免疫因素在脊髓损伤中的作用

背景：胶质瘢痕是中枢神经系统再生的主要障碍，对中枢神经的再生起着物理和化学屏障的作用，如何有效抑制胶质瘢痕形成，促进神经轴突再生，具有重要意义。目的：探讨免疫反应在脊髓损伤后胶质瘢痕的形成过程中的作用。方法：通过计算机分别检索PubMed数据库和中国期刊全文数据库1990年1月至2013年1月与脊髓损伤机制、免疫细胞和脊髓损伤及脊髓损伤后胶质瘢痕形成相关文献。检索词“脊髓损伤，免疫，胶质瘢痕”和“spinalcordinjury，immunity，gliascar”，限定文章检索的语言种类分别为中文和英文。经过筛选共保留72篇文献做进一步分析。结果与结论：脊髓损伤后自身免疫反应在其中所起到的作用仍一直备受争议。研究表明，脊髓损伤可造成机体细胞免疫和非特异性免疫功能的抑制，引起免疫功能降低，监测免疫指标，提高免疫功能，对促进脊髓损伤患者全面康复具有重要意义。胶质瘢痕是阻碍脊髓损伤后修复的最重要的因素。免疫炎症反应是脊髓损伤后继发加重的重要因素。脊髓损伤后的修复程度主要依赖于对残余神经元的保护。使其免受二次损伤，自身免疫性T细胞可以保护残余神经元，T淋巴细胞在脊髓损伤后胶质瘢痕形成中的具体作用还不清楚，需要进一步探索。

Immune factors in spinal cord injury

BACKGROUND： The glial scar is a major obstacle to the regeneration of the central nervous system, which plays a physical and chemical barrier role to central nervous system regeneration. How to effectively inhibit glial scar formation and promote axonal regeneration has great significance. OBJECTIVE： To explore the effect of the immune response in the formation of the glial scar after spinal cord injury. METHODS： A computer-based online search was performed in the PubMed database and the CNKI database for the articles on the mechanisms of spinal cord injury, immune cells and spinal cord injury as well aS the glial scar formation after spinal cord injury from January 1990 to January 2013. The key words were ＂spinal cord injury, immunity, glia scar＂ in Chinese and English. The languages of the articles were limited in Chinese and English. Finally, 72 articles were included for the further analysis according the inclusion criteria. RESULTS AND CONCLUSION： After spinal cord injury, the effect of autoimmune response in which still been much debated. Studies showed that spinal cord injury can cause suppression of cellular immunity and non-specific immune function, causing immune function decreasing. Monitoring immune indicators and improving immune function have great significance in promoting the full rehabilitation of patients with spinal cord injury. Glial scar is the most important factor to prevent the repaidng after spinal cord injury. Immune and inflammatory response is the main reason to secondary spinal cord injury. Degree of repair after spinal cord injury mainly depends on the protection of the residual neurons in order to keep them off secondary damage. However, autoimmune T cells ~an protect the residual neurons, the specific effect of T lymphocytes in glial scar formation after spinal cord injury is still unclear, and further exploration is needed.