Inflammatory Stress Effects on Health and Function After Spinal Cord Injury

Top Spinal Cord Inj Rehabil, 2017 · DOI: 10.1310/sci2303-207 · Published: July 1, 2017

Spinal Cord Injury Cardiovascular Science Immunology

Simple Explanation

Inflammation is a normal response to injury but can become chronic after spinal cord injury (SCI). This chronic inflammation can worsen other health problems and increase the risk of heart and metabolic diseases. Counteracting chronic inflammation should be considered from the initial injury throughout life. Chronic inflammation after SCI can stem from the body's response to the initial injury, autonomic dysfunction, acute infections (like pneumonia or urinary tract infections), skin and skeletal injuries, obesity, and changes in the gut microbiome. These factors can create a cycle of persistent inflammation. Managing chronic inflammation is crucial for improving the health and quality of life for individuals with SCI. Future research should focus on interventions that can effectively change the gut microbiome and inflammatory phenotype to reduce inflammation-related complications.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
Chronic inflammation worsens secondary medical complications and amplifies the risk for cardiometabolic disorders after injury, directly impacting both the quality of life and mortality risk after SCI.
2
Inflammation can worsen pain and depression and even hinder neurological recovery.
3
Autonomic dysreflexia, common in SCI, can lead to surges in catecholamines and blood pressure, causing endothelial damage and inflammatory stress, thereby accelerating cardiovascular disease.

Research Summary

The inflammatory response plays a significant role in both the acute and chronic phases of SCI as an interrelated, multifactorial process that adversely impacts health and quality of life after injury. Common secondary complications of SCI, such as acute infection, injury to the integumentary and skeletal systems, and obesity can all produce inflammation. Chronic inflammation amplifies the risk for cardiometabolic disorders after injury, although treating inflammation as an independent cardiometabolic risk factor has been widely overlooked for this population.

Practical Implications

Clinical Management

Clinicians should prioritize managing chronic inflammation in SCI patients to improve their health and quality of life.

Research Focus

Future research should focus on interventions that can manipulate the gut microbiome and inflammatory phenotype to reduce inflammation-related complications.

Therapeutic Countermeasures

“Exercise as medicine” and dietary interventions may be effective ways to address the inflammatory state and coincident secondary complications after SCI.

Study Limitations

1
The review acknowledges that research on the gut microbiome in SCI is limited.
2
The review points out the need for further work to examine whether changes in microbiome composition and the inflammatory phenotype can be manipulated after SCI.
3
The authors mention the need to identify which interventions produce the most sustained and impactful changes in inflammation-mediated secondary complications.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury