Serum Biomarkers and Clinical Outcomes in Traumatic Spinal Cord Injury: Prospective Cohort Study

Autor: Luis Valmor Cruz Portela, Marcelo de Mello Rieder, Alexandre Pastoris Muller, André Martins de Lima Cecchini, Afonso Kopczynski, Marino Muxfeldt Bianchin, Randhall Bruce Carteri, Carolina David Wiener, Marcelo Salimen Rodolphi, Fernanda Machado Kutchak, Gisele Hansel, Mônia Sartor, Nathan Ryzewski Strogulski, Jean Pierre Oses
Rok vydání: 2019
Předmět:
Zdroj: World Neurosurgery. 122:e1028-e1036
ISSN: 1878-8750
DOI: 10.1016/j.wneu.2018.10.206
Popis: Background A plethora of reactive cellular responses emerge immediately after a traumatic spinal cord injury (SCI) and may influence the patient’s outcomes. We investigated whether serum concentrations of neuron-specific enolase, interleukin-6, glial-derived neurotrophic factor, and neurotrophic growth factor reflect the acute-phase responses to different etiologies of SCI and may serve as predictive biomarkers of neurologic and functional outcomes. Methods Fifty-two patients were admitted to the intensive care unit after SCI due to traffic accidents, falls, and firearm wounds and had blood samples collected within 48 hours and 7 days after SCI. Thirty-six healthy subjects with no history of SCI were included as controls. Neurologic and functional status was evaluated on the basis of American Spinal Injury Association and Functional Independence Measure scores over a period of 48 hours and 6 months after SCI. Results Serum NSE increased significantly 48 hours and 7 days after SCI compared with controls, while interleukin-6 increased only at 48 hours. In contrast, the neurotrophic growth factor level significantly decreased 48 hours and 7 days after SCI. Serum glial-derived neurotrophic factor level did not differ from control at any time point. Also, there was no significant difference in biomarker concentrations between the etiologies of SCI or the level of spinal injury. There were no correlations between biomarker levels at 48 hours with neurologic or functional outcomes 7 days and 6 months after SCI. Conclusions Our results suggest expansive axonal damage coupled with an acute proinflammatory response after SCI. However, in our study biomarker concentration did not correlate with short- or long-term prognosis, such as survival rate or sensory and motor function.
Databáze: OpenAIRE
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