de Mello Rieder Marcelo, Oses Jean Pierre, Kutchak Fernanda Machado, Sartor Mônia, Cecchini André, Rodolphi Marcelo Salimen, Wiener Carolina David, Kopczynski Afonso, Muller Alexandre Pastoris, Strogulski Nathan Ryzewski, Carteri Randhall B, Hansel Gisele, Bianchin Marino Muxfeldt, Portela Luis Valmor
Postgraduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul- UFRGS, Porto Alegre, RS, Brazil; BRAIN Center of Experimental Research, Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Hospital Cristo Redentor, Porto Alegre, Rio Grande do Sul, Brazil.
Postgraduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Rio Grande do Sul, Brazil.
World Neurosurg. 2019 Feb;122:e1028-e1036. doi: 10.1016/j.wneu.2018.10.206. Epub 2018 Nov 7.
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.
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.
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.
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.
创伤性脊髓损伤（SCI）后会立即出现大量反应性细胞反应，这可能会影响患者的预后。我们研究了血清神经元特异性烯醇化酶、白细胞介素-6、胶质细胞源性神经营养因子和神经营养生长因子的浓度是否反映了对不同病因SCI的急性期反应，并能否作为神经和功能预后的预测生物标志物。
52例因交通事故、跌倒和枪伤导致SCI的患者入住重症监护病房，并在SCI后48小时和7天采集血样。36名无SCI病史的健康受试者作为对照。根据美国脊髓损伤协会和功能独立性测量评分，在SCI后48小时和6个月期间评估神经和功能状态。
与对照组相比，SCI后48小时和7天血清NSE显著升高，而白细胞介素-6仅在48小时升高。相反，神经营养生长因子水平在SCI后48小时和7天显著降低。血清胶质细胞源性神经营养因子水平在任何时间点与对照组均无差异。此外，SCI病因或脊髓损伤水平之间的生物标志物浓度无显著差异。SCI后48小时的生物标志物水平与7天和6个月后的神经或功能预后之间无相关性。
我们的结果表明SCI后轴突广泛损伤并伴有急性促炎反应。然而，在我们的研究中，生物标志物浓度与短期或长期预后，如生存率或感觉和运动功能无关。
