Immune response following traumatic spinal cord injury: Pathophysiology and therapies

Traumatic spinal cord injury (SCI) is a devastating condition that is often associated with significant loss of function and/or permanent disability. The pathophysiology of SCI is complex and occurs in two phases. First, the mechanical damage from the trauma causes immediate acute cell dysfunction and cell death. Among the secondary injury mechanisms, inflammation has been shown to be a key determinant of the secondary injury severity and significantly worsens cell death and functional outcomes.

• 1
  Following tSCI, the immune response likely exerts both beneficial and harmful roles and as previously discussed both the innate and adaptive immune systems have been implicated in secondary injury progression in tSCI.
• 2
  Overall, TNFa, IL-1b, and IL-6 have been shown to be key mitigators of the immune response in the early hours/days following SCI.
• 3
  There are multiple promising potential pharmaceutical agents and preclinical/clinical studies have reported no harmful effects and have suggested impressive benefits with NSAID/cyclooxygenase inhibitor, ChABC, and G-CSF therapy after SCI.