Silence Project

Work Packages

Work package 1

Overall Coordination and B-Cell Immunephenotyping. The overall coordination of the SCILENCE project will ensure the successful implementation of this project on a scientific, financial and management level. This includes project initiation and management as well as data and specimen handling with emphasis on the harmonisation of the SCIentinel trial repositories/database with the upcoming SCIentinel-prolong trial activities and all scientific work-packages and administrative and financial issues within the SILENCE project. Joint project meetings will facilitate efficient management and planning of scientific activities, scientific and financial reporting and communication as well as effective workflow between project partners and collaborators to support sharing best practice and maximise synergies between the clinical and immunological aspect and the dissemination of the results in an appropriate manner.

Work package 2

Immune Proteomics. Unbiased autoantibody profiling to compare age- and gender-matched cohort groups (spinal cord injury vs. controls patients with a vertebrae fracture without spinal cord injury) comprises two analytic strategies: Protein microarray analysis and indirect immune fluorescence (WP3).

Work package 3

Translational Humoral Autoimmunity. Within a “bed-to bench” translation we will investigate the underlying neuropathology elicited by the humoral autoantibody response after spinal cord injury and we intend to decipher the underlying mechanisms of “epitope spreading” after acute and chronic spinal cord injury. In parallel to the humoral autoimmunity screening in human samples using protein microarrays (WP2), we will systematically screen serum samples from the SCIentinel trial (n=130) for anti-neuronal and anti-glial (oligodendrocytes, astrocytes) surface antibodies using tissue based assays and cell-based assays (Lancaster and Dalmau, 2012).

Work package 4

The University Hospital Balgrist, University of Zurich, Switzerland will add to the  SCIentinel-prolong prognostic trial a ‘Spinal cord injury-specific electrophysiology’ module. This module will be complementary to the functional outcome assessment of recovery profiles in spinal cord injury patients (WP 5) and can be correlated to the results of the longitudinal analysis of the humoral autoimmunity profiles (WP1-3).

Work package 5

The Santa Lucia Hospital, Spinal Unit (Scivoletto Group) will contribute to the implementation and evaluation of spinal cord injury-specific functional outcome measures. The functional outcome will enable to estimate the clinical relevance of the immunological phenotype (WP 1) and humoral autoimmunity profile (WP 2-3) in relation to neurological and electrophysiological recovery profiles (WP 3) of the patients. The functional outcome assessment added to the SCIentinel-prolong study protocol includes measures of physical disability in terms of the Spinal Cord Independence Measure (SCIM III) and gait-performance (WISCI II).