Immune Status of Individuals with Traumatic Spinal Cord Injury: A Systematic Review and Meta-Analysis.

Valido, Ezra; Boehl, Gabriela; Krebs, Jörg; Pannek, Jürgen; Stojic, Stevan; Atanasov, Atanas G; Glisic, Marija; Stoyanov, Jivko (2023). Immune Status of Individuals with Traumatic Spinal Cord Injury: A Systematic Review and Meta-Analysis. International journal of molecular sciences, 24(22), p. 16385. MDPI 10.3390/ijms242216385

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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 (n = 23, WMD 0.78, 95% CI 0.17; 1.38, I2 83%), neutrophils (n = 11, WMD 0.76, 95% CI 0.09; 1.42, I2 89%), C-reactive protein (CRP) (n = 12, WMD 2.25, 95% CI 1.14; 3.56, I2 95%), and IL6 (n = 13, WMD 2.33, 95% CI 1.20; 3.49, I2 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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology

UniBE Contributor:

Pannek, Jürgen, Glisic, Marija, Stoyanov, Jivko

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1661-6596

Publisher:

MDPI

Funders:

[222] Horizon 2020 ; [226] Swiss School of Public Health Global P3HS

Language:

English

Submitter:

Pubmed Import

Date Deposited:

28 Nov 2023 15:01

Last Modified:

07 Aug 2024 15:44

Publisher DOI:

10.3390/ijms242216385

PubMed ID:

38003575

Uncontrolled Keywords:

immune depression immunology meta-analysis traumatic spinal cord injury

BORIS DOI:

10.48350/189417

URI:

https://boris.unibe.ch/id/eprint/189417

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