Pioneering research in the area of neuroimmunology aims to improve treatment
and medical care of patients who suffer from spinal cord injuries (SCIs). The Ohio
State University SCI Program aims to overcome the roadblocks between preclinical
research and clinical care to accelerate scientific progress tailored for the specific
needs of SCI patients.
Although the immune response after SCI was long misinterpreted as being simplistic
and trivial, accumulating evidence demonstrates a highly dysregulated and
maladaptive pattern. This response is characterized by a sustained inflammatory
scarring at the site of injury on one hand and by developing autoimmunity directed
against CNS proteins on the other. Moreover, a systemic immune deficiency evolves
immediately after injury and reduces the patient’s ability to combat pathogens such
as bacteria. This suppression of the immune system elicits infections and sepsis,
which contribute to the mortality of patients with SCIs.
Ohio State’s Jan Schwab, MD, PhD, and his research team have published seminal
studies identifying the spinal cord injury-induced immune depression syndrome (
SCI-IDS) in both rats and humans. Additionally, a recent study published by this group
demonstrates that SCI-associated infections impair functional neurological recovery
and identifies SCI-associated pneumonia as an independent risk factor for poor
neurological recovery in complete motor paralyzed patients. Thus, infections are not
only infections as for able-body patients with a healthy immune system. By contrast, immune-compromised SCI patients will
acquire infections, which become the main cause of death and reduce the neurological recovery potential. Consequently,
earlier and more aggressive treatment of infections offers an approach to address the specific needs of SCI patients.
Future observational studies will characterize the deficient immune response and detrimental signaling derived from bacterial
infections to develop more effective treatment strategies aimed at reducing mortality and improving neurological outcome.
Based on published evidence, Dr. Schwab envisions developing a continuum of care for SCI patients through the creation
of a step-down unit into which patients would be admitted following their stay in the ICU. His efforts will liaise with eminent
preclinical expertise at OSU on neuroimmunology and spinal cord injury, as well as with a nationally ranked neurorehabilitation
Translating Discoveries from the Lab to
Create Better Treatments for Patients with
Spinal Cord Injuries
(Left) Microglial cells (brown) become alert
and migrate toward neuronal cell bodies
(soma) after spinal cord injury. (Right)
Monocytes (brown) exit blood vessels (blue)
and infiltrate into the lesion after human
traumatic brain injury.