Spinal cord injury may damage immune system.

Spinal cord injury may damage immune system.

Traumatic Spinal Cord Injury: A Gateway to Immune Deficiency Syndrome

Spinal Cord Injury

A severe spinal cord injury is not only physically debilitating but can also trigger an immune deficiency syndrome, putting patients at risk for life-threatening infections. Groundbreaking research conducted by an international team of researchers has shed light on this previously unknown consequence of spinal cord injury. This new study explores the immune deficiency syndrome induced by such injuries, a phenomenon that was initially observed in experimental models.

Dr. Jan Schwab, a professor of neurology and neurosciences at the Ohio State College of Medicine, stresses the significance of this research: “Infections and subsequent sepsis are the main cause of death after spinal-cord injury.” Dr. Schwab explains that their study provides evidence for an immune deficiency that leaves spinal cord-injured patients vulnerable to infections. He also serves as the medical director of the Belford Center for Spinal Cord Injury and a Scholar of the Chronic Brain Injury Initiative at Ohio State.

The study involved 111 patients, and it was found that monocytes, the white blood cells responsible for fighting bacterial infections, were deactivated shortly after spinal cord injury. Moreover, these patients exhibited reduced levels of antibody and immunoglobulins in their blood. These components are crucial for the body’s “learned” or adaptive immune response. The researchers focused on measuring the levels of a cell-surface molecule called mHLA-DR on monocytes. Low levels of mHLA-DR have been shown to predict the susceptibility to sepsis in critically ill patients.

Several factors contribute to the weakened immune system in spinal cord injury patients, including being bedridden, receiving anesthesia, and undergoing surgery. The discovery of this immune deficiency may help healthcare professionals better care for patients with spinal cord injuries. Furthermore, this knowledge opens the door for the development of new treatments aimed at reducing patient susceptibility to infections.

Interestingly, the study found that the risk of developing an immune deficiency syndrome was significantly higher in patients with complete and higher-level injuries, specifically affecting the fourth thoracic vertebra and above. In contrast, patients with incomplete and lower-level injuries, affecting the fifth thoracic vertebra and below, were at a lower risk. The reference group consisted of patients who had vertebral fractures that did not involve the spinal cord. Complete spinal cord injuries result in a total loss of motor and sensory function below the level of injury, while lower-level injuries may allow for some functional preservation.

Patients with more severe injuries also had a higher burden of pulmonary and urinary tract infections. Remarkably, those who experienced infections within one to two weeks after injury displayed particularly low mHLA-DR values only 15 hours after the event. Overall, the research suggests that a neurogenic immune deficiency syndrome drives infection susceptibility in spinal cord injury patients and that this susceptibility varies in severity.

The findings of this groundbreaking study were published on June 28 in the journal Brain. This research not only expands our understanding of the consequences of spinal cord injuries but also provides crucial insights into potential strategies for improving patient outcomes.


Spinal cord injuries are not only physically devastating; they can also have unexpected consequences on the immune system. The recently discovered immune deficiency syndrome induced by spinal cord injury leaves patients vulnerable to life-threatening infections. This groundbreaking research conducted by an international team of scientists has shed light on this phenomenon, highlighting the importance of understanding the complex interplay between trauma and the immune system.

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(Source: Ohio State University Wexner Medical Center, news release, June 29, 2023)

More Information:U.S. National Institutes of Health – Spinal Cord Injury