The inflammatory response and blood-spinal cord barrier integrity in traumatic spinal cord injury: a prospective pilot study

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The inflammatory response and blood-spinal cord barrier integrity in traumatic spinal cord injury : a prospective pilot study. / Wichmann, Thea Overgaard; Kasch, Helge; Dyrskog, Stig et al.

In: Acta Neurochirurgica, Vol. 164, No. 12, 12.2022, p. 3143-3153.

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@article{419b984bcdb741e88455c7f1fa74ac2f,
title = "The inflammatory response and blood-spinal cord barrier integrity in traumatic spinal cord injury: a prospective pilot study",
abstract = "PURPOSE: Triggering of inflammatory responses and disruption of blood-spinal cord barrier (BSCB) integrity are considered pivotal events in the pathophysiology of traumatic spinal cord injury (TSCI). Yet, these events are poorly understood and described in humans. This study aims to describe inflammatory responses and BSCB integrity in human TSCI.METHODS: Fifteen TSCI patients and fifteen non-TSCI patients were prospectively recruited from Aarhus University Hospital, Denmark. Peripheral blood (PB) and cerebrospinal fluid (CSF) were collected at median day 0 [IQR: 1], median day 9 [IQR: 2], and median day 148 [IQR: 49] after injury. PB and CSF were analyzed for immune cells by flow cytometry, cytokines by multiplex immunoassay, and BSCB integrity by IgG Index.RESULTS: Eleven TSCI patients completed follow-up. Results showed alterations in innate and adaptive immune cell counts over time. TSCI patients had significantly increased cytokine concentrations in CSF at the first and second follow-up, while only concentrations of interleukin (IL)-4, IL-8, and tumor necrosis factor-α remained significantly increased at the third follow-up. In PB, TSCI patients had significantly increased IL-6, IL-8, and IL-10 concentrations and significantly decreased interferon-γ concentrations at the first follow-up. Results further showed increased IgG Index indicative of BSCB disruption in seven TSCI patients at the first follow-up, five TSCI patients at the second follow-up, and two patients at the third follow-up.CONCLUSIONS: Our results suggest that TSCI mainly triggers innate inflammatory responses that resolves over time, although with some degree of non-resolving inflammation, particularly in CSF. Our results cannot confirm BSCB disruption in all TSCI patients.",
keywords = "Blood-spinal cord barrier, Flow cytometry, Imaging flow cytometry, Inflammation, Multiplex immunoassay, Traumatic spinal cord injury",
author = "Wichmann, {Thea Overgaard} and Helge Kasch and Stig Dyrskog and Kristian H{\o}y and M{\o}ller, {Bjarne Kuno} and Jan Krog and Hviid, {Claus Vinter B{\o}dker} and Hoffmann, {Hans J{\"u}rgen} and Rasmussen, {Mikkel Mylius}",
year = "2022",
month = dec,
doi = "10.1007/s00701-022-05369-6",
language = "English",
volume = "164",
pages = "3143--3153",
journal = "Acta Neurochirurgica",
issn = "0001-6268",
publisher = "Springer Wien",
number = "12",

}

RIS

TY - JOUR

T1 - The inflammatory response and blood-spinal cord barrier integrity in traumatic spinal cord injury

T2 - a prospective pilot study

AU - Wichmann, Thea Overgaard

AU - Kasch, Helge

AU - Dyrskog, Stig

AU - Høy, Kristian

AU - Møller, Bjarne Kuno

AU - Krog, Jan

AU - Hviid, Claus Vinter Bødker

AU - Hoffmann, Hans Jürgen

AU - Rasmussen, Mikkel Mylius

PY - 2022/12

Y1 - 2022/12

N2 - PURPOSE: Triggering of inflammatory responses and disruption of blood-spinal cord barrier (BSCB) integrity are considered pivotal events in the pathophysiology of traumatic spinal cord injury (TSCI). Yet, these events are poorly understood and described in humans. This study aims to describe inflammatory responses and BSCB integrity in human TSCI.METHODS: Fifteen TSCI patients and fifteen non-TSCI patients were prospectively recruited from Aarhus University Hospital, Denmark. Peripheral blood (PB) and cerebrospinal fluid (CSF) were collected at median day 0 [IQR: 1], median day 9 [IQR: 2], and median day 148 [IQR: 49] after injury. PB and CSF were analyzed for immune cells by flow cytometry, cytokines by multiplex immunoassay, and BSCB integrity by IgG Index.RESULTS: Eleven TSCI patients completed follow-up. Results showed alterations in innate and adaptive immune cell counts over time. TSCI patients had significantly increased cytokine concentrations in CSF at the first and second follow-up, while only concentrations of interleukin (IL)-4, IL-8, and tumor necrosis factor-α remained significantly increased at the third follow-up. In PB, TSCI patients had significantly increased IL-6, IL-8, and IL-10 concentrations and significantly decreased interferon-γ concentrations at the first follow-up. Results further showed increased IgG Index indicative of BSCB disruption in seven TSCI patients at the first follow-up, five TSCI patients at the second follow-up, and two patients at the third follow-up.CONCLUSIONS: Our results suggest that TSCI mainly triggers innate inflammatory responses that resolves over time, although with some degree of non-resolving inflammation, particularly in CSF. Our results cannot confirm BSCB disruption in all TSCI patients.

AB - PURPOSE: Triggering of inflammatory responses and disruption of blood-spinal cord barrier (BSCB) integrity are considered pivotal events in the pathophysiology of traumatic spinal cord injury (TSCI). Yet, these events are poorly understood and described in humans. This study aims to describe inflammatory responses and BSCB integrity in human TSCI.METHODS: Fifteen TSCI patients and fifteen non-TSCI patients were prospectively recruited from Aarhus University Hospital, Denmark. Peripheral blood (PB) and cerebrospinal fluid (CSF) were collected at median day 0 [IQR: 1], median day 9 [IQR: 2], and median day 148 [IQR: 49] after injury. PB and CSF were analyzed for immune cells by flow cytometry, cytokines by multiplex immunoassay, and BSCB integrity by IgG Index.RESULTS: Eleven TSCI patients completed follow-up. Results showed alterations in innate and adaptive immune cell counts over time. TSCI patients had significantly increased cytokine concentrations in CSF at the first and second follow-up, while only concentrations of interleukin (IL)-4, IL-8, and tumor necrosis factor-α remained significantly increased at the third follow-up. In PB, TSCI patients had significantly increased IL-6, IL-8, and IL-10 concentrations and significantly decreased interferon-γ concentrations at the first follow-up. Results further showed increased IgG Index indicative of BSCB disruption in seven TSCI patients at the first follow-up, five TSCI patients at the second follow-up, and two patients at the third follow-up.CONCLUSIONS: Our results suggest that TSCI mainly triggers innate inflammatory responses that resolves over time, although with some degree of non-resolving inflammation, particularly in CSF. Our results cannot confirm BSCB disruption in all TSCI patients.

KW - Blood-spinal cord barrier

KW - Flow cytometry

KW - Imaging flow cytometry

KW - Inflammation

KW - Multiplex immunoassay

KW - Traumatic spinal cord injury

U2 - 10.1007/s00701-022-05369-6

DO - 10.1007/s00701-022-05369-6

M3 - Journal article

C2 - 36190569

VL - 164

SP - 3143

EP - 3153

JO - Acta Neurochirurgica

JF - Acta Neurochirurgica

SN - 0001-6268

IS - 12

ER -