Systemic Inﬂammation and the Breakdown of Intestinal Homeostasis Are Key Events in Chronic Spinal Cord Injury Patients

International Journal of Molecular Sciences, 2021 · DOI: 10.3390/ijms22020744 · Published: January 13, 2021

Simple Explanation

This study investigated the function of circulating monocytes, levels of pro-inflammatory cytokines, gut barrier integrity, and bacterial translocation in patients with chronic spinal cord injury (SCI). It compared 56 SCI patients with 28 healthy individuals to understand how SCI affects these factors. The researchers found that chronic SCI patients had impaired monocyte function, elevated levels of certain pro-inflammatory markers (TNF-α and IL-6), and signs of increased bacterial translocation and damage to the gut barrier. These findings suggest that chronic SCI is not just a neurological condition, but also involves systemic inflammation and gut-related issues that could contribute to other health complications.

Study Duration

Not specified

Participants

56 SCI patients and 28 healthy donors

Evidence Level

Not specified

Key Findings

1
Chronic SCI patients exhibit impaired circulating monocyte function, including diminished TLR4 expression, increased LPS-induced TNF-α production, and defective phagocytosis.
2
These patients also show a systemic proinﬂammatory state characterized by enhanced serum TNF-α and IL-6 levels.
3
Augmented circulating levels of LBP, I-FABP, and zonulin are found in chronic SCI patients, indicating increased bacterial translocation and gut barrier damage.

Research Summary

This paper demonstrates that chronic SCI patients without associated inﬂammatory and infectious diseases show functional impairment of circulating monocytes, with diminished TLR4 expression, increased LPS-induced TNF-α production and defective phagocytosis. These patients also show a systemic proinﬂammatory state characterized by enhanced serum TNF-α and IL-6 levels. Furthermore, augmented circulating levels of LBP, I-FABP, and zonulin are found in chronic SCI patients, indicating increased bacterial translocation and gut barrier damage.

Practical Implications

Therapeutic Strategies

The study's findings suggest potential therapeutic targets to address systemic inflammation, gut barrier damage, and monocyte dysfunction in chronic SCI patients. Immunomodulatory and microbiological strategies could be investigated.

Comorbidity Prevention

Understanding the systemic inflammatory state in chronic SCI may help in preventing or managing comorbidities such as premature coronary heart disease, metabolic syndrome, and diabetes mellitus, which are linked to inflammation.

Diagnostic Biomarkers

The study identifies potential biomarkers, such as LBP, I-FABP, zonulin, and specific monocyte characteristics, that could be used to predict the development of infectious and non-infectious complications in chronic SCI patients.

Study Limitations

1
Limited number of participants.
2
Lack of longitudinal study of the patients.
3
The immune system is a complex system that involves many populations and molecules that must be analyzed together.

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