Secondary immunodeficiency (immune paralysis) following spinal cord injury

Infections are a leading cause of morbidity and mortality in patients with acute spinal cord injury (SCI). It has recently become clear that SCI might increase susceptibility to infection by central nervous system (CNS)-specific mechanisms: CNS injury induces a disruption of the normally well-balanc...

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Bibliographic Details
Published inNeuroforum Vol. 1; no. 3; pp. 43 - 51
Main Authors Brommer, B., Kopp, M.A., Laginha, I., Schwab, J.M.
Format Journal Article
LanguageEnglish
Published Heidelberg Spektrum Akademischer Verlag 01.09.2010
De Gruyter
Subjects
Biomedical and Life Sciences
Biomedicine
Life Sciences
Neurobiology
Neurochemistry
Neurology
Neurosciences
Review Article
Infection
Zentralnervensystem
Immunosuppression
Immunsystem
Immunsuppression
Central nervous system
Spinal cord injuries
Rückenmarkverletzungen
Immune system
Infektion
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Summary:Infections are a leading cause of morbidity and mortality in patients with acute spinal cord injury (SCI). It has recently become clear that SCI might increase susceptibility to infection by central nervous system (CNS)-specific mechanisms: CNS injury induces a disruption of the normally well-balanced interplay between the immune system and the CNS. As a result, SCI also leads to secondary immunodeficiency (SCI injury-induced immunodepression, SCI-IDS) and infection. SCI-IDS (a) starts early after SCI (within 24 h), (b) affects both the innate and adaptive immune system, and (c) is independent of iatrogenic application of high-dose corticosteroids. The fact that increased immunosuppression correlates with lesion level underlines a neurogenic origin. Here we summarize the current understanding and main pathophysiological features of leukocyte dysfunction following SCI. A better understanding of this syndrome may provide insights into how the CNS controls the immune system. Furthermore, the identification of patients suffering from spinal cord injury as immunocompromised is a clinically relevant, yet widely underappreciated finding.
ISSN:1868-856X
1868-856X
DOI:10.1007/s13295-010-0008-8