Objective. To examine (1) if serological or cerebrospinal fluid (CSF) biomarkers can be used as diagnostic and/or prognostic tools in patients with spinal cord injury (SCI) and (2) if literature provides recommendations regarding timing and source of biomarker evaluation. Data Sources. A systematic literature search to identify studies reporting on diagnostic and prognostic blood and/or CSF biomarkers in SCI was conducted in PubMed/MEDLINE, CINAHL, Science Direct, The Cochrane Library, ISI Web of Science, and PEDro. Study Selection. Clinical trials, cohort, and pilot studies on patients with traumatic SCI investigating at least one blood or CSF biomarker were included. Following systematic screening, 19 articles were included in the final analysis. PRISMA guidelines were followed to conduct this review. Data Extraction. Independent extraction of articles was completed by 2 authors using predefined inclusion criteria and study quality indicators. Data Synthesis. Nineteen studies published between 2002 and April 2019 with 1596 patients were included in the systematic review. In 14 studies, blood biomarkers were measured, 4 studies investigated CSF biomarkers, and 1 study used both blood and CSF samples. Conclusions. Serum/CSF concentrations of several biomarkers (S100b, IL-6, GFAP, NSE, tau, TNF-α, IL-8, MCP-1, pNF-H, and IP-10) following SCI are highly time dependent and related to injury severity. Future studies need to validate these markers as true biomarkers and should control for secondary complications associated with SCI. A deeper understanding of secondary pathophysiological events after SCI and their effect on biomarker dynamics may improve their clinical significance as surrogate parameters in future clinical studies.

中文翻译：

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创伤性脊髓损伤中的生物标志物——技术和临床考虑：系统评价

客观的。检查 (1) 血清学或脑脊液 (CSF) 生物标志物是否可用作脊髓损伤 (SCI) 患者的诊断和/或预后工具，以及 (2) 文献是否提供了有关生物标志物评估时间和来源的建议。数据源。在 PubMed/MEDLINE、CINAHL、Science Direct、Cochrane 图书馆、ISI Web of Science 和 PEDro 中进行了系统的文献检索，以确定报告 SCI 诊断和预后血液和/或脑脊液生物标志物的研究。研究选择。包括对创伤性 SCI 患者进行的临床试验、队列和试点研究，这些患者调查了至少一种血液或脑脊液生物标志物。经过系统筛选，19篇文章进入最终分析。遵循 PRISMA 指南进行该审查。数据提取。文章的独立提取由 2 位作者使用预定义的纳入标准和研究质量指标完成。数据合成。系统评价纳入了 2002 年至 2019 年 4 月发表的 19 项研究，涉及 1596 名患者。在 14 项研究中，测量了血液生物标志物，4 项研究调查了 CSF 生物标志物，1 项研究同时使用了血液和 CSF 样本。结论。SCI 后几种生物标志物（S100b、IL-6、GFAP、NSE、tau、TNF-α、IL-8、MCP-1、pNF-H 和 IP-10）的血清/CSF 浓度高度依赖于时间并与损伤严重程度。未来的研究需要将这些标志物验证为真正的生物标志物，并应控制与 SCI 相关的继发性并发症。