Swiss Paraplegic Research, 6207 Nottwil, Switzerland.
Faculty of Health Sciences and Medicine, University of Lucerne, 6003 Lucerne, Switzerland.
Int J Mol Sci. 2023 Nov 16;24(22):16385. doi: 10.3390/ijms242216385.
Individuals with spinal cord injury (SCI) have higher infection rates compared to those without SCI. In this review, the immune status difference between individuals with and without traumatic SCI is investigated by examining their peripheral immune cells and markers. PubMed, Cochrane, EMBASE, and Ovid MEDLINE were searched without language or date restrictions. Studies reporting peripheral immune markers' concentration and changes in functional capabilities of immune cells that compared individuals with and without SCI were included. Studies with participants with active infection, immune disease, and central nervous system (CNS) immune markers were excluded. The review followed the PRISMA guidelines. Effect estimates were measured by Weighted Mean Difference (WMD) using a random-effects model. Study quality was assessed using the National Heart, Lung, and Blood Institute Quality Assessment Tool. Fifty-four studies (1813 with SCI and 1378 without SCI) contributed to the meta-analysis. Leukocytes ( = 23, WMD 0.78, 95% CI 0.17; 1.38, I 83%), neutrophils ( = 11, WMD 0.76, 95% CI 0.09; 1.42, I 89%), C-reactive protein (CRP) ( = 12, WMD 2.25, 95% CI 1.14; 3.56, I 95%), and IL6 ( = 13, WMD 2.33, 95% CI 1.20; 3.49, I 97%) were higher in individuals with SCI vs. without SCI. Clinical factors (phase of injury, completeness of injury, sympathetic innervation impairment, age, sex) and study-related factors (sample size, study design, and serum vs. plasma) partially explained heterogeneity. Immune cells exhibited lower functional capability in individuals with SCI vs. those without SCI. Most studies (75.6%) had a moderate risk of bias. The immune status of individuals with SCI differs from those without SCI and is clinically influenced by the phase of injury, completeness of injury, sympathetic innervation impairment, age, and sex. These results provide information that is vital for monitoring and management strategies to effectively improve the immune status of individuals with SCI.
脊髓损伤 (SCI) 患者的感染率高于未发生 SCI 者。本综述通过检查外周免疫细胞和标志物,研究了创伤性 SCI 患者与非 SCI 患者之间的免疫状态差异。检索了无语言和日期限制的 PubMed、Cochrane、EMBASE 和 Ovid MEDLINE。纳入了比较 SCI 患者和非 SCI 患者外周免疫标志物浓度和免疫细胞功能变化的研究。排除了有活动性感染、免疫性疾病和中枢神经系统 (CNS) 免疫标志物的研究。综述遵循 PRISMA 指南。使用随机效应模型,通过加权均数差 (WMD) 来衡量效应估计值。使用美国国立心肺血液研究所质量评估工具评估研究质量。54 项研究(1813 名 SCI 患者和 1378 名非 SCI 患者)纳入荟萃分析。白细胞( = 23,WMD 0.78,95%CI 0.17;1.38,I 83%)、中性粒细胞( = 11,WMD 0.76,95%CI 0.09;1.42,I 89%)、C 反应蛋白(CRP)( = 12,WMD 2.25,95%CI 1.14;3.56,I 95%)和 IL6( = 13,WMD 2.33,95%CI 1.20;3.49,I 97%)在 SCI 患者中高于非 SCI 患者。临床因素(损伤阶段、损伤完全性、交感神经支配损伤、年龄、性别)和研究相关因素(样本量、研究设计以及血清与血浆)部分解释了异质性。与非 SCI 患者相比,SCI 患者的免疫细胞功能更差。大多数研究(75.6%)存在中度偏倚风险。SCI 患者的免疫状态与非 SCI 患者不同,并且受到损伤阶段、损伤完全性、交感神经支配损伤、年龄和性别等临床因素的影响。这些结果提供了重要信息,对于监测和管理策略有效改善 SCI 患者的免疫状态至关重要。
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