title: Neuroendocrine-immune interactions associated with loss and restoration of immune system function in spinal cord injury and stroke patients.
abstract: Both natural and adaptive immune responses were shown to be strikingly decreased in initial blood samples from 34 spinal cord injury and stroke patients. NK-cell function decreased to 24.8% (mean) 2 weeks after spinal cord injury in previously healthy young adults whose control group revealed a mean NK-cell function of 48.7%. This was accompanied at 2 weeks by increased plasma ACTH (mean of 17.0 pg/ml from 17 patients compared to a mean of 11.2 pg/ml from 12 controls) and urine free cortisol levels (mean of 152.1 micrograms/24 h from 9 patients compared to 53.6 micrograms/24 h from 15 controls). T-cell function and/or activation decreased to below normal values within 3 months after injury as revealed by lymphocyte transformation that was 32.8% of normal at 3 months. T-cell activation diminished as shown by a mean IL-2 receptor level of 179.3 units/ml in patients compared to 328.2 units/ml in controls. Serial monitoring of NK- and T-cell function revealed that specific physical rehabilitation therapy over a period of 6 months after injury restored NK- and T-cell function to near normal levels in most patients. This improvement was accompanied by a parallel rise in the patient's functional independence measurement scores. Results suggest critical neuroendocrine-immune system interactions in the restoration of immune function. Cortisol levels reverted to normal after 6 months of rehabilitation. Limited data suggest that natural immune system depression, NK-cell function, persists in spinal cord injury patients not receiving rehabilitation therapy (mean NK-cell lysis of 10.3%; p < 0.01).
authors.affiliation: Department of Pathology, University of Mississippi Medical Center, Jackson 39216.
authors.forename: J M
authors.initials: JM
authors.lastname: Cruse
authors.forename: R E
authors.initials: RE
authors.lastname: Lewis
authors.forename: G R
authors.initials: GR
authors.lastname: Bishop
authors.forename: W F
authors.initials: WF
authors.lastname: Kliesch
authors.forename: E
authors.initials: E
authors.lastname: Gaitan
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D002561:Cerebrovascular Disorders / Q000276:immunology* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000652:urine; D007113:Immunity, Innate; D007694:Killer Cells, Natural / Q000276:immunology; D007958:Leukocyte Count; D008213:Lymphocyte Activation; D016131:Lymphocyte Subsets / Q000276:immunology; D008297:Male; D010264:Paraplegia / Q000276:immunology / Q000534:rehabilitation; D011782:Quadriplegia / Q000276:immunology / Q000534:rehabilitation; D015375:Receptors, Interleukin-2 / Q000378:metabolism; D013119:Spinal Cord Injuries / Q000276:immunology* / Q000534:rehabilitation
chemical_list: D015375:Receptors, Interleukin-2; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone