LAUSR

Patients with spinal cord injury (SCI) frequently develop infections that may affect quality of life, be life-threatening, and impair their neurological recovery in the acute and subacute injury phase. Therefore, identifying SCI patients at risk for developing infections in this stage is of utmost importance. We determined the systemic levels of immune cell populations, cytokines, chemokines and growth factors in 81 patients with traumatic SCI at 4 weeks after injury and compared them with those of 26 age-matched healthy control subjects. Patients who are going to develop infections between 4 and 16 weeks after injury exhibit higher number of neutrophils and eosinophils, as well as lower numbers of lymphocytes and eotaxin-1 (CCL11) levels. Accordingly, lasso logistic regression shows that incomplete lesions (AIS C and D grades), the levels of eotaxin-1, and the number of lymphocytes, basophils and monocytes are predictive of lower odds of infections. On the other hand, the number of neutrophils and eosinophils as well as, in a lesser extent, the levels of IP-10 (CXCL10), MCP-1 (CCL2), BDNF and VEGF-A are predictors of greater odds of infections. Overall, our results point to systemic immune disbalance after SCI as predictors of infections in a period when infections may greatly interfere with neurological and functional recovery and suggest new pathways and players to further explore novel therapeutic strategies.