A Review on Response of Immune System in Spinal Cord Injury and Therapeutic Agents useful in Treatment

Abstract

Every year more than 12,000 people in US alone suffer from spinal cord injury. However, complete recovery of physical function is difficult due to multiple factors involved in disease progression. Currently available therapeutic regimens do not address all the factors concerned with the disease progression. The present review focuses mainly on the role of immune cells in progression of spinal cord injury and the drugs that target these immune cells. Literature search shows that inflammatory reactions and subsequent reactions that follow direct injury to spinal cord are sometimes responsible for the severity of the disease. Therefore, for design of proper treatment regimen a deep understanding in this area is required. Understanding the pathophysiology will help in creating delivery system that can target multiple factors involved in progression of spinal cord injury. A combination of various treatment strategies is required to reduce the disability in patients with spinal cord injury.

Clinical features of coronavirus disease 2019 (COVID-19) in a cohort of patients with disability due to spinal cord injury

“…To the author's knowledge, this is the first work that describes the clinical profile of Covid-19 in a cohort of SCI patients. The vulnerability of people with SCI is well known [5][6][7][8][9][10]. We have found that more than half of our patients showed one or two symptoms at the moment of Covid-19 confirmation, which is lower than the symptomatic expression in other published case series [18].…”

“…Several demographic and clinical factors associated with the more aggressive Covid-19 phenotype have been identified: male gender, age over 60 years, and the presence of previous comorbidities such as hypertension, diabetes mellitus, obesity, cardiac ischemic disease, lung disease, and immunosuppression [4]. It is reasonable to assume SCI as a high-risk comorbidity, mostly due to the presence of respiratory failure as a result of thoracoabdominal muscle weakness [5] and also because of systemic immunosuppression due to injury [6,7]. Suppression of the immune system after SCI is due to noradrenergic overactivation and excess glucocorticoid release via hypothalamus-pituitary-adrenal axis stimulation [8] and also to autoimmunity [9].…”

Level-Specific Differences in Systemic Expression of Pro- and Anti-Inflammatory Cytokines and Chemokines after Spinal Cord Injury

“…Inflammation after SCI is considered one of the major drivers of secondary injury and tissue loss, and is often considered a dual-edged sword [30,31]. Our current results examined a small percentage of the cytokine/chemokines/growth factors involved, however, due to the spectrum of cells that secrete these factors, we cannot accurately pinpoint the cellular mediators of the temporal and level-specific changes that we have observed.…”

Clinical features of coronavirus disease 2019 (COVID-19) in a cohort of patients with disability due to spinal cord injury

“…To the author´s knowledge, this is the first work that describes the clinical profile of Covid-19 in a cohort of SCI patients. The vulnerability of people with SCI is well known [6][7][8][9][10][11] . We have found that more than half of our patients showed one or two symptoms at the moment of Covid-19 confirmation, which is lower than the symptomatic expression in other published case series 18 .…”