PROJECT: JTC2016: SILENCE

Up to 7 Million patients worldwide live with the debilitating consequences of spinal cord injury (SCI). Inferior neurological and functional recovery profiles may be associated with the maladaptive systemic immune response (MSIR) emerging early after SCI, which is characterized by two immunological conditions: developing post-traumatic autoimmunity against CNS-neo-antigens and the spinal cord injury-induced immune deficiency syndrome (SCI-IDS). By means of well-characterized SCI specimen banks from prospective trials, tissue repositories, and experimental models we target the objectives: I) deciphering profiles of humoral autoimmunity II) evaluation of functionally relevant auto-antigens in bed to bench-side approach, iii) linking autoimmunity to clinical outcomes, iv) and validation across pathologies. An interdisciplinary, translational consortium comprising expertise in immunology, proteomics, neuropathology, neurology, and paraplegiology will decipher distinct signatures of autoimmunity in experimental as well as clinical studies linking those to long-term functional recovery. Supported by preliminary data we will investigate the hypothesis whether inferior and normal rehabilitation responders identified by recursive partitioning display distinct patterns of autoimmunity. Stratification of SCI patients by the occurrence and degree of the MSIR will provide the basis for context and time dependent immunological subgroups required for effective immune-modulatory treatment.