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Characterizing immune involvement in degenerative cervical myelopathy: a systematic review
Journal of Neurosurgery. Spine
|May 1, 2026
Summary
Degenerative cervical myelopathy (DCM) involves immune system activation, with elevated inflammatory markers and immune cells impacting disease progression and treatment response. Understanding this immune component is key for developing new therapies.
Area of Science:
- Neuroimmunology
- Spinal Cord Injury Research
- Degenerative Diseases
Background:
- Degenerative cervical myelopathy (DCM) is a leading cause of spinal cord impairment in adults.
- While mechanical aspects are understood, the immune system's role in DCM pathogenesis and neurological progression is unclear.
- Identifying immune targets could lead to novel therapeutic strategies for DCM.
Purpose of the Study:
- To systematically review the literature on immunological involvement in degenerative cervical myelopathy (DCM).
- To understand the interactions between inflammation, apoptosis, and neurodegeneration in DCM.
- To explore the immune system as a potential therapeutic target for DCM.
Main Methods:
- Systematic literature review of PubMed database up to August 1, 2024.
- Inclusion of studies reporting immune markers (molecular, histological, CSF, peripheral) related to DCM.
- Exclusion of systematic reviews, case reports, and animal studies; synthesis of 10 eligible studies.
Main Results:
- Elevated proinflammatory cytokines (IL-8, TNF-α), IgG bands, and blood-spinal cord barrier disruption in DCM patients' CSF.
- Histological evidence of apoptosis, impaired autophagy, and activated myeloid cells in DCM tissue.
- Peripheral immune profiling showed increased M2 macrophages and CD4 T cells; specific biomarkers correlated with clinical improvement.
Conclusions:
- A significant interplay exists between immune responses and DCM progression, influencing clinical outcomes.
- Inflammatory mechanisms are critical in determining treatment efficacy for degenerative cervical myelopathy.
- Further research into the immune component of DCM is needed to develop targeted immunotherapies.
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