title: Multiple organ dysfunction and systemic inflammation after spinal cord injury: a complex relationship.
abstract: Spinal cord injury (SCI) is a devastating event that results in significant physical disabilities for affected individuals. Apart from local injury within the spinal cord, SCI patients develop a variety of complications characterized by multiple organ dysfunction or failure. These disorders, such as neurogenic pain, depression, lung injury, cardiovascular disease, liver damage, kidney dysfunction, urinary tract infection, and increased susceptibility to pathogen infection, are common in injured patients, hinder functional recovery, and can even be life threatening. Multiple lines of evidence point to pathological connections emanating from the injured spinal cord, post-injury systemic inflammation, and immune suppression as important multifactorial mechanisms underlying post-SCI complications. SCI triggers systemic inflammatory responses marked by increased circulation of immune cells and pro-inflammatory mediators, which result in the infiltration of inflammatory cells into secondary organs and persistence of an inflammatory microenvironment that contributes to organ dysfunction. SCI also induces immune deficiency through immune organ dysfunction, resulting in impaired responsiveness to pathogen infection. In this review, we summarize current evidence demonstrating the relevance of inflammatory conditions and immune suppression in several complications frequently seen following SCI. In addition, we highlight the potential pathways by which inflammatory and immune cues contribute to multiple organ failure and dysfunction and discuss current anti-inflammatory approaches used to alleviate post-SCI complications. A comprehensive review of this literature may provide new insights into therapeutic strategies against complications after SCI by targeting systemic inflammation.
authors.affiliation: Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Joint International Research Laboratory of CNS Regeneration Ministry of Education of PRC, Guangdong Medical Key Laboratory of Brain Function and Diseases, Jinan University, Guangzhou, China. xinsun@jnu.edu.cn.|Co-innovation Center of Neuroregeneration, Nantong, China. xinsun@jnu.edu.cn.
authors.forename: Xin
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee, FL, USA.
authors.forename: Zachary B
authors.initials: ZB
authors.lastname: Jones
authors.affiliation: Institute of Inflammation and Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Chen
authors.affiliation: Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Joint International Research Laboratory of CNS Regeneration Ministry of Education of PRC, Guangdong Medical Key Laboratory of Brain Function and Diseases, Jinan University, Guangzhou, China.|Co-innovation Center of Neuroregeneration, Nantong, China.
authors.forename: Libing
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Joint International Research Laboratory of CNS Regeneration Ministry of Education of PRC, Guangdong Medical Key Laboratory of Brain Function and Diseases, Jinan University, Guangzhou, China.|Co-innovation Center of Neuroregeneration, Nantong, China.
authors.forename: Kwok-Fai
authors.initials: KF
authors.lastname: So
authors.affiliation: Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Joint International Research Laboratory of CNS Regeneration Ministry of Education of PRC, Guangdong Medical Key Laboratory of Brain Function and Diseases, Jinan University, Guangzhou, China. yi.ren@med.fsu.edu.|Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee, FL, USA. yi.ren@med.fsu.edu.|Institute of Inflammation and Diseases, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. yi.ren@med.fsu.edu.
authors.forename: Yi
authors.initials: Y
authors.lastname: Ren
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000209:etiology; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D007154:Immune System Diseases / Q000209:etiology* / Q000473:pathology*; D007674:Kidney Diseases / Q000209:etiology; D008107:Liver Diseases / Q000209:etiology; D009135:Muscular Diseases / Q000209:etiology; D013119:Spinal Cord Injuries / Q000150:complications*
keywords: Immune depression syndrome; Multiple organ dysfunction; Post-injury infection; Spinal cord injury; Systemic inflammatory response syndrome