{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T11:27:11Z","timestamp":1790508431662,"version":"4.1.0"},"reference-count":157,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T00:00:00Z","timestamp":1631836800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 NS106908"],"award-info":[{"award-number":["R01 NS106908"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 NS111761"],"award-info":[{"award-number":["R01 NS111761"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 NS085426"],"award-info":[{"award-number":["R01 NS085426"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>Individuals with spinal cord injuries (SCI) exhibit increased susceptibility to infection, with pneumonia consistently ranking as a leading cause of death. Despite this statistic, chronic inflammation and concurrent immune suppression have only recently begun to be explored mechanistically. Investigators have now identified numerous changes that occur in the peripheral immune system post-SCI, including splenic atrophy, reduced circulating lymphocytes, and impaired lymphocyte function. These effects stem from maladaptive changes in the spinal cord after injury, including plasticity within the spinal sympathetic reflex circuit that results in exaggerated sympathetic output in response to peripheral stimulation below injury level. Such pathological activity is particularly evident after a severe high-level injury above thoracic spinal cord segment 6, greatly increasing the risk of the development of sympathetic hyperreflexia and subsequent disrupted regulation of lymphoid organs. Encouragingly, studies have presented evidence for promising therapies, such as modulation of neuroimmune activity, to improve regulation of peripheral immune function. In this review, we summarize recent publications examining (1) how various immune functions and populations are affected, (2) mechanisms behind SCI-induced immune dysfunction, and (3) potential interventions to improve SCI individuals\u2019 immunological function to strengthen resistance to potentially deadly infections.<\/jats:p>","DOI":"10.3390\/biology10090928","type":"journal-article","created":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T21:23:29Z","timestamp":1631913809000},"page":"928","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Peripheral Immune Dysfunction: A Problem of Central Importance after Spinal Cord Injury"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2486-0457","authenticated-orcid":false,"given":"Marisa","family":"Jeffries","sequence":"first","affiliation":[{"name":"Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA 19129, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Tom","sequence":"additional","affiliation":[{"name":"Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA 19129, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1038\/sj.sc.3101080","article-title":"Causes of death after spinal cord injury","volume":"38","author":"Soden","year":"2000","journal-title":"Spinal Cord"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3238","DOI":"10.1093\/brain\/aws267","article-title":"Functional neurological recovery after spinal cord injury is impaired in patients with infections","volume":"135","author":"Failli","year":"2012","journal-title":"Brain"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1086\/516144","article-title":"Infections in patients with spinal cord injuries","volume":"25","author":"Montgomerie","year":"1997","journal-title":"Clin. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1743","DOI":"10.1111\/j.1460-9568.2007.05447.x","article-title":"Spinal cord injury-induced immune depression syndrome (SCI-IDS)","volume":"25","author":"Riegger","year":"2007","journal-title":"Eur. J. Neurosci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1038\/nrn1765","article-title":"Central nervous system injury-induced immune deficiency syndrome","volume":"6","author":"Meisel","year":"2005","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1038\/sc.2014.184","article-title":"Immune dysfunction and chronic inflammation following spinal cord injury","volume":"53","author":"Allison","year":"2015","journal-title":"Spinal Cord"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.expneurol.2014.04.023","article-title":"The paradox of chronic neuroinflammation, systemic immune suppression, autoimmunity after traumatic chronic spinal cord injury","volume":"258","author":"Schwab","year":"2014","journal-title":"Exp. Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1089\/08977150260139129","article-title":"Elevated serum titers of proinflammatory cytokines and CNS autoantibodies in patients with chronic spinal cord injury","volume":"19","author":"Hayes","year":"2002","journal-title":"J. Neurotrauma"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1016\/j.apmr.2007.08.004","article-title":"Clinical correlates of elevated serum concentrations of cytokines and autoantibodies in patients with spinal cord injury","volume":"88","author":"Davies","year":"2007","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s12979-017-0103-6","article-title":"Immunosenescence in persons with spinal cord injury in relation to urinary tract infections -a cross-sectional study","volume":"14","author":"Pavlicek","year":"2017","journal-title":"Immun. Ageing"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1016\/S0929-6646(08)60062-5","article-title":"Circulating levels of markers of inflammation and endothelial activation are increased in men with chronic spinal cord injury","volume":"106","author":"Wang","year":"2007","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1819","DOI":"10.1089\/neu.2017.5519","article-title":"Persons with chronic spinal cord injury have decreased natural killer cell and increased toll-like receptor\/inflammatory gene expression","volume":"35","author":"Herman","year":"2018","journal-title":"J. Neurotrauma"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1038\/sj.sc.3100638","article-title":"Long-term survival in spinal cord injury: A fifty year investigation","volume":"36","author":"Frankel","year":"1998","journal-title":"Spinal Cord"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1038\/sc.2016.173","article-title":"Infections in the spinal cord-injured population: A systematic review","volume":"55","author":"Farrell","year":"2017","journal-title":"Spinal Cord"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1038\/sc.2017.64","article-title":"Causes of death after traumatic spinal cord injury\u2014A 70-year British study","volume":"55","author":"Savic","year":"2017","journal-title":"Spinal Cord"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1038\/s41393-020-00593-2","article-title":"Causes of death after spinal cord injury in the Czech Republic","volume":"59","author":"Kriz","year":"2021","journal-title":"Spinal Cord"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1179\/2045772311Y.0000000022","article-title":"Mortality in patients with traumatic spinal cord injury: Descriptive analysis of 62 deceased subjects","volume":"34","author":"Thietje","year":"2011","journal-title":"J. Spinal Cord Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1007\/s12975-011-0114-0","article-title":"Respiratory motor control disrupted by spinal cord injury: Mechanisms, evaluation, and restoration","volume":"2","author":"McKay","year":"2011","journal-title":"Transl. Stroke Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"8556","DOI":"10.1038\/s41598-020-65440-z","article-title":"Can Daily walking alone reduce pneumonia-related mortality among older people?","volume":"10","author":"Ikeda","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1249\/MSS.0000000000000142","article-title":"Dose-response relationship between exercise and respiratory disease mortality","volume":"46","author":"Williams","year":"2014","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"233","DOI":"10.2188\/jea.JE20170341","article-title":"Associations of daily walking time with pneumonia mortality among elderly individuals with or without a medical history of myocardial infarction or stroke: Findings from the Japan collaborative cohort study","volume":"29","author":"Ukawa","year":"2019","journal-title":"J. Epidemiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"455","DOI":"10.4187\/respcare.06992","article-title":"Reduced Step count and clinical frailty in hospitalized adults with community-acquired pneumonia","volume":"65","author":"Rice","year":"2020","journal-title":"Respir. Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.expneurol.2010.08.036","article-title":"Impaired immune responses following spinal cord injury lead to reduced ability to control viral infection","volume":"226","author":"Held","year":"2010","journal-title":"Exp. Neurol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3018","DOI":"10.1128\/IAI.00255-13","article-title":"Enhanced susceptibility to urinary tract infection in the spinal cord-injured host with neurogenic bladder","volume":"81","author":"Balsara","year":"2013","journal-title":"Infect. Immun."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1093\/brain\/awv375","article-title":"Spinal cord injury-induced immune deficiency syndrome enhances infection susceptibility dependent on lesion level","volume":"139","author":"Brommer","year":"2016","journal-title":"Brain"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1186\/s12974-016-0574-y","article-title":"Chronic spinal cord injury attenuates influenza virus-specific antiviral immunity","volume":"13","author":"Zha","year":"2016","journal-title":"J. Neuroinflamm."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1186\/s12974-018-1191-8","article-title":"Impaired CD8 T cell antiviral immunity following acute spinal cord injury","volume":"15","author":"Norden","year":"2018","journal-title":"J. Neuroinflamm."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1007\/s11914-012-0117-0","article-title":"Spinal cord injury-induced osteoporosis: Pathogenesis and emerging therapies","volume":"10","author":"Battaglino","year":"2012","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_29","first-page":"127","article-title":"Spinal cord injury and osteoporosis: Causes, mechanisms, and rehabilitation strategies","volume":"1","author":"Tan","year":"2013","journal-title":"Int. J. Phys. Med. Rehabil."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1111\/j.0105-2896.2005.00334.x","article-title":"The role of the immune system in the pathophysiology of osteoporosis","volume":"208","author":"Clowes","year":"2005","journal-title":"Immunol. Rev."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1159\/000431091","article-title":"Immunology of Osteoporosis: A mini-review","volume":"62","author":"Pietschmann","year":"2016","journal-title":"Gerontology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"657","DOI":"10.3389\/fimmu.2018.00657","article-title":"Immunoporosis: Immunology of Osteoporosis-role of T cells","volume":"9","author":"Srivastava","year":"2018","journal-title":"Front. Immunol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1310\/sci2303-207","article-title":"Inflammatory stress effects on health and function after spinal cord injury","volume":"23","author":"Noller","year":"2017","journal-title":"Top. Spinal Cord Inj. Rehabil."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1038\/sj.sc.3101641","article-title":"Neuropathic pain after traumatic spinal cord injury--relations to gender, spinal level, completeness, and age at the time of injury","volume":"42","author":"Werhagen","year":"2004","journal-title":"Spinal Cord"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1615\/CritRevPhysRehabilMed.2013007944","article-title":"Central neuropathic pain in spinal cord injury","volume":"25","author":"Lee","year":"2013","journal-title":"Crit. Rev. Phys. Rehabil. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/s40122-015-0033-y","article-title":"Management of neuropathic pain associated with spinal cord injury","volume":"4","author":"Hagen","year":"2015","journal-title":"Pain Ther."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1002\/ejp.905","article-title":"Neuropathic pain prevalence following spinal cord injury: A systematic review and meta-analysis","volume":"21","author":"Burke","year":"2017","journal-title":"Eur. J. Pain"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1097\/jnr.0000000000000227","article-title":"Neuropathic pain experiences of spinal cord injury patients","volume":"26","author":"Li","year":"2018","journal-title":"J. Nurs. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"438","DOI":"10.5535\/arm.20081","article-title":"Prevalence and characteristics of neuropathic pain in patients with spinal cord injury referred to a rehabilitation center","volume":"44","author":"Kim","year":"2020","journal-title":"Ann. Rehabil. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.expneurol.2011.12.021","article-title":"Immune responses of microglia in the spinal cord: Contribution to pain states","volume":"234","author":"Schomberg","year":"2012","journal-title":"Exp. Neurol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/s00540-018-2579-4","article-title":"Roles of inflammation, neurogenic inflammation, and neuroinflammation in pain","volume":"33","author":"Matsuda","year":"2019","journal-title":"J. Anesth."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S1474-4422(12)70134-5","article-title":"The role of the immune system in the generation of neuropathic pain","volume":"11","author":"Calvo","year":"2012","journal-title":"Lancet Neurol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1186\/s12974-016-0625-4","article-title":"Targeting inflammation as a treatment modality for neuropathic pain in spinal cord injury: A randomized clinical trial","volume":"13","author":"Allison","year":"2016","journal-title":"J. Neuroinflamm."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1089\/neu.2017.5405","article-title":"Impact of complete spinal cord injury on healing of skin ulcers in mouse models","volume":"35","author":"Kumar","year":"2018","journal-title":"J. Neurotrauma"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Zhao, R., Liang, H., Clarke, E., Jackson, C., and Xue, M. (2016). Inflammation in chronic wounds. Int. J. Mol. Sci., 17.","DOI":"10.3390\/ijms17122085"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1097\/01.ASW.0000416006.55218.d0","article-title":"Acute and impaired wound healing: Pathophysiology and current methods for drug delivery, part 1: Normal and chronic wounds: Biology, causes, and approaches to care","volume":"25","author":"Hamblin","year":"2012","journal-title":"Adv. Skin Wound Care"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"316235","DOI":"10.1155\/2015\/316235","article-title":"Curbing inflammation in skin wound healing: A review","volume":"2015","author":"Rosique","year":"2015","journal-title":"Int. J. Inflamm."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1111\/j.1742-481X.2007.00360.x","article-title":"Physiological changes in tissues denervated by spinal cord injury tissues and possible effects on wound healing","volume":"5","author":"Rappl","year":"2008","journal-title":"Int. Wound J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1089\/neu.2016.4611","article-title":"Spinal cord injury suppresses cutaneous inflammation: Implications for peripheral wound healing","volume":"34","author":"Marbourg","year":"2017","journal-title":"J. Neurotrauma"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1097\/PHM.0b013e31802f0247","article-title":"Cardiovascular disease in spinal cord injury: An overview of prevalence, risk, evaluation, and management","volume":"86","author":"Myers","year":"2007","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1042\/AN20130021","article-title":"Neuroendocrine and cardiac metabolic dysfunction and NLRP3 inflammasome activation in adipose tissue and pancreas following chronic spinal cord injury in the mouse","volume":"5","author":"Bigford","year":"2013","journal-title":"ASN Neuro"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1310\/sci1903-183","article-title":"Cardiometabolic risk clustering in spinal cord injury: Results of exploratory factor analysis","volume":"19","author":"Libin","year":"2013","journal-title":"Top. Spinal Cord Inj. Rehabil."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Solinsky, R., Betancourt, L., Schmidt-Read, M., Kupfer, M., Owens, M., Schwab, J.M., Dusseau, N.B., Szlachcic, Y., Sutherland, L., and Taylor, J.A. (2021). Acute spinal cord injury is associated with prevalent cardiometabolic risk factors. Arch. Phys. Med. Rehabil.","DOI":"10.1016\/j.apmr.2021.04.022"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1212\/WNL.0b013e3182a1aa68","article-title":"Cardiovascular disease and spinal cord injury: Results from a national population health survey","volume":"81","author":"Cragg","year":"2013","journal-title":"Neurology"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1038\/sc.2010.12","article-title":"Subclinical atherosclerosis is related to injury level but not to inflammatory parameters in spinal cord injury subjects","volume":"48","author":"Pithon","year":"2010","journal-title":"Spinal Cord"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"613","DOI":"10.2340\/16501977-2351","article-title":"Metabolically healthy obesity and subclinical atherosclerosis in persons with spinal cord injury","volume":"50","author":"Yoon","year":"2018","journal-title":"J. Rehabil. Med."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Bigford, G.E., Szeto, A., Kimball, J., Herderick, E.E., Mendez, A.J., and Nash, M.S. (2021). Cardiometabolic risks and atherosclerotic disease in ApoE knockout mice: Effect of spinal cord injury and Salsalate anti-inflammatory pharmacotherapy. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0246601"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"113704","DOI":"10.1016\/j.expneurol.2021.113704","article-title":"Neuroimmunological therapies for treating spinal cord injury: Evidence and future perspectives","volume":"341","author":"Chio","year":"2021","journal-title":"Exp. Neurol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1002\/jnr.490180107","article-title":"Noradrenergic sympathetic innervation of the spleen: I. Nerve fibers associate with lymphocytes and macrophages in specific compartments of the splenic white pulp","volume":"18","author":"Felten","year":"1987","journal-title":"J. Neurosci. Res."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1002\/jnr.490180108","article-title":"Noradrenergic sympathetic innervation of the spleen: II. Tyrosine hydroxylase (TH)-positive nerve terminals form synapticlike contacts on lymphocytes in the splenic white pulp","volume":"18","author":"Felten","year":"1987","journal-title":"J. Neurosci. Res."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.mce.2010.04.005","article-title":"The anti-inflammatory and immunosuppressive effects of glucocorticoids, recent developments and mechanistic insights","volume":"335","author":"Coutinho","year":"2011","journal-title":"Mol. Cell. Endocrinol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jneuroim.2018.05.007","article-title":"The spleen as a neuroimmune interface after spinal cord injury","volume":"321","author":"Noble","year":"2018","journal-title":"J. Neuroimmunol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1038\/nn.4643","article-title":"Spinal cord injury-induced immunodeficiency is mediated by a sympathetic-neuroendocrine adrenal reflex","volume":"20","author":"Pruss","year":"2017","journal-title":"Nat. Neurosci."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"12970","DOI":"10.1523\/JNEUROSCI.1974-13.2013","article-title":"Autonomic dysreflexia causes chronic immune suppression after spinal cord injury","volume":"33","author":"Zhang","year":"2013","journal-title":"J. Neurosci."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1038\/nn.4289","article-title":"Silencing spinal interneurons inhibits immune suppressive autonomic reflexes caused by spinal cord injury","volume":"19","author":"Ueno","year":"2016","journal-title":"Nat. Neurosci."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.autneu.2017.05.002","article-title":"Autonomic dysreflexia after spinal cord injury: Systemic pathophysiology and methods of management","volume":"209","author":"Eldahan","year":"2018","journal-title":"Auton. Neurosci."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.expneurol.2007.05.019","article-title":"Impaired antibody synthesis after spinal cord injury is level dependent and is due to sympathetic nervous system dysregulation","volume":"207","author":"Lucin","year":"2007","journal-title":"Exp. Neurol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1186\/1742-2094-11-65","article-title":"Chronic thoracic spinal cord injury impairs CD8+ T-cell function by up-regulating programmed cell death-1 expression","volume":"11","author":"Zha","year":"2014","journal-title":"J. Neuroinflamm."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Hong, J., Chang, A., Zavvarian, M.M., Wang, J., Liu, Y., and Fehlings, M.G. (2018). Level-specific differences in systemic expression of pro- and anti-inflammatory cytokines and chemokines after spinal cord injury. Int. J. Mol. Sci., 19.","DOI":"10.20944\/preprints201807.0382.v1"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1038\/sc.2008.32","article-title":"C-Reactive protein in adults with chronic spinal cord injury: Increased chronic inflammation in tetraplegia vs paraplegia","volume":"46","author":"Gibson","year":"2008","journal-title":"Spinal Cord"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s12026-015-8698-1","article-title":"Circulating T cell subsets are altered in individuals with chronic spinal cord injury","volume":"63","author":"Monahan","year":"2015","journal-title":"Immunol. Res."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1093\/ptj\/80.8.808","article-title":"Neuroanatomical substrates of functional recovery after experimental spinal cord injury: Implications of basic science research for human spinal cord injury","volume":"80","author":"Basso","year":"2000","journal-title":"Phys. Ther."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"559313","DOI":"10.3389\/fnsys.2020.559313","article-title":"Spinal cord imaging markers and recovery of volitional leg movement with spinal cord epidural stimulation in individuals with clinically motor complete spinal cord injury","volume":"14","author":"Rejc","year":"2020","journal-title":"Front. Syst. Neurosci."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1038\/sj.sc.3101670","article-title":"Neuropathology: The foundation for new treatments in spinal cord injury","volume":"42","author":"Kakulas","year":"2004","journal-title":"Spinal Cord"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1152\/japplphysiol.00293.2021","article-title":"Recruitment order of motor neurons promoted by epidural stimulation in individuals with spinal cord injury","volume":"131","author":"Ibanez","year":"2021","journal-title":"J. Appl. Physiol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1056\/NEJMoa1803588","article-title":"Recovery of over-ground walking after chronic motor complete spinal cord injury","volume":"379","author":"Angeli","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Hong, J., Chang, A., Liu, Y., Wang, J., and Fehlings, M.G. (2019). Incomplete spinal cord injury reverses the level-dependence of spinal cord injury immune deficiency syndrome. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20153762"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1084\/jem.20151345","article-title":"Gut dysbiosis impairs recovery after spinal cord injury","volume":"213","author":"Kigerl","year":"2016","journal-title":"J. Exp. Med."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1523\/JNEUROSCI.2417-19.2019","article-title":"Attenuating neurogenic sympathetic hyperreflexia robustly improves antibacterial immunity after chronic spinal cord injury","volume":"40","author":"Mironets","year":"2020","journal-title":"J. Neurosci."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"4146","DOI":"10.1523\/JNEUROSCI.2376-17.2018","article-title":"Soluble TNFalpha signaling within the spinal cord contributes to the development of autonomic dysreflexia and ensuing vascular and immune dysfunction after spinal cord injury","volume":"38","author":"Mironets","year":"2018","journal-title":"J. Neurosci."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1007\/s00223-013-9752-4","article-title":"Control of bone remodeling by the peripheral sympathetic nervous system","volume":"94","author":"Elefteriou","year":"2014","journal-title":"Calcif. Tissue Int."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"a031344","DOI":"10.1101\/cshperspect.a031344","article-title":"Neural regulation of bone and bone marrow","volume":"8","author":"Maryanovich","year":"2018","journal-title":"Cold Spring Harb. Perspect. Med."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1038\/nature03398","article-title":"Leptin regulation of bone resorption by the sympathetic nervous system and CART","volume":"434","author":"Elefteriou","year":"2005","journal-title":"Nature"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1517\/14728222.9.5.931","article-title":"The role of the sympathetic nervous system in controlling bone metabolism","volume":"9","author":"Togari","year":"2005","journal-title":"Expert Opin. Ther. Targets"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"17767","DOI":"10.1073\/pnas.1109402108","article-title":"Sympathetic control of bone mass regulated by osteopontin","volume":"108","author":"Nagao","year":"2011","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"2081","DOI":"10.1182\/blood.V96.6.2081","article-title":"Depressed immunity and impaired proliferation of hematopoietic progenitor cells in patients with complete spinal cord injury","volume":"96","author":"Iversen","year":"2000","journal-title":"Blood"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s10517-006-0109-0","article-title":"Characteristics of bone marrow cells under conditions of impaired innervation in patients with spinal trauma","volume":"141","author":"Chernykh","year":"2006","journal-title":"Bull. Exp. Biol. Med."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"3702","DOI":"10.1038\/s41467-020-17564-z","article-title":"Spinal cord injury causes chronic bone marrow failure","volume":"11","author":"Carpenter","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1212\/01.wnl.0000436074.98534.6e","article-title":"Spinal cord injury and type 2 diabetes: Results from a population health survey","volume":"81","author":"Cragg","year":"2013","journal-title":"Neurology"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1310\/sci1204-1","article-title":"Prevalence of obesity after spinal cord injury","volume":"12","author":"Gorgey","year":"2007","journal-title":"Top. Spinal Cord Inj. Rehabil."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.1016\/j.spinee.2013.12.011","article-title":"Spinal cord injury increases the risk of type 2 diabetes: A population-based cohort study","volume":"14","author":"Lai","year":"2014","journal-title":"Spine J."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1080\/10790268.2017.1357104","article-title":"Neurogenic obesity and systemic inflammation following spinal cord injury: A review","volume":"41","author":"Farkas","year":"2018","journal-title":"J. Spinal Cord Med."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1186\/s12974-016-0736-y","article-title":"Multiple organ dysfunction and systemic inflammation after spinal cord injury: A complex relationship","volume":"13","author":"Sun","year":"2016","journal-title":"J. Neuroinflamm."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1080\/10790268.2008.11760738","article-title":"Clinical assessment and management of obesity in individuals with spinal cord injury: A review","volume":"31","author":"Rajan","year":"2008","journal-title":"J. Spinal Cord Med."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1080\/10790268.2017.1357918","article-title":"The influence of level of spinal cord injury on adipose tissue and its relationship to inflammatory adipokines and cardiometabolic profiles","volume":"41","author":"Farkas","year":"2018","journal-title":"J. Spinal Cord Med."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1016\/j.apmr.2004.11.020","article-title":"Fitness, inflammation, and the metabolic syndrome in men with paraplegia","volume":"86","author":"Manns","year":"2005","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1038\/nri3041","article-title":"The anti-inflammatory effects of exercise: Mechanisms and implications for the prevention and treatment of disease","volume":"11","author":"Gleeson","year":"2011","journal-title":"Nat. Rev. Immunol."},{"key":"ref_98","first-page":"971841","article-title":"Low-grade inflammation and spinal cord injury: Exercise as therapy?","volume":"2013","author":"Lira","year":"2013","journal-title":"Mediat. Inflamm."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.apmr.2013.08.246","article-title":"Low-grade systemic inflammation and leptin levels were improved by arm cranking exercise in adults with chronic spinal cord injury","volume":"95","author":"Camacho","year":"2014","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1016\/j.jelekin.2008.03.002","article-title":"Functional electrical stimulation cycling improves body composition, metabolic and neural factors in persons with spinal cord injury","volume":"19","author":"Griffin","year":"2009","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"1324","DOI":"10.1007\/s00125-020-05140-5","article-title":"Obesity, unfavourable lifestyle and genetic risk of type 2 diabetes: A case-cohort study","volume":"63","author":"Schnurr","year":"2020","journal-title":"Diabetologia"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1038\/nri2925","article-title":"Type 2 diabetes as an inflammatory disease","volume":"11","author":"Donath","year":"2011","journal-title":"Nat. Rev. Immunol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1080\/10790268.2006.11753887","article-title":"Diabetes mellitus in individuals with spinal cord injury or disorder","volume":"29","author":"Lavela","year":"2006","journal-title":"J. Spinal Cord Med."},{"key":"ref_104","first-page":"442","article-title":"Type 2 Diabetes and its Impact on the immune system","volume":"16","author":"Berbudi","year":"2020","journal-title":"Curr. Diabetes Rev."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.1161\/01.CIR.0000034509.14906.AE","article-title":"Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: Role of oxidative stress","volume":"106","author":"Esposito","year":"2002","journal-title":"Circulation"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1038\/ni1102-1026","article-title":"Chronic bacterial infections: Living with unwanted guests","volume":"3","author":"Young","year":"2002","journal-title":"Nat. Immunol."},{"key":"ref_107","doi-asserted-by":"crossref","unstructured":"Hannan, T.J., Mysorekar, I.U., Hung, C.S., Isaacson-Schmid, M.L., and Hultgren, S.J. (2010). Early severe inflammatory responses to uropathogenic E. coli predispose to chronic and recurrent urinary tract infection. PLoS Pathog., 6.","DOI":"10.1371\/journal.ppat.1001042"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"6170","DOI":"10.1364\/OE.16.006170","article-title":"Measurement of oxygen saturation in the retina with a spectroscopic sensitive multi aperture camera","volume":"16","author":"Mathews","year":"2008","journal-title":"Opt. Express"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1017\/S0317167100001992","article-title":"High-dose methylprednisolone for acute closed spinal cord injury--only a treatment option","volume":"29","author":"Hugenholtz","year":"2002","journal-title":"Can. J. Neurol. Sci."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"142","DOI":"10.4103\/2152-7806.163452","article-title":"Methylprednisolone in the management of spinal cord injuries: Lessons from randomized, controlled trials","volume":"6","author":"Cheung","year":"2015","journal-title":"Surg. Neurol. Int."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"433","DOI":"10.2106\/JBJS.K.00183","article-title":"Mortality and morbidity in dialysis-dependent patients undergoing spinal surgery: Analysis of a national administrative database in Japan","volume":"94","author":"Chikuda","year":"2012","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"e841","DOI":"10.1212\/WNL.0000000000007998","article-title":"High-dose methylprednisolone for acute traumatic spinal cord injury: A meta-analysis","volume":"93","author":"Liu","year":"2019","journal-title":"Neurology"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"655","DOI":"10.4187\/respcare.06314","article-title":"Clinical pharmacology of corticosteroids","volume":"63","author":"Williams","year":"2018","journal-title":"Respir. Care"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1139\/H09-050","article-title":"Greater daily leisure time physical activity is associated with lower chronic disease risk in adults with spinal cord injury","volume":"34","author":"Buchholz","year":"2009","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1053\/apmr.2002.26605","article-title":"Antimicrobial prophylaxis for urinary tract infection in persons with spinal cord dysfunction","volume":"83","author":"Morton","year":"2002","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/0002-9343(93)90254-M","article-title":"Prophylaxis of urinary tract infection in persons with recent spinal cord injury: A prospective, randomized, double-blind, placebo-controlled study of trimethoprim-sulfamethoxazole","volume":"95","author":"Gribble","year":"1993","journal-title":"Am. J. Med."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/S0022-5347(17)34882-6","article-title":"Ciprofloxacin as prophylaxis for urinary tract infection: Prospective, randomized, cross-over, placebo controlled study in patients with spinal cord lesion","volume":"151","author":"Hoiby","year":"1994","journal-title":"J. Urol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/S1473-3099(18)30279-2","article-title":"Continuous low-dose antibiotic prophylaxis for adults with repeated urinary tract infections (AnTIC): A randomised, open-label trial","volume":"18","author":"Fisher","year":"2018","journal-title":"Lancet Infect. Dis."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1016\/S0022-5347(17)49959-9","article-title":"Urinary infection and complications during clean intermittent catheterization following spinal cord injury","volume":"132","author":"Maynard","year":"1984","journal-title":"J. Urol."},{"key":"ref_120","first-page":"99","article-title":"Epidemiology of urinary tract infection among spinal cord injured patients in rehabilitation ward at Siriraj Hospital","volume":"96","author":"Ploypetch","year":"2013","journal-title":"J. Med. Assoc. Thai."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1093\/jac\/dkl010","article-title":"Prevention of urinary tract infection in spinal cord-injured patients: Safety and efficacy of a weekly oral cyclic antibiotic (WOCA) programme with a 2 year follow-up--an observational prospective study","volume":"57","author":"Salomon","year":"2006","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.ijid.2008.08.006","article-title":"Prevention of urinary tract infection in six spinal cord-injured pregnant women who gave birth to seven children under a weekly oral cyclic antibiotic program","volume":"13","author":"Salomon","year":"2009","journal-title":"Int. J. Infect. Dis."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1016\/j.spinee.2013.06.030","article-title":"An evidence-based clinical guideline for antibiotic prophylaxis in spine surgery","volume":"13","author":"Shaffer","year":"2013","journal-title":"Spine J."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"219","DOI":"10.2106\/JBJS.20.00934","article-title":"Postoperative prophylactic antibiotics in spine surgery: A propensity-matched analysis","volume":"103","author":"Abola","year":"2021","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.jhin.2019.04.017","article-title":"Antibiotic prophylaxis in spine surgery: A comparison of single-dose and 72-hour protocols","volume":"103","author":"Maciejczak","year":"2019","journal-title":"J. Hosp. Infect."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/j.apmr.2008.10.017","article-title":"A systematic review of the management of autonomic dysreflexia after spinal cord injury","volume":"90","author":"Krassioukov","year":"2009","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.4103\/1673-5374.215241","article-title":"Autonomic dysreflexia: A cardiovascular disorder following spinal cord injury","volume":"12","author":"Sharif","year":"2017","journal-title":"Neural. Regen. Res."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1097\/00152193-200302000-00014","article-title":"How do I respond to autonomic dysreflexia?","volume":"33","author":"Kim","year":"2003","journal-title":"Nursing"},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"83","DOI":"10.3389\/fnhum.2018.00083","article-title":"Normalization of blood pressure with spinal cord epidural stimulation after severe spinal cord injury","volume":"12","author":"Harkema","year":"2018","journal-title":"Front. Hum. Neurosci."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"e14969","DOI":"10.14814\/phy2.14969","article-title":"Effects of early exercise training on the severity of autonomic dysreflexia following incomplete spinal cord injury in rodents","volume":"9","author":"Harman","year":"2021","journal-title":"Physiol. Rep."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1177\/1545968315593807","article-title":"Passive hind-limb cycling reduces the severity of autonomic dysreflexia after experimental spinal cord injury","volume":"30","author":"West","year":"2016","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.1016\/S0022-5347(05)65183-X","article-title":"Intravesical capsaicin versus resiniferatoxin in patients with detrusor hyperreflexia: A prospective randomized study","volume":"167","author":"Giannantoni","year":"2002","journal-title":"J. Urol."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1046\/j.1464-410X.2003.04171.x","article-title":"The role of capsaicin-sensitive afferents in autonomic dysreflexia in patients with spinal cord injury","volume":"91","author":"Igawa","year":"2003","journal-title":"BJU Int."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1038\/sc.2010.67","article-title":"Gabapentin for spasticity and autonomic dysreflexia after severe spinal cord injury","volume":"49","author":"Rabchevsky","year":"2011","journal-title":"Spinal Cord"},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"329","DOI":"10.3389\/fphys.2012.00329","article-title":"Effects of gabapentin on muscle spasticity and both induced as well as spontaneous autonomic dysreflexia after complete spinal cord injury","volume":"3","author":"Rabchevsky","year":"2012","journal-title":"Front. Physiol."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"113083","DOI":"10.1016\/j.expneurol.2019.113083","article-title":"Paradoxical effects of continuous high dose gabapentin treatment on autonomic dysreflexia after complete spinal cord injury","volume":"323","author":"Eldahan","year":"2020","journal-title":"Exp. Neurol."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"108667","DOI":"10.1016\/j.celrep.2020.108667","article-title":"Acute post-injury blockade of alpha2delta-1 calcium channel subunits prevents pathological autonomic plasticity after spinal cord injury","volume":"34","author":"Brennan","year":"2021","journal-title":"Cell Rep."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/j.pain.2010.11.014","article-title":"TNF-alpha contributes to spinal cord synaptic plasticity and inflammatory pain: Distinct role of TNF receptor subtypes 1 and 2","volume":"152","author":"Zhang","year":"2011","journal-title":"Pain"},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"2722","DOI":"10.1093\/brain\/awr203","article-title":"Transmembrane tumour necrosis factor is neuroprotective and regulates experimental autoimmune encephalomyelitis via neuronal nuclear factor-kappaB","volume":"134","author":"Taoufik","year":"2011","journal-title":"Brain"},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"2736","DOI":"10.1093\/brain\/awr199","article-title":"Inhibition of soluble tumour necrosis factor is therapeutic in experimental autoimmune encephalomyelitis and promotes axon preservation and remyelination","volume":"134","author":"Brambilla","year":"2011","journal-title":"Brain"},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1186\/s12974-014-0159-6","article-title":"Central but not systemic administration of XPro1595 is therapeutic following moderate spinal cord injury in mice","volume":"11","author":"Novrup","year":"2014","journal-title":"J. Neuroinflamm."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"2186","DOI":"10.1089\/neu.2020.7504","article-title":"Pharmacological inhibition of soluble tumor necrosis factor-alpha two weeks after high thoracic spinal cord injury does not affect sympathetic hyperreflexia","volume":"38","author":"Mironets","year":"2021","journal-title":"J. Neurotrauma"},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1365-2249.2008.03713.x","article-title":"Allergy and the gastrointestinal system","volume":"153","author":"Vighi","year":"2008","journal-title":"Clin. Exp. Immunol."},{"key":"ref_144","doi-asserted-by":"crossref","unstructured":"Kirby, T.O., and Ochoa-Reparaz, J. (2018). The gut microbiome in multiple sclerosis: A potential therapeutic avenue. Med. Sci., 6.","DOI":"10.3390\/medsci6030069"},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"a029017","DOI":"10.1101\/cshperspect.a029017","article-title":"The gut microbiome and multiple sclerosis","volume":"8","author":"Kirby","year":"2018","journal-title":"Cold Spring Harb. Perspect. Med."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"131","DOI":"10.5765\/jkacap.190039","article-title":"Alteration of gut microbiota in autism spectrum disorder: An overview","volume":"31","author":"Oh","year":"2020","journal-title":"J. Korean Acad. Child Adolesc. Psychiatry"},{"key":"ref_147","first-page":"e9966","article-title":"Gut microbiome and depression: How microbes affect the way we think","volume":"12","author":"Limbana","year":"2020","journal-title":"Cureus"},{"key":"ref_148","doi-asserted-by":"crossref","unstructured":"Gungor, B., Adiguzel, E., Gursel, I., Yilmaz, B., and Gursel, M. (2016). Intestinal Microbiota in patients with spinal cord injury. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0145878"},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1186\/s12967-018-1735-9","article-title":"Gut microbiota dysbiosis in male patients with chronic traumatic complete spinal cord injury","volume":"16","author":"Zhang","year":"2018","journal-title":"J. Transl. Med."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"E11","DOI":"10.3171\/2018.12.FOCUS18206","article-title":"Spinal cord injury and the human microbiome: Beyond the brain-gut axis","volume":"46","author":"Wallace","year":"2019","journal-title":"Neurosurg. Focus"},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"2646","DOI":"10.1089\/neu.2018.6012","article-title":"Melatonin treatment alleviates spinal cord injury-induced gut dysbiosis in mice","volume":"36","author":"Jing","year":"2019","journal-title":"J. Neurotrauma"},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"704","DOI":"10.3389\/fimmu.2020.00704","article-title":"Traumatic spinal cord injury and the gut microbiota: Current insights and future challenges","volume":"11","author":"Jogia","year":"2020","journal-title":"Front. Immunol."},{"key":"ref_153","doi-asserted-by":"crossref","unstructured":"Lin, R., Xu, J., Ma, Q., Chen, M., Wang, L., Wen, S., Yang, C., Ma, C., Wang, Y., and Luo, Q. (2020). Alterations in the fecal microbiota of patients with spinal cord injury. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0236470"},{"key":"ref_154","doi-asserted-by":"crossref","unstructured":"Schmidt, E.K.A., Torres-Espin, A., Raposo, P.J.F., Madsen, K.L., Kigerl, K.A., Popovich, P.G., Fenrich, K.K., and Fouad, K. (2020). Fecal transplant prevents gut dysbiosis and anxiety-like behaviour after spinal cord injury in rats. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0226128"},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"12743","DOI":"10.1038\/s41598-021-92027-z","article-title":"Changes in gut microbiota in the acute phase after spinal cord injury correlate with severity of the lesion","volume":"11","author":"Bazzocchi","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s40168-021-01007-y","article-title":"Effect of fecal microbiota transplantation on neurological restoration in a spinal cord injury mouse model: Involvement of brain-gut axis","volume":"9","author":"Jing","year":"2021","journal-title":"Microbiome"},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.nbd.2018.12.008","article-title":"Following spinal cord injury, PDE4B drives an acute, local inflammatory response and a chronic, systemic response exacerbated by gut dysbiosis and endotoxemia","volume":"124","author":"Myers","year":"2019","journal-title":"Neurobiol. Dis."}],"container-title":["Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-7737\/10\/9\/928\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:01:08Z","timestamp":1760166068000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-7737\/10\/9\/928"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,17]]},"references-count":157,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["biology10090928"],"URL":"https:\/\/doi.org\/10.3390\/biology10090928","relation":{},"ISSN":["2079-7737"],"issn-type":[{"value":"2079-7737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,17]]}}}