Department of Hand and Foot Surgery, Zhejiang Rongjun Hospital, Jiaxing, China.
Department of Neurosurgery, The Central Hospital Affiliated to Shaoxing University, Jiaxing, China.
Front Immunol. 2023 Jan 5;13:1070540. doi: 10.3389/fimmu.2022.1070540. eCollection 2022.
Spinal cord injury (SCI) is a devastating neurological condition prevalent worldwide. Where the pathological mechanisms underlying SCI are concerned, we can distinguish between primary injury caused by initial mechanical damage and secondary injury characterized by a series of biological responses, such as vascular dysfunction, oxidative stress, neurotransmitter toxicity, lipid peroxidation, and immune-inflammatory response. Secondary injury causes further tissue loss and dysfunction, and the immune response appears to be the key molecular mechanism affecting injured tissue regeneration and functional recovery from SCI. Immune response after SCI involves the activation of different immune cells and the production of immunity-associated chemicals. With the development of new biological technologies, such as transcriptomics, the heterogeneity of immune cells and chemicals can be classified with greater precision. In this review, we focus on the current understanding of the heterogeneity of these immune components and the roles they play in SCI, including reactive astrogliosis and glial scar formation, neutrophil migration, macrophage transformation, resident microglia activation and proliferation, and the humoral immunity mediated by T and B cells. We also summarize findings from clinical trials of immunomodulatory therapies for SCI and briefly review promising therapeutic drugs currently being researched.
脊髓损伤(SCI)是一种全球普遍存在的破坏性神经系统疾病。就 SCI 的病理机制而言,我们可以区分由初始机械损伤引起的原发性损伤和以一系列生物学反应为特征的继发性损伤,如血管功能障碍、氧化应激、神经递质毒性、脂质过氧化和免疫炎症反应。继发性损伤导致进一步的组织损失和功能障碍,免疫反应似乎是影响 SCI 损伤组织再生和功能恢复的关键分子机制。SCI 后的免疫反应涉及不同免疫细胞的激活和免疫相关化学物质的产生。随着转录组学等新技术的发展,免疫细胞和化学物质的异质性可以更精确地分类。在这篇综述中,我们重点介绍了这些免疫成分的异质性及其在 SCI 中的作用的最新认识,包括反应性星形胶质细胞增生和胶质瘢痕形成、中性粒细胞迁移、巨噬细胞转化、固有小胶质细胞激活和增殖,以及 T 和 B 细胞介导的体液免疫。我们还总结了 SCI 免疫调节治疗的临床试验结果,并简要回顾了目前正在研究的有前途的治疗药物。