Abstract
BackgroundAcute traumatic cervical spinal cord injury (SCI) is a leading cause of disability in adolescents and young adults worldwide. Evidence from previous studies suggests that circulating cell-free DNA is associated with severity following acute injury. The present study determined whether plasma DNA levels in acute cervical SCI are predictive of outcome.MethodsIn present study, serial plasma nuclear DNA (nDNA) and mitochondrial DNA (mtDNA) levels were obtained from 44 patients with acute traumatic cervical SCI at five time points from day 1 to day 180 post-injury. Control blood samples were obtained from 66 volunteers.ResultsData showed a significant increase in plasma nDNA and mtDNA concentrations at admission in SCI patients compared to the control group. Plasma nDNA levels at admission, but not plasma mtDNA levels, were significantly associated with the Japanese Orthopaedic Association (JOA) score and Injury Severity Score in patients with acute traumatic cervical SCI. In patients with non-excellent outcomes, plasma nDNA increased significantly at days 1, 14 and 30 post-injury. Furthermore, its level at day 14 was independently associated with outcome. Higher plasma nDNA levels at the chosen cutoff point (> 45.6 ng/ml) predicted poorer outcome with a sensitivity of 78.9% and a specificity of 78.4%.ConclusionsThese results indicate JOA score performance and plasma nDNA levels reflect the severity of spinal cord injury. Therefore, the plasma nDNA assays can be considered as potential neuropathological markers in patients with acute traumatic cervical SCI.
Highlights
Acute traumatic cervical spinal cord injury (SCI) is a leading cause of disability in adolescents and young adults worldwide
WBC, plasma nuclear DNA (nDNA) and mitochondrial DNA (mtDNA) at admission were statistic significantly higher in acute cervical SCI patients (11.3 vs. 5.6, 40.3 vs. 25.1, and 43.6 vs. 12.6; p ≦ 0.001, p = 0.005, and p ≦ 0.001, respectively)
Macher et al [10] revealed that plasma deoxyribonucleic acid (DNA) levels at 24 h after admission were positively correlated with the Injury Severity Score (ISS) and Acute Physiology and Chronic Health Enquiry (APACHE II) score in patients with traumatic brain injury (TBI), but there was no association with the presence of extracranial injury
Summary
Acute traumatic cervical spinal cord injury (SCI) is a leading cause of disability in adolescents and young adults worldwide. Evidence from previous studies suggests that circulating cell-free DNA is associated with severity following acute injury. The present study determined whether plasma DNA levels in acute cervical SCI are predictive of outcome. Acute traumatic spinal cord injury (SCI) is a major cause of disability among teenagers and young adults in many countries [1]. Cells tend to experience apoptosis or cell death due to impairment of the mitochondrial function following SCI [25,26,27,28] This process releases cell-free DNA, including mitochondrial DNA (mtDNA) and nuclear DNA (nDNA), to serum
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