Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Anne Barton, University of Manchester, United Kingdom
- Second opponent: Professor Vibeke Videm, Norwegian University of Science and Technology, Trondheim
- Third member and chair of the evaluation committee: Professor II Mathias Toft, University of Oslo
Chair of the Defence
Professor II Berit Flatø, University of Oslo
Principal Supervisor
Professor Benedicte Alexandra Lie, University of Oslo
Summary
Chronic low back pain affects people of all ages, genders, and ethnicities, and contributes to disability and lost productivity worldwide. Unfortunately, the underlying cause of the pain is often unknown, and treatment options are few and with limited effect. Long-term antibiotics treatment has lately been suggested for a subgroup of patients having Modic changes, spinal vertebrae lesions identified by MRI, however, on inconsistent evidence basis.
Through whole blood gene expression analyses, this thesis aimed to increase the pathobiological understanding of three subphenotypes of these patients: The volume and intensity of the patients’ spinal lesions measured by MRI, the patients’ self-reported disability and intensity of pain, and long-term antibiotics use.
Patients with increased volume and intensity of their Modic changes as measured on MRI exhibited higher expression of genes involved in mitochondrial metabolism and immune response, particularly interferon signaling. Disability and pain intensity were also reflected in the gene expression of patients, with sex-specific aspects of the immune system implicated in the progress of pain. Long-term antibiotic treatment was found associated with changes in gene expression and DNA methylation that persisted nine months after the treatment was discontinued.
The findings in this thesis point to the importance of inflammation and immune mechanisms in the pathobiology of patients with chronic low back pain with Modic changes, and emphasize the need to consider sex differences in future research and treatment approaches. The study also raises concerns about potential side effects of prolonged antibiotics use.
Additional information
Contact the research support staff.