Altered Circulating Immune Cell Distribution in Traumatic Spinal Cord Injury Patients in Relation to Clinical Parameters

Frontiers in Immunology, 2022 · DOI: 10.3389/fimmu.2022.873315 · Published: June 28, 2022

Simple Explanation

Following a spinal cord injury, an inflammatory immune reaction is triggered which results in advanced secondary tissue damage. This study aimed to extensively analyse the circulating immune cell composition in traumatic SCI patients in relation to clinical parameters. Findings from this study suggest that post-SCI inflammation is driven by memory immune cell subsets.

Study Duration

Acute (0-4 days), Subacute (3 weeks), Chronic (6 to >18 weeks)

Participants

18 traumatic SCI patients and 18 healthy controls

Evidence Level

Not specified

Key Findings

1
Total and CD4+ T cell frequencies were increased in cSCI patients.
2
Both CD4+ T cells and B cells were shifted towards memory phenotypes in (s)aSCI patients and cSCI patients, respectively.
3
Decreased immunoglobulin (Ig)G+ and increased IgM+ B cell frequencies reﬂected disease severity, as these correlated with American Spinal Injury Association (ASIA) impairment scale (AIS) scores.

Research Summary

This study performed a detailed immune profiling of SCI patients in the (sub)acute and chronic disease phase using high-dimensional flow cytometry. Changes in the frequencies of circulating immune cell subsets were identified in SCI patients compared to HC, reflecting more memory T and B cell responses in SCI patients. Overall, immune cells of SCI patients were shifted towards memory phenotypes, probably due to repeated immune activation, with most pronounced effects on B cells.

Practical Implications

Prognostic Value

Monitoring circulating IgM+ and IgG+ B cell frequencies is feasible and could potentially be relevant for prognosis and clinical evaluation of SCI patients.

Therapeutic Targets

The study identifies new potential B cell related targets, such as CD74, for which the clinical, prognostic and therapeutic value for SCI management should be further studied.

Understanding SCI Pathology

The findings contribute to a better understanding of the systemic immune response post-SCI, particularly the role of memory immune cells and B cell responses in the secondary injury phase.

Study Limitations

1
A low number of SCI patients was included.
2
Absolute numbers of the included immune cell subsets should be analyzed.
3
The antigen specificity of the post-SCI memory and CD74+ B cell response remains unknown.

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