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Characteristics of the Spinal Cord Injured Patient as a Host of Central Nervous System Implanted Biomaterials

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Engineering Biomaterials for Neural Applications

Abstract

Spinal cord injury (SCI) is a systemic injury. The spinal damage provokes not only local responses but also a number of dysregulations in peripheral organs that, in turn, affect the spinal cord. Each human lesion is unique and thus biomaterial-based therapies should be individually tailored. Studies performed on human subjects and postmortem tissue samples are burdened by important limitations. Four categories of human SCI have been established based on the macroscopic/low magnification appearance of the injured cord: solid cord injuries, contusions/cavities, lacerations, and massive compressions. In addition, two different damages occur after SCI: the insult itself that leads to the primary damage and the subsequent cascade of pathological processes that further enlarge the lesion, defined as the secondary damage. Beside, there is increasing evidence that acute and chronic SCI are associated with a severe dysfunction of the immune system, which includes three main syndromic alterations: (i) systemic inflammation; (ii) immunodeficiency; and (iii) autoimmune reactions. SCI dysfunction is mainly due to the alteration in the communication between the immune and neuroendocrine systems. Intestinal dysbiosis has been found in SCI patients, accompanied by loss of the integrity of the intestinal barrier. This increased intestinal permeability may play a role in the observed increase in bacterial translocation and, through it, in the disturbances of the innate and adaptive immune responses found.

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Acknowledgement

We thank Dr. Elisa López-Dolado and Dr. Raquel Madroñero Mariscal for their help with Fig. 2.4 composition.

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Authors and Affiliations

  1. Laboratory of Neuroinflammation, Hospital Nacional de Parapléjicos, (SESCAM), Toledo, Spain

    Daniel García-Ovejero & Ángel Arévalo-Martín

  2. Diseases of Immune System and Oncology Department, Hospital Universitario Príncipe de Asturias, Madrid, Spain

    David Díaz

  3. School of Medicine, Medicine and Medical Specialties Department, Universidad de Alcalá (UAH), Madrid, Spain

    David Díaz

  4. Diseases of Immune System and Oncology Department, Hospital Universitario Príncipe de Asturias, Madrid, Spain

    Melchor Álvarez-Mon

  5. School of Medicine, Medicine and Medical Specialties Department, Universidad de Alcalá (UAH), Madrid, Spain

    Melchor Álvarez-Mon

  6. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera Colmenar Viejo, Madrid, Spain

    Melchor Álvarez-Mon

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  1. Daniel García-Ovejero
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  2. Ángel Arévalo-Martín
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  3. David Díaz
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  4. Melchor Álvarez-Mon
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Correspondence to Daniel García-Ovejero or Melchor Álvarez-Mon .

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  1. SESCAM, Hospital Nacional de Parapléjicos, Toledo, Spain

    Elisa López-Dolado

  2. CSIC, Instituto de Ciencia de Materiales de Madrid, Madrid, Spain

    María Concepción Serrano

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García-Ovejero, D., Arévalo-Martín, Á., Díaz, D., Álvarez-Mon, M. (2022). Characteristics of the Spinal Cord Injured Patient as a Host of Central Nervous System Implanted Biomaterials. In: López-Dolado, E., Concepción Serrano, M. (eds) Engineering Biomaterials for Neural Applications. Springer, Cham. https://doi.org/10.1007/978-3-030-81400-7_2

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