Peripheral Immune Dysfunction: A Problem of Central Importance After Spinal Cord Injury

Overview

Journal Biology (Basel)

Publisher MDPI

Specialty Biology

Date 2021 Sep 28

PMID 34571804

Citations 12

Authors

Marisa A Jeffries

Veronica J Tom

Affiliations

Soon will be listed here.

Abstract

Individuals with spinal cord injuries (SCI) exhibit increased susceptibility to infection, with pneumonia consistently ranking as a leading cause of death. Despite this statistic, chronic inflammation and concurrent immune suppression have only recently begun to be explored mechanistically. Investigators have now identified numerous changes that occur in the peripheral immune system post-SCI, including splenic atrophy, reduced circulating lymphocytes, and impaired lymphocyte function. These effects stem from maladaptive changes in the spinal cord after injury, including plasticity within the spinal sympathetic reflex circuit that results in exaggerated sympathetic output in response to peripheral stimulation below injury level. Such pathological activity is particularly evident after a severe high-level injury above thoracic spinal cord segment 6, greatly increasing the risk of the development of sympathetic hyperreflexia and subsequent disrupted regulation of lymphoid organs. Encouragingly, studies have presented evidence for promising therapies, such as modulation of neuroimmune activity, to improve regulation of peripheral immune function. In this review, we summarize recent publications examining (1) how various immune functions and populations are affected, (2) mechanisms behind SCI-induced immune dysfunction, and (3) potential interventions to improve SCI individuals' immunological function to strengthen resistance to potentially deadly infections.

Citing Articles

Short- and long-term effects of transcutaneous spinal cord stimulation on autonomic cardiovascular control and arm-crank exercise capacity in individuals with a spinal cord injury (STIMEX-SCI): study protocol.

Hodgkiss D, Balthazaar S, Welch J, Wadley A, Cox P, Lucas R BMJ Open. 2025; 15(1):e089756.

PMID: 39819908 PMC: 11751795. DOI: 10.1136/bmjopen-2024-089756.

Urinary Tract Infections in Relation to Bladder Emptying in Patients with Spinal Cord Injury.

Milicevic S, Sekulic A, Nikolic D, Tomasevic-Todorovic S, Lazarevic K, Pelemis S J Clin Med. 2024; 13(13).

PMID: 38999463 PMC: 11242679. DOI: 10.3390/jcm13133898.

Patients with Chronic Spinal Cord Injury Display a Progressive Alteration over the Years of the Activation Stages of the T Lymphocyte Compartment.

Haro S, Gomez-Lahoz A, Monserrat J, Atienza-Perez M, Fraile-Martinez O, Ortega M Int J Mol Sci. 2023; 24(24).

PMID: 38139422 PMC: 10744286. DOI: 10.3390/ijms242417596.

Immune Status of Individuals with Traumatic Spinal Cord Injury: A Systematic Review and Meta-Analysis.

Valido E, Boehl G, Krebs J, Pannek J, Stojic S, Atanasov A Int J Mol Sci. 2023; 24(22).

PMID: 38003575 PMC: 10670917. DOI: 10.3390/ijms242216385.

Epidural Steroid Injection Prior to Spinal Surgery: A Step-Wise and Wise Approach.

Kozak M, Hallan D, Rizk E Cureus. 2023; 15(9):e45125.

PMID: 37842405 PMC: 10569744. DOI: 10.7759/cureus.45125.

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