Spinal cord and brain trauma

Abstract

Microglia are the first responders to central nervous system (CNS) trauma. They are thought to be a central player in initiating and orchestrating a cascade of changes that lead to an elaborate inflammatory response at the site of injury. This inflammatory response also includes the influx of peripheral immune cells into the injured CNS. In this chapter we will focus our attention on the microglial response to spinal cord injury, but where possible we will include discussion of microglial responses after traumatic brain injury. We will discuss the differences in the early and late responses of microglia to CNS injury; the signaling molecules, cytokines and other factors that modulate their responses, the evidence for their beneficial and detrimental effects, and the effects of their activation at the epicenter of the injury and in sites distal to the injury. Attention will also be focused on the evidence of microglial changes in chronic spinal cord and brain trauma. We will highlight the preclinical evidence for targeting some aspects of the microglial response to treat spinal cord and brain trauma and take a look at some future directions to pursue.