NEUROENDOCRINE-IMMUNE INTERACTIONS ASSOCIATED WITH LOSS AND RESTORATION OF IMMUNE-SYSTEM FUNCTION IN SPINAL-CORD INJURY AND STROKE PATIENTS

被引:67
作者
CRUSE, JM [1 ]
LEWIS, RE [1 ]
BISHOP, GR [1 ]
KLIESCH, WF [1 ]
GAITAN, E [1 ]
机构
[1] MISSISSIPPI METHODIST REHABIL CTR,JACKSON,MS
关键词
STRESS; NK-CELL; T-CELL; IMMUNOSUPPRESSION; SPINAL CORD INJURY; NEUROIMMUNOENDOCRINOLOGY; PHYSICAL REHABILITATION;
D O I
10.1007/BF02918615
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Both natural and adaptive immune responses were shown to be strikingly decreased in initial blood samples from 34 spinal cord injury and stroke patients. NK-cell function decreased to 24.8% (mean) 2 weeks after spinal cord injury in previously healthy young adults whose control group revealed a mean NK-cell function of 48.7%. This was accompanied at 2 weeks by increased plasma ACTH (mean of 17.0 pg/ml from 17 patients compared to a mean of 11.2 pg/ml from 12 controls) and urine free cortisol levels (mean of 152.1 mug/24 h from 9 patients compared to 53.6 mug/24 h from 15 controls). T-cell function and/or activation decreased to below normal values within 3 months after injury as revealed by lymphocyte transformation that was 32.8% of normal at 3 months. T-cell activation diminished as shown by a mean IL-2 receptor level of 179.3 units/ml in patients compared to 328.2 units/ml in controls. Serial monitoring of NK- and T-cell function revealed that specific physical rehabilitation therapy over a period of 6 months after injury restored NK- and T-cell function to near normal levels in most patients. This improvement was accompanied by a parallel rise in the patients' functional independence measurement scores. Results suggest critical neuroendocrine-immune system interactions in the restoration of immune function. Cortisol levels reverted to normal after 6 months of rehabilitation. Limited data suggest that natural immune system depression, NK-cell function, persists in spinal cord injury patients not receiving rehabilitation therapy (mean NK-cell lysis of 10.3%; p < 0.01).
引用
收藏
页码:104 / 116
页数:13
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