Dynamics of Key Proteins and Systemic Inflammatory Profiles during Neuro-immune Modulation after Spinal Cord Injury
Abstract
Spinal cord injury (SCI) is a serious neurological trauma causing permanent functional impairments. This retrospective study (2022-2024) of 80 SCI patients examined dynamic protein changes during neural repair and their link to peripheral inflammatory mediators.
Before and at 2 and 4 weeks after treatment, patients' spinal cord function was assessed with the American Spinal Injury Association (ASIA) impairment scale. Motor nerve conduction velocities (MCV) and sensory nerve conduction velocities (SCV) were measured. Enzyme-linked immunosorbent assay (ELISA) was used to quantify serum levels of pro-inflammatory cytokines interleukin-6 (IL-6), interleukin-17 (IL-17), and tumor necrosis factor-α (TNF-α), alongside neurotrophic factors basic fibroblast growth factor (bFGF), mature brain-derived neurotrophic factor (mBDNF), neurotrophin-3 (NT-3), and neurotrophin-4 (NT-4). Patients' self-care abilities were evaluated with the Functional Independence Measure (FIM) scale and quality of life with the World Health Organization Quality of Life-Brief Version (WHO-QOL-BREF) scale.
During treatment, ASIA sensory and motor scores improved significantly. MCV and SCV of median, ulnar, tibial, and common peroneal nerves increased significantly. The levels of pro-inflammatory cytokines IL-6, IL-17, and TNF-α decreased significantly, while the serum levels of neurotrophic factors bFGF, mBDNF, NT-3, and NT-4 increased significantly. There was a significant negative correlation between pro-inflammatory cytokines and neurotrophic factors at 2 and 4 weeks after treatment, which was stronger at 4 weeks. FIM and WHO-QOL-BREF scores also improved significantly with treatment time.
These findings suggest a close interaction between the dynamic changes in key proteins and systemic inflammatory profiles during neural repair after SCI.
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2. Izzy S. Traumatic spinal cord injury. Continuum (Minneap Minn). 2024;30(1):53-72.
3. Sterner RC, Sterner RM. Immune response following traumatic spinal cord injury: Pathophysiology and therapies. Front Immunol. 2022;13:1084101.
4. Adegeest CY, Ter Wengel PV, Peul WC. Traumatic spinal cord injury: acute phase treatment in critical care. Curr
Opin Crit Care. 2023;29(6):659-65.
5. Sunshine MD, Bindi VE, Nguyen BL, Doerr V, Boeno FP, Chandran V, et al. Oxygen therapy attenuates neuroinflammation after spinal cord injury. J Neuroinflammation. 2023;20(1):303.
6. Zhang Q, Yu B, Zhang Y, Tian Y, Yang S, Chen Y, et al. Combination of single-cell and bulk RNA seq reveals the immune infiltration landscape and targeted therapeutic drugs in spinal cord injury. Front Immunol. 2023;14:1068359.
7. Baroudi M, Rezk A, Daher M, Balmaceno-Criss M, Gregoryczyk JG, Sharma Y, et al. Management of traumatic spinal cord injury: A current concepts review of contemporary and future treatment. Injury. 2024;55(6):111472.
8. Wang JZ, Yang M, Meng M, Li ZH. Clinical characteristics and treatment of spinal cord injury in children and adolescents. Chin J Traumatol. 2023;26(1):8-13.
9. Rose Hill EJ, Bertelli JA. Spinal cord injury: Epidemiology, spontaneous recovery, and hand therapy for the reconstructive hand surgeon. J Hand Surg Am. 2023;48(7):711-8.
10. Guo J, Cao J, Wu J, Gao J. Electrical stimulation and conductive materials: electrophysiology-based treatment for spinal cord injury. Biomater Sci. 2024.
11. Yu T, Yang LL, Zhou Y, Wu MF, Jiao JH. Exosome-mediated repair of spinal cord injury: a promising therapeutic strategy. Stem Cell Res Ther. 2024;15(1):6.
12. Song Q, Cui Q, Sun S, Wang Y, Yuan Y, Zhang L. Crosstalk between cell death and spinal cord injury: Neurology and therapy. Mol Neurobiol. 2024.
13. Wang Y, Liang J, Xu B, Yang J, Wu Z, Cheng L. TrkB/BDNF signaling pathway and its small molecular agonists in CNS injury. Life Sci. 2023;336:122282.
14. Zou Z, Liu R, Wang Y, Tan H, An G, Zhang B, et al. Protein arginine methyltransferase 8 regulates ferroptosis and macrophage polarization in spinal cord injury via glial cell-derived neurotrophic factor. CNS Neurosci Ther. 2023;29(8):2145-61.
15. Shamsnia HS, Peyrovinasab A, Amirlou D, Sirouskabiri S, Rostamian F, Basiri N, et al. BDNF-TrkB signaling pathway in spinal cord injury: Insights and implications. Mol Neurobiol. 2024.
16. DiSabato DJ, Marion CM, Mifflin KA, Alfredo AN, Rodgers KA, Kigerl KA, et al. System failure: Systemic inflammation following spinal cord injury. Eur J Immunol. 2023;e2250274.
17. Jerome AD, Sas AR, Wang Y, Hammond LA, Wen J, Atkinson JR, et al. Cytokine polarized, alternatively activated bone marrow neutrophils drive axon regeneration. Nat Immunol. 2024.
18. Li J, Wang P, Zhou T, Jiang W, Wu H, Zhang S, et al. Neuroprotective effects of interleukin 10 in spinal cord injury. Front Mol Neurosci. 2023;16:1214294.
19. Kayagaki N, Webster JD, Newton K. Control of cell death in health and disease. Annu Rev Pathol. 2024;19:157-80.
20. Kedia-Mehta N, Finlay DK. Competition for nutrients and its role in controlling immune responses. Nat Commun. 2019;10(1):2123.
21. Palasz E, Wilkaniec A, Stanaszek L, Andrzejewska A, Adamczyk A. Glia-neurotrophic factor relationships: Possible role in pathobiology of neuroinflammation-related brain disorders. Int J Mol Sci. 2023;24(7).
22. World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Participants. JAMA. 2025;333(1):71-4.
23. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-91.
24. Zhang Z, Li Q, Yang X, Li B, Zhou Y, Hu T, et al. Effects of hyperbaric oxygen therapy on postoperative recovery after incomplete cervical spinal cord injury. Spinal Cord. 2022;60(2):129-34.
25. Kirshblum S, Botticello A, Benedetto J, Donovan J, Marino R, Hsieh S, et al. A comparison of diagnostic stability of the ASIA Impairment Scale versus Frankel classification systems for traumatic spinal cord injury. Arch Phys Med Rehabil. 2020;101(9):1556-62.
26. Li Z, Gao Y, Jia Y, Chen S. Correlation between hemoglobin glycosylation index and nerve conduction velocity in patients with type 2 diabetes mellitus. Diabetes Metab Syndr Obes. 2021;14:4757-65.
27. Kobayashi T, Kodama A, Okazaki T, Honma T, Yamada T, Ishibashi H, et al. Prognostic significance of preoperative functional independence measure (FIM) on long-term outcomes in patients with chronic limb-threatening ischemia (CLTI). Ann Vasc Surg. 2022;83:275-83.
28. Kumar V, Malhotra V, Sinha V. Evaluation of individual quality of life (QOL) among patients with tracheostomy using WHO-QOL BREF questionnaire. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 3):5207-16.
29. Sargent L, Smitherman J, Sorenson M, Brown R, Starkweather A. Cognitive and physical impairment in spinal cord injury: A scoping review and call for new understanding. J Spinal Cord Med. 2023;46(3):343-66.
30. Freyermuth-Trujillo X, Segura-Uribe JJ, Salgado-Ceballos H, Orozco-Barrios CE, Coyoy-Salgado A. Inflammation: A target for treatment in spinal cord injury. Cells. 2022;11(17).
31. Ren J. Advances in combination therapy for gastric cancer: integrating targeted agents and immunotherapy. Adv Clin Pharmacol Ther. 2024;1(1):1-15.
32. Michel-Flutot P, Bourcier CH, Emam L, Gasser A, Glatigny S, Vinit S, et al. Extracellular traps formation following cervical spinal cord injury. Eur J Neurosci. 2023;57(4):692-704.
33. de Sena-Tomás C, Rebola Lameira L, Rebocho da Costa M, Naique Taborda P, Laborde A, Orger M, et al. Neutrophil immune profile guides spinal cord regeneration in zebrafish. Brain Behav Immun. 2024;120:514-31.
34. Seo YK. Modulation of inflammatory responses to enhance nerve recovery after spinal cord injury. Tissue Eng Regen Med. 2024;21(3):367-8.
35. Shipman H, Monsour M, Foley MM, Marbacher S, Croci DM, Bisson EF. Interleukin-6 in spinal cord injury: Could immunomodulation replace immunosuppression in the management of acute traumatic spinal cord injuries? J Neurol Surg A Cent Eur Neurosurg. 2024;85(6):602-9.
36. Boehl G, Raguindin PF, Valido E, Bertolo A, Itodo OA, Minder B, et al. Endocrinological and inflammatory markers in individuals with spinal cord injury: A systematic review and meta-analysis. Rev Endocr Metab Disord. 2022;23(5):1035-50.
37. Tang W, Zhao K, Li X, Zhou X, Liao P. Bone marrow mesenchymal stem cell-derived exosomes promote the recovery of spinal cord injury and inhibit ferroptosis by inactivating IL-17 pathway. J Mol Neurosci. 2024;74(2):33.
38. Bai M, Sang Z, Cui Y, Feng H, Liu Y, Dai Z, et al. Multi-omics analysis identified and confirmed TNF-α as a key initiator of the inflammatory response following spinal cord injury. Int J Biol Macromol. 2025;311(Pt 2):143866.
39. Martínez-Moreno CG, Calderón-Vallejo D, Díaz-Galindo C, Hernández-Jasso I, Olivares-Hernández JD, Ávila-Mendoza J, et al. Neurotrophic and synaptic effects of GnRH and/or GH upon motor function after spinal cord injury in rats. Sci Rep. 2024;14(1):26420.
40. Sanati M, Manavi MA, Noruzi M, Behmadi H, Akbari T, Jalali S, et al. Carbohydrates and neurotrophic factors: A promising partnership for spinal cord injury rehabilitation. Biomater Adv. 2024;166:214054.
41. Li Y, Tran A, Graham L, Brock J, Tuszynski MH, Lu P. BDNF guides neural stem cell-derived axons to ventral interneurons and motor neurons after spinal cord injury. Exp Neurol. 2023;359:114259.
42. Ardizzone A, Bova V, Casili G, Filippone A, Lanza M, Repici A, et al. bFGF-like activity supported tissue regeneration, modulated neuroinflammation, and rebalanced Ca2+ homeostasis following spinal cord injury. Int J Mol Sci. 2023;24(19):Article number unavailable.
43. Stepanova OV, Voronova AD, Chadin AV, Fursa GA, Karsuntseva EK, Valikhov MP, et al. Neurotrophin-3 enhances the effectiveness of cell therapy in chronic spinal cord injuries. Bull Exp Biol Med. 2022;173(1):114-118.
44. Muheremu A, Shu L, Liang J, Aili A, Jiang K. Sustained delivery of neurotrophic factors to treat spinal cord injury. Transl Neurosci. 2021;12(1):494-511.
45. Khan AW, Farooq M, Hwang MJ, Haseeb M, Choi S. Autoimmune neuroinflammatory diseases: Role of interleukins. Int J Mol Sci. 2023;24(9):Article number unavailable.
46. Li J, Wang P, Zhou T, Jiang W, Wu H, Zhang S, et al. Neuroprotective effects of interleukin 10 in spinal cord injury. Front Mol Neurosci. 2023;16:1214294.
47. Thompson CD, Zurko JC, Hanna BF, Hellenbrand DJ, Hanna A. The therapeutic role of interleukin-10 after spinal cord injury. J Neurotrauma. 2013;30(15):1311-24.
48. Beskid NM, Kolawole EM, Coronel MM, Nguyen B, Evavold B, García AJ, et al. IL-10-functionalized hydrogels support immunosuppressive dendritic cell phenotype and function. ACS Biomater Sci Eng. 2022;8(10):4341-53.
49. Wang C, Li T, Zeng X, Wu L, Gao M, Tong N, et al. Sustained delivery of IL-10 by self-assembling peptide hydrogel to reprogram macrophages and promote diabetic alveolar bone defect healing. Dent Mater. 2023;39(4):418-29.
50. Li D, Zhang P, Yao X, Li H, Shen H, Li X, et al. Exosomes derived from miR-133b-modified mesenchymal stem cells promote recovery after spinal cord injury. Front Neurosci. 2018;12:845.
51. Yari H, Mikhailova MV, Mardasi M, Jafarzadehgharehziaaddin M, Shahrokh S, Thangavelu L, et al. Emerging role of mesenchymal stromal cells (MSCs)-derived exosome in neurodegeneration-associated conditions: A groundbreaking cell-free approach. Stem Cell Res Ther. 2022;13(1):423.
2. Izzy S. Traumatic spinal cord injury. Continuum (Minneap Minn). 2024;30(1):53-72.
3. Sterner RC, Sterner RM. Immune response following traumatic spinal cord injury: Pathophysiology and therapies. Front Immunol. 2022;13:1084101.
4. Adegeest CY, Ter Wengel PV, Peul WC. Traumatic spinal cord injury: acute phase treatment in critical care. Curr
Opin Crit Care. 2023;29(6):659-65.
5. Sunshine MD, Bindi VE, Nguyen BL, Doerr V, Boeno FP, Chandran V, et al. Oxygen therapy attenuates neuroinflammation after spinal cord injury. J Neuroinflammation. 2023;20(1):303.
6. Zhang Q, Yu B, Zhang Y, Tian Y, Yang S, Chen Y, et al. Combination of single-cell and bulk RNA seq reveals the immune infiltration landscape and targeted therapeutic drugs in spinal cord injury. Front Immunol. 2023;14:1068359.
7. Baroudi M, Rezk A, Daher M, Balmaceno-Criss M, Gregoryczyk JG, Sharma Y, et al. Management of traumatic spinal cord injury: A current concepts review of contemporary and future treatment. Injury. 2024;55(6):111472.
8. Wang JZ, Yang M, Meng M, Li ZH. Clinical characteristics and treatment of spinal cord injury in children and adolescents. Chin J Traumatol. 2023;26(1):8-13.
9. Rose Hill EJ, Bertelli JA. Spinal cord injury: Epidemiology, spontaneous recovery, and hand therapy for the reconstructive hand surgeon. J Hand Surg Am. 2023;48(7):711-8.
10. Guo J, Cao J, Wu J, Gao J. Electrical stimulation and conductive materials: electrophysiology-based treatment for spinal cord injury. Biomater Sci. 2024.
11. Yu T, Yang LL, Zhou Y, Wu MF, Jiao JH. Exosome-mediated repair of spinal cord injury: a promising therapeutic strategy. Stem Cell Res Ther. 2024;15(1):6.
12. Song Q, Cui Q, Sun S, Wang Y, Yuan Y, Zhang L. Crosstalk between cell death and spinal cord injury: Neurology and therapy. Mol Neurobiol. 2024.
13. Wang Y, Liang J, Xu B, Yang J, Wu Z, Cheng L. TrkB/BDNF signaling pathway and its small molecular agonists in CNS injury. Life Sci. 2023;336:122282.
14. Zou Z, Liu R, Wang Y, Tan H, An G, Zhang B, et al. Protein arginine methyltransferase 8 regulates ferroptosis and macrophage polarization in spinal cord injury via glial cell-derived neurotrophic factor. CNS Neurosci Ther. 2023;29(8):2145-61.
15. Shamsnia HS, Peyrovinasab A, Amirlou D, Sirouskabiri S, Rostamian F, Basiri N, et al. BDNF-TrkB signaling pathway in spinal cord injury: Insights and implications. Mol Neurobiol. 2024.
16. DiSabato DJ, Marion CM, Mifflin KA, Alfredo AN, Rodgers KA, Kigerl KA, et al. System failure: Systemic inflammation following spinal cord injury. Eur J Immunol. 2023;e2250274.
17. Jerome AD, Sas AR, Wang Y, Hammond LA, Wen J, Atkinson JR, et al. Cytokine polarized, alternatively activated bone marrow neutrophils drive axon regeneration. Nat Immunol. 2024.
18. Li J, Wang P, Zhou T, Jiang W, Wu H, Zhang S, et al. Neuroprotective effects of interleukin 10 in spinal cord injury. Front Mol Neurosci. 2023;16:1214294.
19. Kayagaki N, Webster JD, Newton K. Control of cell death in health and disease. Annu Rev Pathol. 2024;19:157-80.
20. Kedia-Mehta N, Finlay DK. Competition for nutrients and its role in controlling immune responses. Nat Commun. 2019;10(1):2123.
21. Palasz E, Wilkaniec A, Stanaszek L, Andrzejewska A, Adamczyk A. Glia-neurotrophic factor relationships: Possible role in pathobiology of neuroinflammation-related brain disorders. Int J Mol Sci. 2023;24(7).
22. World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Participants. JAMA. 2025;333(1):71-4.
23. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-91.
24. Zhang Z, Li Q, Yang X, Li B, Zhou Y, Hu T, et al. Effects of hyperbaric oxygen therapy on postoperative recovery after incomplete cervical spinal cord injury. Spinal Cord. 2022;60(2):129-34.
25. Kirshblum S, Botticello A, Benedetto J, Donovan J, Marino R, Hsieh S, et al. A comparison of diagnostic stability of the ASIA Impairment Scale versus Frankel classification systems for traumatic spinal cord injury. Arch Phys Med Rehabil. 2020;101(9):1556-62.
26. Li Z, Gao Y, Jia Y, Chen S. Correlation between hemoglobin glycosylation index and nerve conduction velocity in patients with type 2 diabetes mellitus. Diabetes Metab Syndr Obes. 2021;14:4757-65.
27. Kobayashi T, Kodama A, Okazaki T, Honma T, Yamada T, Ishibashi H, et al. Prognostic significance of preoperative functional independence measure (FIM) on long-term outcomes in patients with chronic limb-threatening ischemia (CLTI). Ann Vasc Surg. 2022;83:275-83.
28. Kumar V, Malhotra V, Sinha V. Evaluation of individual quality of life (QOL) among patients with tracheostomy using WHO-QOL BREF questionnaire. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 3):5207-16.
29. Sargent L, Smitherman J, Sorenson M, Brown R, Starkweather A. Cognitive and physical impairment in spinal cord injury: A scoping review and call for new understanding. J Spinal Cord Med. 2023;46(3):343-66.
30. Freyermuth-Trujillo X, Segura-Uribe JJ, Salgado-Ceballos H, Orozco-Barrios CE, Coyoy-Salgado A. Inflammation: A target for treatment in spinal cord injury. Cells. 2022;11(17).
31. Ren J. Advances in combination therapy for gastric cancer: integrating targeted agents and immunotherapy. Adv Clin Pharmacol Ther. 2024;1(1):1-15.
32. Michel-Flutot P, Bourcier CH, Emam L, Gasser A, Glatigny S, Vinit S, et al. Extracellular traps formation following cervical spinal cord injury. Eur J Neurosci. 2023;57(4):692-704.
33. de Sena-Tomás C, Rebola Lameira L, Rebocho da Costa M, Naique Taborda P, Laborde A, Orger M, et al. Neutrophil immune profile guides spinal cord regeneration in zebrafish. Brain Behav Immun. 2024;120:514-31.
34. Seo YK. Modulation of inflammatory responses to enhance nerve recovery after spinal cord injury. Tissue Eng Regen Med. 2024;21(3):367-8.
35. Shipman H, Monsour M, Foley MM, Marbacher S, Croci DM, Bisson EF. Interleukin-6 in spinal cord injury: Could immunomodulation replace immunosuppression in the management of acute traumatic spinal cord injuries? J Neurol Surg A Cent Eur Neurosurg. 2024;85(6):602-9.
36. Boehl G, Raguindin PF, Valido E, Bertolo A, Itodo OA, Minder B, et al. Endocrinological and inflammatory markers in individuals with spinal cord injury: A systematic review and meta-analysis. Rev Endocr Metab Disord. 2022;23(5):1035-50.
37. Tang W, Zhao K, Li X, Zhou X, Liao P. Bone marrow mesenchymal stem cell-derived exosomes promote the recovery of spinal cord injury and inhibit ferroptosis by inactivating IL-17 pathway. J Mol Neurosci. 2024;74(2):33.
38. Bai M, Sang Z, Cui Y, Feng H, Liu Y, Dai Z, et al. Multi-omics analysis identified and confirmed TNF-α as a key initiator of the inflammatory response following spinal cord injury. Int J Biol Macromol. 2025;311(Pt 2):143866.
39. Martínez-Moreno CG, Calderón-Vallejo D, Díaz-Galindo C, Hernández-Jasso I, Olivares-Hernández JD, Ávila-Mendoza J, et al. Neurotrophic and synaptic effects of GnRH and/or GH upon motor function after spinal cord injury in rats. Sci Rep. 2024;14(1):26420.
40. Sanati M, Manavi MA, Noruzi M, Behmadi H, Akbari T, Jalali S, et al. Carbohydrates and neurotrophic factors: A promising partnership for spinal cord injury rehabilitation. Biomater Adv. 2024;166:214054.
41. Li Y, Tran A, Graham L, Brock J, Tuszynski MH, Lu P. BDNF guides neural stem cell-derived axons to ventral interneurons and motor neurons after spinal cord injury. Exp Neurol. 2023;359:114259.
42. Ardizzone A, Bova V, Casili G, Filippone A, Lanza M, Repici A, et al. bFGF-like activity supported tissue regeneration, modulated neuroinflammation, and rebalanced Ca2+ homeostasis following spinal cord injury. Int J Mol Sci. 2023;24(19):Article number unavailable.
43. Stepanova OV, Voronova AD, Chadin AV, Fursa GA, Karsuntseva EK, Valikhov MP, et al. Neurotrophin-3 enhances the effectiveness of cell therapy in chronic spinal cord injuries. Bull Exp Biol Med. 2022;173(1):114-118.
44. Muheremu A, Shu L, Liang J, Aili A, Jiang K. Sustained delivery of neurotrophic factors to treat spinal cord injury. Transl Neurosci. 2021;12(1):494-511.
45. Khan AW, Farooq M, Hwang MJ, Haseeb M, Choi S. Autoimmune neuroinflammatory diseases: Role of interleukins. Int J Mol Sci. 2023;24(9):Article number unavailable.
46. Li J, Wang P, Zhou T, Jiang W, Wu H, Zhang S, et al. Neuroprotective effects of interleukin 10 in spinal cord injury. Front Mol Neurosci. 2023;16:1214294.
47. Thompson CD, Zurko JC, Hanna BF, Hellenbrand DJ, Hanna A. The therapeutic role of interleukin-10 after spinal cord injury. J Neurotrauma. 2013;30(15):1311-24.
48. Beskid NM, Kolawole EM, Coronel MM, Nguyen B, Evavold B, García AJ, et al. IL-10-functionalized hydrogels support immunosuppressive dendritic cell phenotype and function. ACS Biomater Sci Eng. 2022;8(10):4341-53.
49. Wang C, Li T, Zeng X, Wu L, Gao M, Tong N, et al. Sustained delivery of IL-10 by self-assembling peptide hydrogel to reprogram macrophages and promote diabetic alveolar bone defect healing. Dent Mater. 2023;39(4):418-29.
50. Li D, Zhang P, Yao X, Li H, Shen H, Li X, et al. Exosomes derived from miR-133b-modified mesenchymal stem cells promote recovery after spinal cord injury. Front Neurosci. 2018;12:845.
51. Yari H, Mikhailova MV, Mardasi M, Jafarzadehgharehziaaddin M, Shahrokh S, Thangavelu L, et al. Emerging role of mesenchymal stromal cells (MSCs)-derived exosome in neurodegeneration-associated conditions: A groundbreaking cell-free approach. Stem Cell Res Ther. 2022;13(1):423.
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| Inflammation mediators Neural conduction Neuroimmunomodulation Spinal cord injuries | ||
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How to Cite
1.
Niu J, Cui Q, Li M, Liu Y. Dynamics of Key Proteins and Systemic Inflammatory Profiles during Neuro-immune Modulation after Spinal Cord Injury. Iran J Allergy Asthma Immunol. 2026;:1-17.
