Autoimmunity And Immune Deficiency After Spinal Cord Injury: Association With Rehabilitation Outcomes

Maladaptive Systemic Immune Response After Spinal Cord Injury: Humoral Post-traumatic Autoimmunity Against Central and Peripheral Nervous System Antigens in Association With Neurogenous Immune Depression as a Confounder of Rehabilitation

The SCIentinel-prolong study systematically analyzes humoral autoantibody responses and thier interaction with post-spinal cord injury (SCI) immune-deficiency and infections as well as their association with the clinical course of rehabilitation. Therefore, molecular and immunological tests in blood and cerebrospinal fluid specimen are combined with clinical outcomes ranging from neurological function, neuropathic pain and spasticity to walking tests and measures of independence in daily living within the first year after SCI. Including a control group with participants suffering from vertebral fractures without SCI allows to differentiate between neurological and general injury and treatment effects.

Inclusion Criteria:

• Acute traumatic SCI, American Spinal Injury Association Impairment Scale (AIS) A to D, neurologic level of injury C3 - L2 or acute vertebral fracture without SCI
• Inclusion within 21 days post-injury
• For Italian centers only: SCI-Treatment using Methylprednisolone (according to NASCIS).

Exclusion Criteria:

• Non-traumatic SCI
• Severe multiple trauma
• Serious traumatic brain injury
• Pre-exiting neurological diseases
• Malignant Neoplasia, except in complete remission for 5 years
• Rheumatic diseases / collagenosis / vasculitis
• Other autoimmune diseases
• Pre-existing chronic infection
• Severe alcohol or drug addiction
• Pregnancy or lactation
• Simultaneous participation in interventional clinical trials
• For centers in Germany or Switzerland only: SCI-treatment using Methylprednisolone (according to NASCIS).