Pagan-Rivera Luis H, Ocasio-Rivera Samuel E, Godoy-Vitorino Filipa, Miranda Jorge D
Physiology Department, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.
Microbiology and Medical Zoology Department, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.
Front Microbiol. 2024 Dec 18;15:1490855. doi: 10.3389/fmicb.2024.1490855. eCollection 2024.
Spinal cord injury (SCI) is a devastating pathological state causing motor, sensory, and autonomic dysfunction. To date, SCI remains without viable treatment for its patients. After the injury, molecular events centered at the lesion epicenter create a non-permissive environment for cell survival and regeneration. This newly hostile setting is characterized by necrosis, inflammation, demyelination, axotomy, apoptosis, and gliosis, among other events that limit locomotor recovery. This review provides an overview of the pathophysiology of SCI, highlighting the potential role of the gut microbiota in modulating the inflammatory response and influencing neurological recovery following trauma to the spinal cord. Emphasis on the bidirectional communication between the gut and central nervous system, known as the gut-brain axis is given. After trauma, the gut-brain/spinal cord axis promotes the production of pro-inflammatory metabolites that provide a non-permissive environment for cell survival and locomotor recovery. Therefore, any possible pharmacological treatment, including antibiotics and painkillers, must consider their effects on microbiome dysbiosis to promote cell survival, regeneration, and behavioral improvement. Overall, this review provides valuable insights into the pathophysiology of SCI and the evolving understanding of the role of the gut microbiota in SCI, with implications for future research and clinical practice.
脊髓损伤（SCI）是一种导致运动、感觉和自主神经功能障碍的毁灭性病理状态。迄今为止，SCI患者仍没有可行的治疗方法。损伤后，以损伤中心为核心的分子事件为细胞存活和再生创造了一个不利的环境。这种新形成的不利环境的特征包括坏死、炎症、脱髓鞘、轴突切断、凋亡和胶质增生等，这些事件限制了运动功能的恢复。本综述概述了SCI的病理生理学，强调了肠道微生物群在调节炎症反应和影响脊髓损伤后神经恢复方面的潜在作用。重点介绍了肠道与中枢神经系统之间的双向通信，即肠-脑轴。创伤后，肠-脑/脊髓轴促进促炎代谢产物的产生，为细胞存活和运动功能恢复提供了一个不利的环境。因此，任何可能的药物治疗，包括抗生素和止痛药，都必须考虑它们对微生物群失调的影响，以促进细胞存活、再生和行为改善。总的来说，本综述为SCI的病理生理学以及对肠道微生物群在SCI中作用的不断演变的理解提供了有价值的见解，对未来的研究和临床实践具有启示意义。
