Multiple organ dysfunction and systemic inflammation after spinal cord injury: a complex relationship

Journal of Neuroinflammation, 2016 · DOI: 10.1186/s12974-016-0736-y · Published: September 28, 2016

Spinal Cord Injury Critical Care Immunology

Simple Explanation

Spinal cord injury (SCI) can lead to complications beyond the initial damage, including dysfunction in various organs. These complications can hinder recovery and even be life-threatening. Systemic inflammation and immune suppression following SCI are believed to play a role in these complications. The review summarizes evidence demonstrating their relevance and discusses potential therapeutic approaches. This review highlights the potential pathways by which inflammatory and immune cues contribute to multiple organ failure and dysfunction and discusses current anti-inflammatory approaches used to alleviate post-SCI complications.

Study Duration

Not specified

Participants

16 SCI patients and ten healthy controls in a pilot study

Evidence Level

Review

Key Findings

1
SCI triggers systemic inflammatory responses, marked by increased immune cells and pro-inflammatory mediators, leading to inflammation in secondary organs.
2
SCI induces immune deficiency through immune organ dysfunction, resulting in impaired responsiveness to pathogen infection.
3
Many anti-inflammatory strategies that attempt to ameliorate local intraspinal inflammation and promote neural tissue repair may find their true value in alleviating dysfunction in multiple organs secondary to the injured spinal cord.

Research Summary

Post-SCI multiple organ dysfunction is influenced by multifactorial mechanisms, and the extent to which systemic inflammation and immune depression contribute to SCI-associated complications is still an open question. Systemic inflammatory responses following SCI induce infiltration of inflammatory cells into secondary tissues, activation of resident immune cells, and stimulation of pro-inflammatory cytokine production, all of which contribute to the pathogenesis of multiple organ dysfunction after SCI. Therefore, inflammation and immunity not only contribute to the progression of intraspinal injury but also are important determinants of multiple organ dysfunction after SCI.

Practical Implications

Therapeutic Targets

Targeting systemic inflammation and immune suppression may provide new therapeutic strategies against complications after SCI.

Immunomodulatory Therapies

Immunomodulators of inflammation-associated pathways, small-molecule agonists or antagonists, and blocking antibodies are promising tools to mitigate complications after SCI.

Co-application of Therapies

Co-application of anti-inflammatory strategies with other treatment approaches after SCI may provide a therapeutic benefit for patients.

Study Limitations

1
The extent to which systemic inflammation and immune depression contribute to SCI-associated complications is still an open question.
2
There is a lack of human clinical trials employing anti-inflammatory strategies for SCI-induced multiple organ dysfunction.
3
Detailed mechanisms of how post-SCI complications develop with systemic inflammation and suppressed immunity need further understanding.

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