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PLoS One. 2018 Nov 29;13(11):e0208144. doi: 10.1371/journal.pone.0208144. eCollection 2018.

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

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Laboratory of Bacterial Pathogenesis and Immunology, Rockefeller University, New York, New York, United States of America.
Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic.
Department of Microbiology, Faculty of Medicine, Masaryk University, St. Anne's University Hospital, Brno, Czech Republic.
Faculty of Health and Life Sciences, School of Life Sciences, Coventry University, Coventry, United Kingdom.
Celgene Corporation, Information Knowledge and Utilization, San Francisco, California, United States of America.
Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America.
Department of Biomedicine, Aarhus University, Aarhus, Denmark.
The School of Life and Health Sciences, Aston University, Aston Triangle, Birmingham, United Kingdom.


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 phylogroup-dependent. 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.

Conflict of interest statement

MNC, FSA, JCB, JLS, OS, JES, KM, and VAF have stock ownership or options in DiscitisDX, Inc. KM is an employee of Celgene Corporation. There are no other financial or non-financial competing interests. This does not alter the authors' adherence to PLOS policies on sharing data and materials.

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