INTRODUCTION Traumatic Spinal Cord Injury (TSCI) is a severe incident resulting in loss of motor and sensory function caused by complex pathological mechanisms including massive oxidative stress and extensive inflammatory processes. The essential trace elements selenium (Se) and copper (Cu) play crucial roles as part of the antioxidant defense. HYPOTHESIS Remission after TSCI is associated with characteristic dynamics of early changes in serum Cu and Se status. STUDY DESIGN Single-center prospective observational study. PATIENTS AND METHODS Serum samples from TSCI patients were analyzed (n = 52); 21 recovered and showed a positive abbreviated injury score (AIS) conversion within 3 months (G1), whereas 21 had no remission (G0). Ten subjects with vertebral fractures without neurological impairment served as control (C). Different time points (at admission, and after 4, 9, 12, and 24 h) were analyzed for total serum Se and Cu concentrations by total reflection X-ray fluorescence, and for Selenoprotein P (SELENOP) and Ceruloplasmin (CP) by sandwich ELISA. RESULTS At admission, CP and SELENOP concentrations were higher in the remission group (G1) than in the non-remission group (G0). Within 24 h, there were marginal changes in Se, SELENOP, Cu and CP concentrations in the groups of controls (C) and G0. In contrast, these parameters decreased significantly in G1. Binary logistic regression analysis including Cu and Se levels at admission in combination with Se and CP levels after 24 h allowed a prediction for potential remission, with an area under the curve (AUC) of 87.7% (CI: 75.1%-100.0%). CONCLUSION These data indicate a strong association between temporal changes of the Se and Cu status and the clinical outcome after TSCI. The dynamics observed may reflect an ongoing redistribution of the trace elements in favor of a better anti-inflammatory response and a more successful neurological regeneration.

中文翻译：

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硒和铜的状态-脊髓损伤后神经功能缓解的潜在路标。

简介创伤性脊髓损伤（TSCI）是一种严重的事件，由于复杂的病理机制（包括大量的氧化应激和广泛的炎症过程）导致运动和感觉功能丧失。必需的微量元素硒（Se）和铜（Cu）在抗氧化防御中起着至关重要的作用。假说TSCI后的缓解与血清铜和硒状态的早期变化的特征动力学有关。研究设计单中心前瞻性观察研究。患者与方法分析了TSCI患者的血清样本（n = 52）；21例康复，并在3个月内（G1）表现为缩写伤害评分（AIS）转换为正，而21例未缓解（G0）。十名无神经损伤的椎体骨折患者作为对照组（C）。通过全反射X射线荧光分析不同时间点（入院时，入院后以及4、9、12和24小时后）的总血清Se和Cu浓度，以及通过三明治分析硒蛋白P（SELENOP）和铜蓝蛋白（CP） ELISA。结果入院时，缓解组（G1）的CP和SELENOP浓度高于非缓解组（G0）。在24小时内，对照组（C）和G0组的Se，SELENOP，Cu和CP浓度发生了少量变化。相反，这些参数在G1中显着下降。二元逻辑回归分析包括入院时的铜和硒水平以及24小时后的硒和CP水平，可以预测潜在的缓解，曲线下面积（AUC）为87.7％（CI：75.1％-100.0％）。结论这些数据表明，硒和铜状态的时间变化与TSCI后的临床结局之间密切相关。观察到的动力学可能反映了微量元素的持续重新分布，有利于更好的消炎反应和更成功的神经再生。