Abstract

Therapeutic development for spinal cord injury is hindered by the difficulty in conducting clinical trials, which to date have relied solely on functional outcome measures for patient enrollment, stratification, and evaluation. Biological biomarkers that accurately classify injury severity and predict neurologic outcome would represent a paradigm shift in the way spinal cord injury clinical trials could be conducted. MicroRNAs have emerged as attractive biomarker candidates due to their stability in biological fluids, their phylogenetic similarities, and their tissue specificity. Here we characterized a porcine model of spinal cord injury using a combined behavioural, histological, and molecular approach. We performed next-generation sequencing on microRNAs in serum samples collected before injury and then at 1, 3, and 5 days post injury. We identified 58, 21, 9, and 7 altered miRNA after severe, moderate, and mild spinal cord injury, and SHAM surgery, respectively. These data were combined with behavioural and histological analysis. Overall miRNA expression at 1 and 3 days post injury strongly correlates with outcome measures at 12 weeks post injury. The data presented here indicate that serum miRNAs are promising candidates as biomarkers for the evaluation of injury severity for spinal cord injury or other forms of traumatic, acute, neurologic injury.

Highlights

  • Spinal cord injury (SCI) is a devastating condition, often resulting in life-long disability

  • We investigated the potential for miRNA measured in serum and cerebrospinal fluid (CSF) to serve as biomarkers of injury severity after acute traumatic spinal cord injury (SCI) in a pig (Sus scrofa) model

  • Samples of cerebrospinal fluid (CSF) and serum were collected at baseline (BSL), 15 minutes prior to injury, and

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Summary

Introduction

Spinal cord injury (SCI) is a devastating condition, often resulting in life-long disability. It has been estimated that the use of biomarkers in the selection of subjects for early Alzheimer’s trials could reduce sample size by 67% and trials costs by 60% as compared to trials depending solely upon clinical measures[8] For these reasons, there has been considerable research interest in establishing cerebrospinal fluid (CSF) and serum biomarkers after acute SCI, traumatic brain injury, and other acute and chronic neurologic conditions[9,10,11,12,13,14,15,16,17]. The total amount of miRNA at these time points significantly correlated with injury severity, measured by force of impact, as well as with functional outcome scores at 12 weeks post injury (wpi), measured using the Porcine Thoracic Injury Behaviour Score (PTIBS)

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