Title |
Spinal cord injury-induced immunodeficiency is mediated by a sympathetic-neuroendocrine adrenal reflex
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Published in |
Nature Neuroscience, September 2017
|
DOI | 10.1038/nn.4643 |
Pubmed ID | |
Authors |
Harald Prüss, Andrea Tedeschi, Aude Thiriot, Lydia Lynch, Scott M Loughhead, Susanne Stutte, Irina B Mazo, Marcel A Kopp, Benedikt Brommer, Christian Blex, Laura-Christin Geurtz, Thomas Liebscher, Andreas Niedeggen, Ulrich Dirnagl, Frank Bradke, Magdalena S Volz, Michael J DeVivo, Yuying Chen, Ulrich H von Andrian, Jan M Schwab |
Abstract |
Acute spinal cord injury (SCI) causes systemic immunosuppression and life-threatening infections, thought to result from noradrenergic overactivation and excess glucocorticoid release via hypothalamus-pituitary-adrenal axis stimulation. Instead of consecutive hypothalamus-pituitary-adrenal axis activation, we report that acute SCI in mice induced suppression of serum norepinephrine and concomitant increase in cortisol, despite suppressed adrenocorticotropic hormone, indicating primary (adrenal) hypercortisolism. This neurogenic effect was more pronounced after high-thoracic level (Th1) SCI disconnecting adrenal gland innervation, compared with low-thoracic level (Th9) SCI. Prophylactic adrenalectomy completely prevented SCI-induced glucocorticoid excess and lymphocyte depletion but did not prevent pneumonia. When adrenalectomized mice were transplanted with denervated adrenal glands to restore physiologic glucocorticoid levels, the animals were completely protected from pneumonia. These findings identify a maladaptive sympathetic-neuroendocrine adrenal reflex mediating immunosuppression after SCI, implying that therapeutic normalization of the glucocorticoid and catecholamine imbalance in SCI patients could be a strategy to prevent detrimental infections. |
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Scientists | 6 | 4% |
Science communicators (journalists, bloggers, editors) | 2 | 1% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 134 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Ph. D. Student | 30 | 22% |
Researcher | 23 | 17% |
Student > Bachelor | 10 | 7% |
Student > Master | 9 | 7% |
Student > Doctoral Student | 7 | 5% |
Other | 19 | 14% |
Unknown | 36 | 27% |
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Immunology and Microbiology | 9 | 7% |
Other | 12 | 9% |
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