Neuroinflammation: Yin & Yang of our Immune System

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After sustaining a spinal cord injury, a patient’s inflammatory responses get to work quickly to repair damaged nerve tissue. However, this response by our immune system also has a detrimental effect.

It happens quicker than you’d think: a slip of the knife while chopping vegetables or a finger cut on some broken glass. Lacerations are commonplace. The human body responds automatically to injuries like this with inflammation (Latin, Inflammatio). An army of white blood cells and other cells are immediately dispatched to the wound. There they destroy bacteria and heal the damaged tissue. As soon as you feel the signs of inflammation, such as heat or swelling, the healing process is already well underway.
A spinal cord injury also triggers an inflammatory response in the nerve tissue. The technical term for this reaction is neuroinflammation. The processes are similar to those triggered by a cut finger. At first, the blood platelets attempt to stop the bleeding in the spinal cord. Then highly specialised immune cells remove damaged tissue debris and start repairing the injury with specific molecules, and a scar forms to seal the wound. These are the positive effects of neuroinflammation.
Unfortunately, neuroinflammation also has a dark side. The immune cells release substances that damage healthy neural tissue around the injury, so they end up contributing significantly to what is known as secondary injury. Secondary injury is best described as a wildfire that spreads rapidly in the first few days after the trauma and worsens the initial injury. As a result, patients with spinal cord injuries lose additional bodily functions.
So, healing and damaging processes are closely interlinked, like yin and yang. Research aims to influence this delicate balance in favour of the patients. An ideal scenario would be to initially contain the wildfire, thereby reducing the harmful effect of neuroinflammation. In a second step, medication or therapy could stimulate the growth of damaged cells. The combination of both promises a significant recovery of neural tissue and the rescue of the patients’ important bodily functions. Although it is difficult, in practice, to really make any difference to the balance, some therapies are being tested on patients with spinal cord injuries.
There is hope that, in the not too distant future, it will be possible to decrease the effect of the dark side of neuroinflammation (yin) and promote the positive effects (yang).

Therapy: Hypothermia
Effect: This therapy lowers the body temperature to between 32 and 34 degrees Celsius in order to prevent the damaged tissue from dying.
Phase: Clinical Phase-II - Study in preparation

Effect: This antibiotic has far-reaching impacts that go beyond its antibacterial effect. Among other effects, it protects neurones, is anti-inflammatory, and inhibits programmed cell death.
Phase: Clinical Phase-III - Study underway

Therapy: Oestrogen
Effect: The female hormone oestrogen is a real all-rounder. It reduces oedema in the neural tissue, slows the penetration of inflammatory cells and curbs the loss of myelin (insulating layer of nerves).
Phase: In pre-clinical phase

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