Restoration of depressed immune function in spinal cord injury patients receiving rehabilitation therapy
Restoration of depressed immune function in spinal cord injury patients receiving rehabilitation therapy
复制标题
DOI：
10.1038/sc.1996.14
复制
发表时间：
1996-02-01
期刊：
影响因子：
--
通讯作者：
Lampton, JA
中科院分区：
文献类型：
--
作者：
Kliesch, WF;Cruse, JM;Lampton, JA
与年龄匹配的对照组相比，49例脊髓损伤、28例四肢瘫痪和21例截瘫患者的自然和适应性免疫应答在损伤后2周显著降低。所有值均表示为平均值。脊髓损伤后2周，NK细胞功能下降至21.0%，而对照组为48.6%。在2周时，患者血浆ACTH值增加至17.0 pg/ml，而对照组为11.2 pg/ml，患者尿游离皮质醇水平升高至162.4 μ g/24 h，而对照组为53.6 μ g/24 h。损伤后3个月，T细胞功能下降至正常（淋巴细胞转化）的40.2%。T细胞活化（IL-2 R）减少，即，183.4微克/毫升，对照组为328.2微克/毫升。经过康复治疗，NK细胞功能在伤后7个月时增加到41.6%。NK细胞介导的溶解在7和9个月之间急剧减少，在10个月时降至22.8%，并最终恢复到损伤后2周的水平。康复治疗有助于在损伤后6个月将T细胞功能恢复至正常的92.0%，并保持6个月以上。IL-2 R值与淋巴细胞转化平行改善。而NK细胞诱导的裂解仍然受到抑制，即，未接受治疗的患者6个月时为11.8%，12个月以上时为11.4%，康复患者6个月时NK细胞功能恢复至40.6%，停止治疗后降至23.0%。颈部损伤组NK细胞介导的溶解值明显低于胸部损伤组。两组患者的NK细胞功能评分均高于对照组。经康复治疗后，颈部组的NK细胞介导的溶解从15.2%增加到28.4%，而胸部组的NK细胞介导的溶解从26.8%改善到43.7%。通过康复治疗，颈部组淋巴细胞转化率从37.3%提高到85.6%，胸部组从48.4%提高到88.9%。与健康年龄匹配的对照组的126相比，通过康复治疗，颈椎组的TBI评分从49.7提高到74.0，胸椎组的TBI评分从79.8提高到97.3。
Both natural and adaptive immune responses were strikingly decreased 2 weeks after injury in 49 spinal cord injuries, 28 tetraplegic and 21 paraplegic patients compared to agematched controls. All values are expressed as means. NK cell function decreased to 21.0% 2 weeks after spinal cord injury compared to 48.6% in controls. At 2 weeks, plasma ACTH values increased to 17.0 pg/ml in patients compared to 11.2 pg/ml in controls and urine free cortisol levels were elevated to 162.4 mu g/24 h in patients compared to 53.6 ug/24 h in controls. T cell function decreased to 40.2% of normal (lymphocyte transformation) by 3 months post injury. T cell activation (IL-2R) was diminished, i.e., 183.4 ug/ml compared to 328.2 ug/ml in controls. With rehabilitation therapy, NK cell function increased to 41.6% by 7 months post injury. NK cell-mediated lysis diminished sharply between 7 and 9 months decreasing to 22.8% at 10 months and ultimately returning to the 2 week post injury level. Rehabilitation therapy contributed to the restoration of T cell function to 92.0% of normal by 6 months post injury where it remained for 6+ months. IL-2R values improved in parallel with lymphocyte transformation. Whereas NK cell-induced lysis remained depressed, i.e., 11.8% at 6 months and 11.4% at 12+ months in patients not receiving therapy, the restoration of NK cell function at 6 months to 40.6% in rehabilitated patients decreased to 23.0% with cessation of treatment. NK cell-mediated lysis values in cervical injury patients were significantly less than those in the thoracic injury group. FIM scores of the two paralleled their NK cell function. With rehabilitation therapy, NK cell-mediated lysis in the cervical group increased from 15.2% to 28.4%, whereas it improved in the thoracic group with therapy from 26.8% to 43.7%. With rehabilitation therapy, lymphocyte transformation in the cervical group increased from 37.3% to 85.6% and improved in the thoracic group from 48.4% to 88.9%. With rehabilitation therapy, FIM scores improved from 49.7 to 74.0 in the cervical group and from 79.8 to 97.3 in thoracic patients compared to 126 in controls of healthy age matched controls.