Immune Status of Individuals with Traumatic Spinal Cord Injury: A Systematic Review and Meta-Analysis
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 O...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/24/22/16385 |
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| author | Ezra Valido Gabriela Boehl Jörg Krebs Jürgen Pannek Stevan Stojic Atanas G. Atanasov Marija Glisic Jivko Stoyanov |
| author_facet | Ezra Valido Gabriela Boehl Jörg Krebs Jürgen Pannek Stevan Stojic Atanas G. Atanasov Marija Glisic Jivko Stoyanov |
| author_sort | Ezra Valido |
| collection | DOAJ |
| description | 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 (<i>n</i> = 23, WMD 0.78, 95% CI 0.17; 1.38, I<sup>2</sup> 83%), neutrophils (<i>n</i> = 11, WMD 0.76, 95% CI 0.09; 1.42, I<sup>2</sup> 89%), C-reactive protein (CRP) (<i>n</i> = 12, WMD 2.25, 95% CI 1.14; 3.56, I<sup>2</sup> 95%), and IL6 (<i>n</i> = 13, WMD 2.33, 95% CI 1.20; 3.49, I<sup>2</sup> 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. |
| first_indexed | 2024-03-09T16:45:03Z |
| format | Article |
| id | doaj.art-7a3d26bc91b243199882d9c26b44326a |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-09T16:45:03Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
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| series | International Journal of Molecular Sciences |
| spelling | doaj.art-7a3d26bc91b243199882d9c26b44326a2023-11-24T14:47:24ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672023-11-0124221638510.3390/ijms242216385Immune Status of Individuals with Traumatic Spinal Cord Injury: A Systematic Review and Meta-AnalysisEzra Valido0Gabriela Boehl1Jörg Krebs2Jürgen Pannek3Stevan Stojic4Atanas G. Atanasov5Marija Glisic6Jivko Stoyanov7Swiss Paraplegic Research, 6207 Nottwil, SwitzerlandSwiss Paraplegic Research, 6207 Nottwil, SwitzerlandClinical Trial Unit, Swiss Paraplegic Center, 6207 Nottwil, SwitzerlandNeuro-Urology, Swiss Paraplegic Center, 6207 Nottwil, SwitzerlandSwiss Paraplegic Research, 6207 Nottwil, SwitzerlandLudwig Boltzman Institute for Digital Health and Patient Safety, Medical University of Vienna, 1090 Vienna, AustriaSwiss Paraplegic Research, 6207 Nottwil, SwitzerlandSwiss Paraplegic Research, 6207 Nottwil, SwitzerlandIndividuals 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 (<i>n</i> = 23, WMD 0.78, 95% CI 0.17; 1.38, I<sup>2</sup> 83%), neutrophils (<i>n</i> = 11, WMD 0.76, 95% CI 0.09; 1.42, I<sup>2</sup> 89%), C-reactive protein (CRP) (<i>n</i> = 12, WMD 2.25, 95% CI 1.14; 3.56, I<sup>2</sup> 95%), and IL6 (<i>n</i> = 13, WMD 2.33, 95% CI 1.20; 3.49, I<sup>2</sup> 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.https://www.mdpi.com/1422-0067/24/22/16385traumatic spinal cord injuryimmunologymeta-analysisimmune depression |
| spellingShingle | Ezra Valido Gabriela Boehl Jörg Krebs Jürgen Pannek Stevan Stojic Atanas G. Atanasov Marija Glisic Jivko Stoyanov Immune Status of Individuals with Traumatic Spinal Cord Injury: A Systematic Review and Meta-Analysis International Journal of Molecular Sciences traumatic spinal cord injury immunology meta-analysis immune depression |
| title | Immune Status of Individuals with Traumatic Spinal Cord Injury: A Systematic Review and Meta-Analysis |
| title_full | Immune Status of Individuals with Traumatic Spinal Cord Injury: A Systematic Review and Meta-Analysis |
| title_fullStr | Immune Status of Individuals with Traumatic Spinal Cord Injury: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Immune Status of Individuals with Traumatic Spinal Cord Injury: A Systematic Review and Meta-Analysis |
| title_short | Immune Status of Individuals with Traumatic Spinal Cord Injury: A Systematic Review and Meta-Analysis |
| title_sort | immune status of individuals with traumatic spinal cord injury a systematic review and meta analysis |
| topic | traumatic spinal cord injury immunology meta-analysis immune depression |
| url | https://www.mdpi.com/1422-0067/24/22/16385 |
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