1. Secondary immunodeficiency (immune paralysis) following spinal cord injury
- Author
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Marcel A. Kopp, Benedikt Brommer, Jan M. Schwab, and Ines Laginha
- Subjects
medicine.medical_specialty ,Neurology ,business.industry ,medicine.medical_treatment ,Central nervous system ,Immunosuppression ,medicine.disease ,Acquired immune system ,Lesion ,Immune system ,medicine.anatomical_structure ,Immunology ,medicine ,Neurochemistry ,medicine.symptom ,business ,Spinal cord injury - Abstract
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.
- Published
- 2010
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