Peripheral white blood cell responses as emerging biomarkers for patient stratification and prognosis in acute spinal cord injury.
Peripheral white blood cell responses as emerging biomarkers for patient stratification and prognosis in acute spinal cord injury.
复制标题
DOI：
10.1097/wco.0000000000000995
复制
发表时间：
2021-12-01
影响因子：
4.8
通讯作者：
Ruitenberg MJ
中科院分区：
文献类型：
--
作者：
Jogia T;Kopp MA;Schwab JM;Ruitenberg MJ
到目前为止，急性创伤性脊髓损伤(SCI)后患者的预后主要依赖于对损伤特征所致的残存功能的神经学评估。随着新出现的候选治疗药物等待在早期临床试验中进行测试，需要整合神经源性和非神经源性SCI病理生理学以及发病前患者特征的整体高产量预后生物标记物。越来越清楚的是，急性脊髓损伤后的有效预测将受益于对全身水平的病理生理变化的评估，并由此延伸到以病变为中心的方法。免疫标记物反映组织损伤和宿主免疫功能，通过常规采血很容易获得。新的研究强调了循环中的白细胞，特别是中性粒细胞和淋巴细胞作为SCI严重程度和预后的系统预后指标的价值。我们综述了在方法和途径方面的最新进展，这些方法和途径可能允许在急性脊髓损伤后进行更精确的诊断和更好的预测，讨论这些方法和途径如何有助于加深我们对脊髓损伤病理生理学的理解，并在临床试验中使用。
To date, prognostication of patients after acute traumatic spinal cord injury (SCI) mostly relies on the neurological assessment of residual function attributed to lesion characteristics. With emerging treatment candidates awaiting to be tested in early clinical trials, there is a need for wholistic high-yield prognostic biomarkers that integrate both neurogenic and nonneurogenic SCI pathophysiology as well as premorbid patient characteristics. It is becoming clearer that effective prognostication after acute SCI would benefit from integrating an assessment of pathophysiological changes on a systemic level, and with that, extend from a lesion-centric approach. Immunological markers mirror tissue injury as well as host immune function and are easily accessible through routine blood sampling. New studies have highlighted the value of circulating white blood cells, neutrophils and lymphocytes in particular, as prognostic systemic indicators of SCI severity and outcomes. We survey recent advances in methods and approaches that may allow for a more refined diagnosis and better prognostication after acute SCI, discuss how these may help deepen our understanding of SCI pathophysiology, and be of use in clinical trials.