Multiple organ dysfunction and systemic inflammation after spinal cord injury: a complex relationshipReport as inadecuate




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Journal of Neuroinflammation

, 13:260

First Online: 06 October 2016Received: 03 August 2016Accepted: 28 September 2016

Abstract

Spinal cord injury SCI is a devastating event that results in significant physical disabilities for affected individuals. Apart from local injury within the spinal cord, SCI patients develop a variety of complications characterized by multiple organ dysfunction or failure. These disorders, such as neurogenic pain, depression, lung injury, cardiovascular disease, liver damage, kidney dysfunction, urinary tract infection, and increased susceptibility to pathogen infection, are common in injured patients, hinder functional recovery, and can even be life threatening. Multiple lines of evidence point to pathological connections emanating from the injured spinal cord, post-injury systemic inflammation, and immune suppression as important multifactorial mechanisms underlying post-SCI complications. SCI triggers systemic inflammatory responses marked by increased circulation of immune cells and pro-inflammatory mediators, which result in the infiltration of inflammatory cells into secondary organs and persistence of an inflammatory microenvironment that contributes to organ dysfunction. SCI also induces immune deficiency through immune organ dysfunction, resulting in impaired responsiveness to pathogen infection. In this review, we summarize current evidence demonstrating the relevance of inflammatory conditions and immune suppression in several complications frequently seen following SCI. In addition, we highlight the potential pathways by which inflammatory and immune cues contribute to multiple organ failure and dysfunction and discuss current anti-inflammatory approaches used to alleviate post-SCI complications. A comprehensive review of this literature may provide new insights into therapeutic strategies against complications after SCI by targeting systemic inflammation.

KeywordsSpinal cord injury Multiple organ dysfunction Systemic inflammatory response syndrome Immune depression syndrome Post-injury infection AbbreviationsBMDBone mineral density

HOHeterotopic ossification

NBDNeurogenic bowel dysfunction

SCISpinal cord injury

SCI-IDSSCI-induced immune depression syndrome

SIRSSystemic inflammatory response syndrome

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Author: Xin Sun - Zachary B. Jones - Xiao-ming Chen - Libing Zhou - Kwok-Fai So - Yi Ren

Source: https://link.springer.com/article/10.1186/s12974-016-0736-y







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