Neurotoxic or Neuroprotective? Current Controversies in SCI-Induced Autoimmunity

Curr Phys Med Rehabil Reports, 2013 · DOI: 10.1007/s40141-013-0021-2 · Published: September 1, 2013

Simple Explanation

Following a spinal cord injury (SCI), the body's immune system responds, but it's unclear whether this response is helpful (neuroprotective) or harmful (neurotoxic). Some evidence suggests the immune response damages tissue, while other studies indicate it aids in tissue regeneration. B cells, a type of immune cell, can produce antibodies that attack the body's own tissues, potentially worsening the damage after SCI. However, T cells, another type of immune cell, may promote tissue repair and regeneration in the injured spinal cord. Dendritic cells (DCs), which activate T cells, have shown promise in improving motor function recovery in SCI animal models when used in vaccination therapy. Further research is needed to understand the roles of B and T cells after SCI and to test the effectiveness of DC vaccination in humans.

Study Duration

Not specified

Participants

13 subjects with SCI and 7 controls (for one study mentioned) or rodent models

Evidence Level

Review of experimental and clinical studies

Key Findings

1
B cells may mediate a harmful autoimmune response following SCI, with B cell knockout mice experiencing less reduction in motor function after SCI than wild-type mice.
2
T cells can play a role in recruiting other resident CNS cells implicated in tissue repair and regeneration, suggesting a protective role of autoimmunity after SCI.
3
Dendritic cell vaccination, where DCs are exposed to CNS antigens and injected into injured animals, has shown neuroprotective effects and improved recovery in rodent models of SCI.

Research Summary

The review addresses the controversy surrounding the autoimmune response following traumatic spinal cord injury (SCI), exploring whether it is primarily neuroprotective, neurotoxic, or a combination of both. B cells have been implicated in pathological autoimmunity after SCI through the production of auto-antibodies and pro-inflammatory cytokines, contributing to tissue damage and hindering recovery. T cells and dendritic cells have demonstrated potential for protective autoimmunity, promoting tissue repair and regeneration after SCI, with dendritic cell vaccination showing promise in animal models.

Practical Implications

Therapeutic Targeting of B Cells

Suppressing B cell activity or modulating their function could be a therapeutic strategy to mitigate harmful autoimmune responses after SCI.

Dendritic Cell Vaccination

Further development and clinical trials of dendritic cell vaccination therapy may offer a novel approach to promote tissue repair and neurological recovery after SCI.

Cytokine Modulation

Targeting specific cytokines, such as BAFF and APRIL, may help improve neurological outcomes after SCI by influencing B cell survival and activation.

Study Limitations

1
Contradictory results regarding the role of T cells in SCI-induced autoimmunity.
2
Suppressed function and activity of DCs after SCI.
3
The window for the induction of a protective or reparative autoimmune response is relatively small.

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