Hulme C H, Brown S J, Fuller H R, Riddell J, Osman A, Chowdhury J, Kumar N, Johnson W E, Wright K T
Institute of Science and Technology in Medicine (ISTM), Keele University, Keele, UK.
Midland Centre for Spinal Injuries, RJAH Orthopaedic Hospital, Oswestry, UK.
Spinal Cord. 2017 Feb;55(2):114-125. doi: 10.1038/sc.2016.174. Epub 2016 Dec 20.
Review study.
The identification of prognostic biomarkers of spinal cord injury (SCI) will help to assign SCI patients to the correct treatment and rehabilitation regimes. Further, the detection of biomarkers that predict permanent neurological outcome would aid in appropriate recruitment of patients into clinical trials. The objective of this review is to evaluate the current state-of-play in this developing field.
Studies from multiple countries were included.
We have completed a comprehensive review of studies that have investigated prognostic biomarkers in either the blood or cerebrospinal fluid (CSF) of animals and humans following SCI.
Targeted and unbiased approaches have identified several prognostic biomarkers in CSF and blood. These proteins associate with cellular damage following SCI and include components from neurons, oligodendrocytes and reactive astrocytes, that is, neurofilament proteins, glial fibrillary acidic protein, Tau and S100 calcium-binding protein β. Unbiased approaches have also identified microRNAs that are specific to SCI, as well as other cell damage-associated proteins.
The discovery and validation of stable, specific, sensitive and reproducible biomarkers of SCI is a rapidly expanding field of research. So far, few studies have utilised unbiased approaches aimed at the discovery of biomarkers within the CSF or blood in this field; however, some targeted approaches have been successfully used. Several studies using various animal models and some with small human patient cohorts have begun to pinpoint biomarkers in the CSF and blood with putative prognostic value. An increased sample size will be required to validate these biomarkers in the heterogeneous clinical setting.
综述研究。
识别脊髓损伤（SCI）的预后生物标志物将有助于为SCI患者安排正确的治疗和康复方案。此外，检测能够预测永久性神经功能转归的生物标志物将有助于患者适当纳入临床试验。本综述的目的是评估这一发展中领域的当前进展情况。
纳入了来自多个国家的研究。
我们全面回顾了在动物和人类SCI后血液或脑脊液（CSF）中研究预后生物标志物的相关研究。
靶向和非靶向方法已在脑脊液和血液中识别出几种预后生物标志物。这些蛋白质与SCI后的细胞损伤相关，包括来自神经元、少突胶质细胞和反应性星形胶质细胞的成分，即神经丝蛋白、胶质纤维酸性蛋白、Tau蛋白和S100钙结合蛋白β。非靶向方法还识别出了SCI特异性的微小RNA以及其他与细胞损伤相关的蛋白质。
发现和验证稳定、特异、敏感且可重复的SCI生物标志物是一个快速发展的研究领域。到目前为止，该领域中很少有研究采用旨在在脑脊液或血液中发现生物标志物的非靶向方法；然而，一些靶向方法已成功应用。一些使用各种动物模型以及一些纳入小样本人类患者队列的研究已开始确定脑脊液和血液中具有潜在预后价值的生物标志物。在异质性临床环境中验证这些生物标志物需要增加样本量。
