Moghaddam Arash, Sperl André, Heller Raban, Kunzmann Kevin, Graeser Viola, Akbar Michael, Gerner Hans Jürgen, Biglari Bahram
Heidelberg Trauma Research Group, Department of Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Heidelberg, Germany.
Institute for Medical Biometry and Informatics, Heidelberg University Hospital, Heidelberg, Germany.
PLoS One. 2016 Jul 22;11(7):e0159764. doi: 10.1371/journal.pone.0159764. eCollection 2016.
After traumatic spinal cord injury, an acute phase triggered by trauma is followed by a subacute phase involving inflammatory processes. We previously demonstrated that peripheral serum cytokine expression changes depend on neurological outcome after spinal cord injury. In a subsequent intermediate phase, repair and remodeling takes place under the mediation of growth factors such as Insulin-like Growth Factor 1 (IGF-1). IGF-1 is a promising growth factor which is thought to act as a neuroprotective agent. Since previous findings were taken from animal studies, our aim was to investigate this hypothesis in humans based on peripheral blood serum. Forty-five patients after traumatic spinal cord injury were investigated over a period of three months after trauma. Blood samples were taken according to a fixed schema and IGF-1 levels were determined. Clinical data including AIS scores at admission to the hospital and at discharge were collected and compared with IGF-1 levels. In our study, we could observe distinct patterns in the expression of IGF-1 in peripheral blood serum after traumatic spinal cord injury regardless of the degree of plegia. All patients showed a marked increase of levels seven days after injury. IGF-1 serum levels were significantly different from initial measurements at four and nine hours and seven and 14 days after injury, as well as one, two and three months after injury. We did not detect a significant correlation between fracture and the IGF-1 serum level nor between the quantity of operations performed after trauma and the IGF-1 serum level. Patients with clinically documented neurological remission showed consistently higher IGF-1 levels than patients without neurological remission. This data could be the base for the establishment of animal models for further and much needed research in the field of spinal cord injury.
创伤性脊髓损伤后，由创伤引发的急性期之后是涉及炎症过程的亚急性期。我们先前证明，外周血清细胞因子表达变化取决于脊髓损伤后的神经学结果。在随后的中间阶段，在胰岛素样生长因子1（IGF-1）等生长因子的介导下进行修复和重塑。IGF-1是一种有前景的生长因子，被认为可作为神经保护剂。由于先前的研究结果来自动物实验，我们的目的是基于外周血血清在人类中研究这一假设。对45例创伤性脊髓损伤患者在创伤后的三个月内进行了调查。按照固定方案采集血样并测定IGF-1水平。收集包括入院时和出院时的美国脊髓损伤协会（AIS）评分在内的临床数据，并与IGF-1水平进行比较。在我们的研究中，无论瘫痪程度如何，我们都能观察到创伤性脊髓损伤后外周血血清中IGF-1表达的明显模式。所有患者在受伤七天后水平均显著升高。IGF-1血清水平在受伤后4小时和9小时、7天和14天以及1个月、2个月和3个月时与初始测量值有显著差异。我们未检测到骨折与IGF-1血清水平之间以及创伤后手术数量与IGF-1血清水平之间存在显著相关性。有临床记录的神经功能恢复患者的IGF-1水平始终高于无神经功能恢复的患者。这些数据可为建立动物模型以在脊髓损伤领域进行进一步且急需的研究奠定基础。
