Abstract
Pro- and anti-inflammatory cytokines might have a large impact on the secondary phase and on the neurological outcome of patients with acute spinal cord injury (SCI). We measured the serum levels of different cytokines (Interferon-γ, Tumor Necrosis Factor-α, Interleukin-1β, IL-6, IL-8, IL-10, and Vascular Endothelial Growth Factor) over a 12-week period in 40 acute traumatic SCI patients: at admission on average one hour after initial trauma; at four, nine, 12, and 24 h; Three, and seven days after admission; and two, four, eight, and twelve weeks after admission. This was done using a Luminex Performance Human High Sensitivity Cytokine Panel. SCI was classified using the American Spinal Injury Association (ASIA) Impairment Scale (AIS) at time of admission and after 12 weeks. TNFα, IL-1β, IL-6, IL-8, and IL-10 concentrations were significantly higher in patients without neurological remission and in patients with an initial AIS A (p < 0.05). This study shows significant differences in cytokine concentrations shown in traumatic SCI patients with different neurological impairments and within a 12-week period. IL-8 and IL-10 are potential peripheral markers for neurological remission and rehabilitation after traumatic SCI. Furthermore our cytokine expression pattern of the acute, subacute, and intermediate phase of SCI establishes a possible basis for future studies to develop standardized monitoring, prognostic, and tracking techniques.
Highlights
It is reported that the average annual incidence of spinal cord injury (SCI) in the United States is 40 cases per million [1]
Many studies compared the cerebrospinal fluid (CSF) and serum concentration after traumatic SCI in humans, this was the first study in which a large patient collective was examined prospectively over a long period of time, including clinical follow-up
Davies et al [19] demonstrated significantly higher TNFα and IL-6 levels in the serum of traumatic SCI patients compared with a control group; the taking of blood samples was carried out at different time points after injury
Summary
It is reported that the average annual incidence of SCI in the United States is 40 cases per million [1]. Damage to the spinal cord and the following consequences such as para- and tetraplegia have a devastating impact on the patient’s life. The injury is associated with dramatic medical, psychological, social, and economic consequences regarding the patient’s and his/her family’s life [2,3,4]. Depending on the extent and localization of the neurological damage, the deficits can range from incomplete sensory to a complete sensorimotor deficit. Secondary complications like chronic urinary tract infections, decubitus, cardiac, and vegetative dysregulation, as far as spinal shock, still threaten the patient’s life. Causal therapy for damaged structures still remains unfeasible [4]
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