Brain, 2021 · DOI: 10.1093/brain/awaa360 · Published: December 1, 2020
This study examines the inflammatory response and tissue damage in human spinal cord injuries. It compares spinal cord tissue from individuals with traumatic injuries to those without, focusing on immune cells and oxidative damage. The research identifies different patterns of inflammation in the core of the injury versus the surrounding tissue. The lesion core showed infiltration of blood-derived macrophages, while the surrounding rim showed proliferation of microglia with a pro-inflammatory phenotype. The study also found evidence of long-term oxidative damage in the tissue surrounding the injury, suggesting it may contribute to ongoing problems after the initial trauma.
The different inflammatory cellular composition and activation in the lesion core compared with its rim results in distinct inflammatory milieus of relevance for topical cell transplantation, but also neuroprotective, or immunomodulatory interventions in SCI patients.
Long-lasting oxidative tissue injury might be a substantial contributor to (i) an impaired response to rehabilitation; (ii) overall failure of recovery; or (iii) delayed loss of recovered function. This suggests the need for therapies addressing oxidative stress to improve rehabilitation outcomes.
The identification of a subpopulation of SCI patients with B cell infiltration and antibody synthesis suggests that B cell- and antibody-mediated neurotoxic immune mechanisms may contribute to tissue injury in a subset of SCI patients. These patients may benefit from targeted immunotherapies.