Trivedi Alpa, Olivas Andrea D, Noble-Haeusslein Linda J
Department of Neurosurgery, University of California San Francisco, CA 94143.
Clin Neurosci Res. 2006 Dec;6(5):283-292. doi: 10.1016/j.cnr.2006.09.007.
The immune response that accompanies spinal cord injury contributes to both injury and reparative processes. It is this duality that is the focus of this review. Here we consider the complex cellular and molecular immune responses that lead to the infiltration of leukocytes and glial activation, promote oxidative stress and tissue damage, influence wound healing, and subsequently modulate locomotor recovery. Immunomodulatory strategies to improve outcomes are gaining momentum as ongoing research carefully dissects those pathways, which likely mediate cell injury from those, which favor recovery processes. Current therapeutic strategies address divergent approaches including early immunoblockade and vaccination with immune cells to prevent early tissue damage and support a wound-healing environment that favors plasticity. Despite these advances, there remain basic questions regarding how inflammatory cells interact in the injured spinal cord. Such questions likely arise as a result of our limited understanding of immune cell/neural interactions in a dynamic environment that culminates in progressive cell injury, demyelination, and regenerative failure.
伴随脊髓损伤的免疫反应对损伤和修复过程都有影响。正是这种双重性成为了本综述的重点。在此，我们探讨复杂的细胞和分子免疫反应，这些反应导致白细胞浸润和胶质细胞活化，促进氧化应激和组织损伤，影响伤口愈合，并随后调节运动功能恢复。随着正在进行的研究仔细剖析那些可能介导细胞损伤的途径与那些有利于恢复过程的途径，改善治疗结果的免疫调节策略正越来越受到关注。当前的治疗策略采用了不同的方法，包括早期免疫阻断和用免疫细胞进行疫苗接种，以预防早期组织损伤并支持有利于可塑性的伤口愈合环境。尽管取得了这些进展，但关于炎症细胞在损伤脊髓中如何相互作用仍存在一些基本问题。这些问题的出现可能是由于我们对动态环境中免疫细胞与神经相互作用的理解有限，这种动态环境最终导致进行性细胞损伤、脱髓鞘和再生失败。
