blood-spinal_cord_barrier [Neurosurgery Wiki]

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The blood-spinal cord barrier (BSCB), a physical [[barrier]] between the blood and [[spinal cord]] [[parenchyma]], prevents the [[toxin]]s, [[blood cell]]s, and [[pathogen]]s from entering the [[spinal cord]] and maintains a tightly controlled chemical balance in the spinal environment, which is necessary for proper neural function.
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Triggering of inflammatory responses and disruption of blood-spinal cord barrier (BSCB) integrity are considered pivotal events in the [[traumatic spinal cord injury pathophysiology]] (TSCI). Yet, these events are poorly understood and described in humans. This study aims to describe inflammatory responses and BSCB integrity in human TSCI.

Methods: Fifteen TSCI patients and fifteen non-TSCI patients were prospectively recruited from Aarhus University Hospital, Denmark. Peripheral blood (PB) and cerebrospinal fluid (CSF) were collected at median day 0 [IQR: 1], median day 9 [IQR: 2], and median day 148 [IQR: 49] after injury. PB and CSF were analyzed for immune cells by flow cytometry, cytokines by multiplex immunoassay, and BSCB integrity by IgG Index.

Results: Eleven TSCI patients completed follow-up. Results showed alterations in innate and adaptive immune cell counts over time. TSCI patients had significantly increased cytokine concentrations in CSF at the first and second follow-up, while only concentrations of interleukin (IL)-4, IL-8, and tumor necrosis factor-α remained significantly increased at the third follow-up. In PB, TSCI patients had significantly increased IL-6, IL-8, and IL-10 concentrations and significantly decreased interferon-γ concentrations at the first follow-up. Results further showed increased IgG Index indicative of BSCB disruption in seven TSCI patients at the first follow-up, five TSCI patients at the second follow-up, and two patients at the third follow-up.

Results suggest that [[traumatic spinal cord injury]] mainly triggers innate [[inflammatory response]]s that resolves over time, although with some degree of non-resolving [[inflammation]], particularly in [[CSF]]. Results cannot confirm  [[blood-spinal cord barrier disruption]] in all [[traumatic spinal cord injury]] patients
((Wichmann TO, Kasch H, Dyrskog S, Høy K, Møller BK, Krog J, Hviid CVB, Hoffmann HJ, Rasmussen MM. The inflammatory response and blood-spinal cord barrier integrity in [[traumatic spinal cord injury]]: a prospective pilot study. Acta Neurochir (Wien). 2022 Oct 3. doi: 10.1007/s00701-022-05369-6. Epub ahead of print. PMID: 36190569.)).