Tumor necrosis factor-alpha, interleukin-6, and interleukin-8 secretion and the acute-phase response in patients with bacterial and tuberculous osteomyelitis

J Infect Dis. 1998 Jun;177(6):1582-7. doi: 10.1086/515313.


Osteomyelitis, or bone infection, is a major worldwide cause of morbidity. Treatment is frequently unsatisfactory, yet little is known about pathogenesis of infection. Plasma tumor necrosis factor (TNF), interleukin (IL)-6, and IL-8 concentrations were measured before and after lipopolysaccharide stimulation of whole blood from patients with bacterial and tuberculous osteomyelitis and from controls. Patients with bacterial and tuberculous osteomyelitis mounted an acute-phase response and were anemic and febrile. However, plasma IL-6 concentrations were significantly elevated in only tuberculous osteomyelitis patients (vs. controls, P < .05). IL-6 concentrations correlated with erythrocyte sedimentation rate, C-reactive protein level, and plasma albumin concentration, all acute-phase markers. There were no other correlations between cytokine concentrations and clinical data. Following ex vivo stimulation, TNF, IL-6, and IL-8 were secreted equally by patients and controls. In summary, tuberculous osteomyelitis is characterized by elevated systemic IL-6 concentrations associated with an acute-phase response. For further insight into immunopathology of osteomyelitis, studies on infected bone are required.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acute-Phase Reaction / immunology*
  • Adult
  • Bacterial Infections / immunology*
  • Cytokines / metabolism*
  • Female
  • Humans
  • Interleukin-6 / blood
  • Interleukin-6 / metabolism
  • Interleukin-8 / blood
  • Interleukin-8 / metabolism
  • Male
  • Osteomyelitis / immunology*
  • Osteomyelitis / microbiology
  • Tuberculosis / immunology*
  • Tuberculosis, Osteoarticular / immunology*
  • Tumor Necrosis Factor-alpha / metabolism


  • Cytokines
  • Interleukin-6
  • Interleukin-8
  • Tumor Necrosis Factor-alpha