Role of inﬂammation in neurological damage and regeneration following spinal cord injury and its therapeutic implications

Burns & Trauma, 2023 · DOI: https://doi.org/10.1093/burnst/tkac054 · Published: January 1, 2023

Spinal Cord Injury Regenerative Medicine Genetics

Simple Explanation

Spinal cord injury (SCI) often leads to loss of motor and sensory function due to neuron damage from the initial injury and subsequent inflammation. While inflammation is necessary for spinal cord recovery, its specific role in SCI is complex due to conflicting evidence. This review examines how inflammation impacts neural circuits after SCI, focusing on cell death, axon regeneration, and neural remodeling, while also discussing drugs that modulate inflammation in SCI treatment.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
Inflammatory responses after SCI are complex, with both beneficial and detrimental effects.
2
M2-like macrophages, normally repressed, may reduce axonal dieback by reducing gliosis and the expression of proinflammatory cytokines such as IL-1.
3
Acute inflammation in zebrafish promotes healing after SCI, possibly due to the rapid expansion of M2 anti-inflammatory macrophages.

Research Summary

Inflammation has a complex role in SCI, with early events critical for clearing debris and limiting acute injury severity. Excessive inflammation after acute stages can impair regeneration, but certain inflammatory events like M2 macrophage activation can be beneficial. Future studies should focus on the precise function of distinct immune cells and downstream signaling to develop effective regenerative medicine strategies targeting inflammation.

Practical Implications

Therapeutic Strategies

Targeting inflammation management as a key therapeutic strategy for preventing apoptosis, oxidative damage, and promoting angiogenesis and neuronal regeneration.

Drug Development

Development of regenerative medicine strategies by effectively targeting inflammation is critical.

Combination Therapies

Concurrent targeting of multiple immune cells or signaling pathways may have synergistic effects in treating SCI.

Study Limitations

1
Poor therapeutic efficacy and the possibility of negative side effects of current anti-inflammatory drugs for SCI.
2
Limited understanding of the SCI-associated inflammatory responses.
3
The risks associated with corticosteroid treatment (e.g. gastrointestinal bleeding and wound infection) and limitations in functional recovery restrict its use

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