Evidence for proangiogenic cellular and humoral systemic response in patients with acute onset of spinal cord injury

The Journal of Spinal Cord Medicine, 2015 · DOI: 10.1179/2045772314Y.0000000227 · Published: January 1, 2015

Spinal Cord Injury Cardiovascular Science

Simple Explanation

This study investigates the body's response to spinal cord injury (SCI) by examining changes in blood vessel-related cells and factors. Specifically, it looks at endothelial progenitor cells (EPCs) and endothelial cells (ECs), which are important for blood vessel repair, as well as various substances that influence their function after SCI. Researchers measured the levels of EPCs, ECs, and various growth factors in the blood of SCI patients at different times post-injury and compared them to healthy individuals. They also analyzed gene expression in blood cells to understand how SCI affects the body's immune response. The study found that SCI leads to an increase in both EPCs and ECs in the blood, along with changes in the levels of several growth factors. Additionally, gene expression analysis revealed a decrease in immune response-related genes in blood cells of SCI patients.

Study Duration

7 days

Participants

20 patients with SCI and 25 healthy subjects

Evidence Level

Not specified

Key Findings

1
Spinal cord injury (SCI) triggers the mobilization of bone marrow-derived endothelial progenitor cells (EPCs), leading to a higher count of EPCs in the peripheral blood of patients within 7 days post-injury.
2
SCI is associated with an increased number of circulating endothelial cells (ECs) in the peripheral blood, indicating endothelial damage and a systemic response to the injury.
3
The plasma levels of several chemoattractive and proangiogenic cytokines, including HGF, ET-1, Ang2, EGF, and PLGF, are significantly altered in patients with SCI, suggesting their role in the regenerative responses to injury.

Research Summary

This study demonstrates that acute SCI induces a systemic response characterized by increased circulating EPCs and ECs, along with altered levels of chemoattractive and proangiogenic factors. Gene expression analysis reveals a significant downregulation of genes associated with both innate and adaptive immune responses in peripheral blood cells of SCI patients. These findings provide insights into the mechanisms governing the human organism's response to SCI, potentially aiding in the development of effective therapeutic strategies targeting vascular regeneration and immune modulation.

Practical Implications

Therapeutic Development

Understanding the role of EPCs and angiogenic factors in SCI could lead to new therapies aimed at promoting vascular regeneration and improving outcomes for patients.

Diagnostic Markers

Changes in EPC and EC counts, as well as cytokine levels, could serve as potential biomarkers for assessing the severity and progression of SCI.

Immunomodulation Strategies

The observed downregulation of immune response genes suggests that immunomodulatory therapies may be beneficial in managing the secondary damage associated with SCI.

Study Limitations

1
Relatively small sample size.
2
The presence of concomitant injuries in some patients may confound the results.
3
The study focuses on the acute phase of SCI; long-term effects are not evaluated.

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