Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 11 , Pages 1384-1393, November 2007

Clinical Correlates of Elevated Serum Concentrations of Cytokines and Autoantibodies in Patients With Spinal Cord Injury

  • Andrew L. Davies, MSc

      Affiliations

    • Graduate Program in Neuroscience, London, ON, Canada
    • University of Western Ontario, London, ON, Canada.
    • ,
  • Keith C. Hayes, PhD

      Affiliations

    • Department of Physical Medicine & Rehabilitation, London, ON, Canada
    • Lawson Health Research Institute, London, ON, Canada
    • University of Western Ontario, London, ON, Canada.
    • Corresponding Author InformationReprint requests to Keith C. Hayes, PhD, Parkwood Hospital/SJHC, 801 Commissioners Rd E, London, ON N6C 5J1, Canada
    • ,
  • Gregory A. Dekaban, PhD

      Affiliations

    • Department of Microbiology and Immunology, London, ON, Canada
    • Biotherapeutics Research Group, Robarts Research Institute, London, ON, Canada
    • University of Western Ontario, London, ON, Canada.

Abstract 

Davies AL, Hayes KC, Dekaban GA. Clinical correlates of elevated serum concentrations of cytokines and autoantibodies in patients with spinal cord injury.

Objective

To determine the serum cytokine profiles of patients with spinal cord injury (SCI) and varying clinical presentations relative to healthy, able-bodied, age-matched control subjects.

Design

Cross-sectional study.

Setting

Clinical research unit.

Participants

People with SCI (N=56) and different clinical presentations, and healthy, able-bodied, age-matched control subjects (N=35).

Interventions

Not applicable.

Main Outcome Measures

Serum levels of the proinflammatory cytokines interleukin (IL) 1β, IL-6, tumor necrosis factor alpha (TNF-α), the anti-inflammatory cytokines IL-4 and IL-10, the regulatory cytokine IL-2, the IL-1 receptor antagonist (IL-1RA), and autoantibodies against myelin-associated glycoprotein and GM1 ganglioside (anti-GM1) immunoglobulin (IgG and IgM), as determined by enzyme-linked immunosorbent assay. The relationship between elevated serum cytokine levels and clinical variables was also studied.

Results

SCI subjects exhibited serum concentrations of IL-6, TNF-α, IL-1RA, and anti-GM1 (IgG) that were greater (P<.05) than control group values. Elevated cytokine concentrations were not associated with high white blood cell counts, level of injury, or American Spinal Injury Association classification; they were evident in SCI subjects who were asymptomatic for medical complications, but were further elevated in subjects with pain, urinary tract infection (UTI), and pressure ulcers.

Conclusions

Elevated levels of circulating proinflammatory cytokines and autoantibodies are present in the serum of SCI subjects without medical complications, and are further elevated in SCI subjects with neuropathic pain, UTI, or pressure ulcers, relative to healthy, able-bodied control subjects. These findings may be indicative of a protective autoimmunity, simply a consequence of occult or evident infection, or evidence of cytokine dysregulation that may contribute to an immune-mediated impairment of axonal conduction.

Key Words: Autoantibodies, Cytokines, Gangliosides, Interleukin-1 receptors, Interleukin-6, Myelin-associated glycoprotein, Pressure ulcer, Rehabilitation, Spinal cord injuries, Tumor necrosis factor, Urinary tract infections

 

 Supported by the Parkwood Hospital Foundation and the Ontario Neurotrauma Foundation.

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

PII: S0003-9993(07)01342-1

doi:10.1016/j.apmr.2007.08.004

Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 11 , Pages 1384-1393, November 2007

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