x
Sansonetti PJ (2011) To be or not to be a pathogen: that is the mucosally relevant question. Mucosal Immunol 4:8–14. https://doi.org/10.1038/mi.2010.77
Harder J, Gläser R, Schröder J-M (2007) Human antimicrobial proteins effectors of innate immunity. J Endotoxin Res 13:317–338. https://doi.org/10.1177/0968051907088275
Zhang H, Kim JK, Edwards CA et al (2005) Clusterin inhibits apoptosis by interacting with activated Bax. Nat Cell Biol 7:909–915. https://doi.org/10.1038/ncb1291
Zuo L, Prather ER, Stetskiv M et al (2019) Inflammaging and oxidative stress in human diseases: from molecular mechanisms to novel treatments. Int J MolSci. https://doi.org/10.3390/ijms20184472
Madera L, Ma S, Hancock REW (2011) Host defense (Antimicrobial) peptides and proteins. Immune Response Infect. https://doi.org/10.1128/9781555816872.ch4
Mookherjee N, Hamill P, Gardy J et al (2009) Systems biology evaluation of immune responses induced by human host defence peptide LL-37 in mononuclear cells. MolBiosyst 5:483–496. https://doi.org/10.1039/b813787k
Bachmeier BE, Nerlich A, Mittermaier N et al (2009) Matrix metalloproteinase expression levels suggest distinct enzyme roles during lumbar disc herniation and degeneration. Eur Spine J 18:1573–1586. https://doi.org/10.1007/s00586-009-1031-8
Klos A, Tenner AJ, Johswich K-O et al (2009) The role of the Anaphylatoxins in health and disease. MolImmunol 46:2753–2766. https://doi.org/10.1016/j.molimm.2009.04.027
Krock E, Rosenzweig DH, Currie JB et al (2017) Toll-like receptor activation induces degeneration of human intervertebral discs. Sci Rep 7:17184. https://doi.org/10.1038/s41598-017-17472-1
Hajishengallis G, Lambris JD (2010) Crosstalk pathways between Toll-like receptors and the complement system. Trends Immunol 31:154–163. https://doi.org/10.1016/j.it.2010.01.002
Richmond BW, Du R-H, Han W et al (2018) Bacterial-derived neutrophilic inflammation drives lung remodeling in a mouse model of chronic obstructive pulmonary disease. Am J Respir Cell MolBiol 58:736–744. https://doi.org/10.1165/rcmb.2017-0329OC
Gavin C, Meinke S, Heldring N et al (2019) The complement system is essential for the phagocytosis of mesenchymal stromal cells by monocytes. Front Immunol. https://doi.org/10.3389/fimmu.2019.02249
Wilkins LJ, Monga M, Miller AW (2019) Defining dysbiosis for a cluster of chronic diseases. Sci Rep 9:12918. https://doi.org/10.1038/s41598-019-49452-y
Ragland SA, Criss AK (2017) From bacterial killing to immune modulation: recent insights into the functions of lysozyme. PLoSPathog 13:e1006512. https://doi.org/10.1371/journal.ppat.1006512
van Hensbergen VP, Wu Y, van Sorge NM, Touqui L (2020) Type IIA Secreted phospholipase A2 in host defense against bacterial infections. Trends Immunol 41:313–326. https://doi.org/10.1016/j.it.2020.02.003
Acknowledgement
SR, SDCR, TC, and MR conceived and formulated the project. NSM, TC contributed to the design of the analysis; performed laboratory experiments and bulk of data analysis; SDCR, KSSV, KRM, and SAP wrote and prepared the manuscript. All authors have read through and given the final approval of the submitted publication. We also acknowledge the efforts of Ms M Sujitha and Ms M Dhanalakshmi for assistance in LC–MS/MS experiments.
Funding
The project was funded by Ganga Orthopaedic Research & Education Foundation (GOREF 2019–07).
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Rajasekaran, S., Chitraa, T., Dilip Chand Raja, S. et al. Subclinical infection can be an initiator of inflammaging leading to degenerative disk disease: evidence from host-defense response mechanisms. Eur Spine J 30, 2586–2604 (2021). https://doi.org/10.1007/s00586-021-06826-z
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DOI: https://doi.org/10.1007/s00586-021-06826-z