Inflammatory C-reactive protein and cytokine levels in asymptomatic people with chronic spinal cord injury.

OBJECTIVE

To determine the relation between serologic markers of information and clinical characteristics of people with chronic spinal cord injury (SCI).

DESIGN

Cross-sectional study.

SETTING

Academic medical center SCI outpatient clinic.

PARTICIPANTS

Convenience sample of 37 men with chronic SCI and 10 healthy control subjects.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Serum levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and C-reactive protein (CRP).

RESULTS

The following results achieved statistical significance at P less than .05. Asymptomatic chronic SCI patients differed from referent controls with respect to serum CRP levels but not IL-6 or TNF-alpha. In SCI patients, higher levels of CRP correlated negatively with hemoglobin and albumin levels. A longer time since injury correlated with lower TNF-alpha values, whereas higher TNF-alpha levels correlated with higher serum albumin. Pressure ulcers and indwelling urinary catheters were associated with higher mean levels of CRP but not of the cytokines TNF-alpha and IL-6. Intermittent urinary catheterization was associated with lower levels of CRP when compared with other methods of bladder management.

CONCLUSIONS

Asymptomatic people with long-term SCI, especially those with indwelling urinary catheters, showed serologic evidence of a systemic inflammatory state. There was no evidence of an elevation in proinflammatory cytokines. Detection of an ongoing systemic inflammatory response in apparently healthy people with indwelling urinary catheters and small skin ulcers further supports the aggressive pursuit of catheter-free voiding options and pressure ulcer healing.