Fundamental role of C1q in autoimmunity and inflammation

C1q, historically viewed as the initiating component of the classical complement pathway, also exhibits a variety of complement-independent activities in both innate and acquired immunity. Recent studies focusing on C1q\u27s suppressive role in the immune system have provided new insight into how abnormal C1q expression and bioactivity may contribute to autoimmunity. In particular, molecular networks involving C1q interactions with cell surface receptors and other ligands are emerging as mechanisms involved in C1q\u27s modulation of immunity. Here, we discuss the role of C1q in controlling immune cell function, including recently elucidated mechanisms of action, and suggest how these processes are critical for maintaining tissue homeostasis under steady-state conditions and in preventing autoimmunity

The effect of footrests on sitting balance in paraplegic subjects

Objective: To test the hypothesis that footrests contribute to active control of sitting balance. Design: Cross-sectional group study. Setting: Rehabilitation center. Participants: Ten persons with complete low thoracic (T9-12) spinal cord injury (SCI), 10 persons with complete lumbar (L1-5) SCI, and 10 matched able-bodied controls. Intervention: An elastically suspended footrest. Main Outcome Measures: Reaching distance, time needed to perform a bimanual forward-reaching movement, center of pressure displacement, and muscle activity. Results: Controls performed the forward-re aching movement slower and with less forward acceleration of the center of mass tCOM) in the chair with the elastic footrest. Furthermore, they revealed a typical change in muscle activity patterns when the solid footrest was replaced by the elastic one. Persons with SCI performed the forward-reaching movement equally fast in both footrest conditions, but those with lumbar SCI showed less forward acceleration of the COM, whereas persons with thoracic SCI revealed more forward acceleration of the COM in the chair with the elastic footrest. Muscle activity patterns in persons with SCI did not indicate alternative muscle use through possible compensations or reflex activity. Conclusions: Regarding wheelchair design, footrest condition does not seem to affect the range in which manual activities of daily living can be performed, but it does affect how they are performe

Trajectories of musculoskeletal shoulder pain after spinal cord injury: Identification and predictors.

Objective/ Background: Although shoulder pain is a problem in up to 86% of persons with a spinal cord injury (SCI), so far, no studies have empirically identified longitudinal patterns (trajectories) of musculoskeletal shoulder pain after SCI. The objective of this study was: (1) to identify distinct trajectories of musculoskeletal shoulder pain in persons with SCI, and (2) to determine possible predictors of these trajectories. Design/Methods: Multicenter, prospective cohort study in 225 newly injured persons with SCI. Outcome Measure: Shoulder pain was assessed on five occasions up to 5 years after discharge. Latent class growth mixture modeling was used to identify the distinct shoulder pain trajectories. Results: Three distinct shoulder pain trajectories were identified: (1) a " No or Low pain" trajectory (64%), (2) a "High pain" (30%) trajectory, and (3) a trajectory with a "Decrease of pain" (6%). Compared with the "No or Low pain" pain trajectory, the "High pain" trajectory consisted of more persons with tetraplegia, shoulder pain before injury, limited shoulder range of motion (ROM), lower manual muscle test scores, or more spasticity at t1. Multiple logistic regression analysis showed two significant predictors for the "High pain" trajectory (as compared with the "No or Low pain" trajectory): having a tetraplegia (odds ratio (OR) = 3.2; P = 0.002) and having limited shoulder ROM (OR = 2.8; P = 0.007). Conclusion: Shoulder pain in people with SCI follows distinct trajectories. At risk for belonging to the "High pain" trajectory are persons with tetraplegia and those with a limited shoulder ROM at start of active rehabilitation. © The Academy of Spinal Cord Injury Professionals, Inc. 2014