Neurotoxic or Neuroprotective? Current Controversies in SCI-Induced Autoimmunity.

Controversy exists regarding the autoimmune response that has been observed following traumatic spinal cord injury (SCI). It is not clear if this represents a protective response by the immune system to prevent further tissue damage, a pathological reaction of the immune system to central nervous system antigens released by the injury, or a combination of both. Experimental evidence indicates that B cells produce auto-antibodies following SCI and that the presence of self-reactive antibodies is associated with tissue damage. Conversely, other studies suggest T cell activity at the site of the injury promotes tissue regeneration. Vaccination with dendritic cells exposed to central nervous system (CNS) antigens dramatically improves recovery of motor function in spinal cord injured rats. Further research is required to determine the nature of post-SCI B cell and T cell responses and to establish efficacy of dendritic cell vaccination therapy in clinical studies. This information is critical for the development of therapies to either suppress or promote immune responses following neurotrauma to improve neurological outcomes.