Early expression and cellular localization of proinflammatory cytokines interleukin-1beta, interleukin-6, and tumor necrosis factor-alpha in human traumatic spinal cord injury.

STUDY DESIGN

Post-traumatic inflammatory response was studied in 11 human cases of acute spinal cord contusion injury.

OBJECTIVES

To examine the inflammatory cellular response and the immunocytochemical expression and localization of interleukin-1beta, interleukin-6, and tumor necrosis factor-alpha in human spinal cord after contusion injury.

SUMMARY OF BACKGROUND DATA

: The post-traumatic inflammatory response plays an important role in secondary injury mechanisms after spinal cord injury, and interleukin-1beta, interleukin-6, and tumor necrosis factor-alpha are key inflammatory mediators.

METHODS

: The study group comprised 11 patients with spinal cord contusion injury and 2 normal individuals. Histologic and immunocytochemical assessments were undertaken to evaluate the inflammatory cellular response and the immunoexpression of interleukin-1beta, interleukin-6, and tumor necrosis factor-alpha in the injured human spinal cord. The cellular sources of interleukin-1beta, interleukin-6, and tumor necrosis factor-alpha were elucidated by immunofluorescence double-labeled confocal imaging.

RESULTS

: Increased immunoreactivity of interleukin-1beta, interleukin-6, and tumor necrosis factor-alpha was detected in neurons 0.5 hour after injury, and in neurons and microglia 5 hours after injury, but the expression of these proinflammatory cytokines was short-lived and declined sharply to baseline by 2 days after injury. In the inflammatory cellular response, as early as 0.5 hour after spinal cord injury, activated microglia were detected, and axonal swellings and axons were surrounded by microglial processes. Numerous neutrophils appeared in the injured cord 1 day after injury, and then their number declined dramatically, whereas macrophages progressively increased after day 1.

CONCLUSIONS

Endogenous cells (neurons and microglia) in the human spinal cord, not the blood-borne leukocytes, contribute to the early production of interleukin-1beta, interleukin-6, and tumor necrosis factor-alpha in the post-traumatic inflammatory response, and microglia are involved the early response to traumatic axonal injury.