Neural Regeneration Research ›› 2026, Vol. 21 ›› Issue (1): 298-299.doi: 10.4103/NRR.NRR-D-24-01078

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Spinal cord injury–associated disruption of the autonomic immune control: Does biological sex matter?

Sara Rito-Fernandes, António J. Salgado, Nuno A. Silva# , Susana Monteiro*, #   

  1. Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal (Rito-Fernandes S, Salgado AJ, Silva NA, Monteiro S) ICVS/3B’s Associate Lab, PT Government Associated Lab, Braga/Guimarães, Portugal (Rito-Fernandes S, Salgado AJ, Silva NA, Monteiro S)
  • Online:2026-01-15 Published:2025-04-23
  • Contact: Susana Monteiro, PhD, susanamonteiro@med.uminho.pt
  • Supported by:
    This work was funded by the Santa Casa Neuroscience Awards—Prize Melo e Castro for Spinal Cord Injury Research (MC-18-2021) (to AJS and NAS), and by the Wings for Life Spinal Cord Research Foundation (WFL-PT-14/23) (to NAS). This work was also funded by national funds through the Foundation for Science and Technology (FCT)—projects UIDB/50026/2020, UIDP/50026/2020, and EXPL/MED-PAT/0931/2021 - http://doi.org/10.54499/EXPL/MEDPAT/0931/2021, supported by the Norte Portugal Regional Operational Programme (NORTE 2020) under the PORTUGAL 2020 Partnership Agreement through the European Regional Development Fund (ERDF) (to SM). We would like to acknowledge the support given by the Portuguese Foundation of Science and Technology to SM (CEECIND/01902/2017- Doi: 10.54499/ CEECIND/01902/2017/CP1458/CT0024), and NAS (CEECIND/04794/2007).

Abstract: The impact of spinal cord injury (SCI) on the immune system is increasingly recognized in a field traditionally focused on motor impairments. SCI can seriously affect the immune system by progressively disrupting the regulatory mechanisms that control immune responses. This dysregulation varies widely among patients and can evolve over time, ranging from systemic inflammatory responses to immunosuppression, greatly contributing to the morbidity and mortality of individuals with SCI (Bao et al., 2011; Brennan et al., 2024). Pro-inflammatory mediators produced at the site of injury not only instigate intraspinal inflammation by promoting the influx of peripheral leukocytes into the injured spinal cord, but also enter the bloodstream, triggering a systemic inflammatory response. Systemic inflammatory response is characterized by the activation and mobilization of circulating inflammatory cells, mainly neutrophils, which can infiltrate unaffected peripheral organs. The resulting pro-inflammatory microenvironment established within these tissues can lead to organ damage and dysfunction (Bao et al., 2011). When this dysregulation affects lymphoid organs, it can further exacerbate SCIassociated complications by causing secondary immunosuppression, resulting in increased vulnerability to infections (Brennan et al., 2024).