Abstract
BackgroundNatural killer (NK) cells comprise the main components of lymphocyte-mediated nonspecific immunity. Through their effector function they play a crucial role combating bacterial and viral challenges. They are also thought to be key contributors to the systemic spinal cord injury-induced immune-deficiency syndrome (SCI-IDS). SCI-IDS increases susceptibility to infection and extends to the post-acute and chronic phases after SCI.Methods and designThe prospective study of NK cell function after traumatic SCI was carried out in two centers in Berlin, Germany. SCI patients and control patients with neurologically silent vertebral fracture also undergoing surgical stabilization were enrolled. Furthermore healthy controls were included to provide reference data. The NK cell function was assessed at 7 (5–9) days, 14 days (11–28) days, and 10 (8–12) weeks post-trauma. Clinical documentation included the American Spinal Injury Association (ASIA) impairment scale (AIS), neurological level of injury, infection status, concomitant injury, and medications. The primary endpoint of the study is CD107a expression by NK cells (cytotoxicity marker) 8–12 weeks following SCI. Secondary endpoints are the NK cell’s TNF-α and IFN-γ production by the NK cells 8–12 weeks following SCI.DiscussionThe protocol of this study was developed to investigate the hypotheses whether i) SCI impairs NK cell function throughout the post-acute and sub-acute phases after SCI and ii) the degree of impairment relates to lesion height and severity. A deeper understanding of the SCI-IDS is crucial to enable strategies for prevention of infections, which are associated with poor neurological outcome and elevated mortality.Trial registrationDRKS00009855.
Highlights
Natural killer (NK) cells comprise the main components of lymphocyte-mediated nonspecific immunity
The protocol of this study was developed to investigate the hypotheses whether i) spinal cord injury (SCI) impairs NK cell function throughout the post-acute and sub-acute phases after SCI and ii) the degree of impairment relates to lesion height and severity
Given that NK cell function is crucial to combat viral and bacterial infections, and the ability to control infections after SCI [32] is significantly impaired, we aim to investigate whether lymphocyte mediated non-specific immunity driven by NK cells is impaired after SCI and to characterize the functional role of NK cells as a contributing factor to the spinal cord injury-induced immune-deficiency syndrome (SCI-IDS)
Summary
Natural killer (NK) cells comprise the main components of lymphocyte-mediated nonspecific immunity Through their effector function they play a crucial role combating bacterial and viral challenges. SCI-IDS was first characterized in quantitative terms [5, 6] as a reduction of leukocyte subpopulations such as T-, and B-lymphocytes and MHC class II+ cells, occurring during the first week after trauma as observed in both experimental models and clinical pilot SCI studies [5, 6] This transient lymphopenia alone cannot be held accountable for the persistent increased susceptibility to infectious diseases in SCI patients giving rise to the possibility that a qualitative deficit might persist beyond the first week after injury
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