title: Diagnostic Value of Serum Levels of GFAP, pNF-H, and NSE Compared With Clinical Findings in Severity Assessment of Human Traumatic Spinal Cord Injury.
abstract: METHODS
  An analytical cohort study.
  
  
  OBJECTIVE
  This study aimed to evaluate severity of traumatic spinal cord injury (SCI) based on the serum levels of phosphorylated form of heavy subunit of neurofilament (pNF-H), neuron-specific enolase (NSE), and glial fibrillary acidic protein (GFAP), which are axonal, neural cell body, and glial cell injury markers, respectively.
  
  
  BACKGROUND
  Prior studies have reported elevated serum levels of pNF-H, NSE, and GFAP as biomarkers for the detection of traumatic SCI in animals. However, in this study, these biomarkers were studied in humans and with an extended level of timing.
  
  
  METHODS
  The study included 35 patients with SCI with a mean age of 36.5 years. All patients were evaluated using the American Spinal Injury Association Impairment Scale, followed by examinations including radiography and spinal computed tomography for determining the injury level. Serum levels of NSE, pNF-H, and GFAP were determined using enzyme-linked immunosorbent assay.
  
  
  RESULTS
  The mean serum level of GFAP was significantly higher in patients with SCI than in the control group. Mean serum levels of pNF-H and NSE were significantly higher during 24 and 48 hours after injury in patients with SCI than in the control group. The serum level of GFAP was appropriate for estimating the severity of SCI in the first 24 hours after injury.
  
  
  CONCLUSIONS
  Our findings suggest that increased serum levels of GFAP, NSE, and pNF-H can be used for the diagnosis and degree of SCI severity in trauma patients. During 48 hours after injury, estimation of serum levels of pNF-H, NSE, and GFAP, combined with neurological testing, could predict the presence of SCI and severity prior to spinal computed tomography and surgical or conservative interventions.
  
  
  METHODS
  2.
authors.affiliation: *Neuroscience Research Center and †Neurobiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ‡Department of Emergency Medicine, Shohadye Haftom Tir Hospital, Tehran, Iran; and §Shahid Beheshti University of Medical Sciences, Tehran, Iran; and ¶Department of Pharmacology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Ahadi
authors.forename: Fariba
authors.initials: F
authors.lastname: Khodagholi
authors.forename: Abdolhadi
authors.initials: A
authors.lastname: Daneshi
authors.forename: Ali
authors.initials: A
authors.lastname: Vafaei
authors.forename: Amir Ali
authors.initials: AA
authors.lastname: Mafi
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Jorjani
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D015331:Cohort Studies; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016900:Neurofilament Proteins / Q000097:blood*; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D013119:Spinal Cord Injuries / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005904:Glial Fibrillary Acidic Protein; D016900:Neurofilament Proteins; D010751:Phosphopyruvate Hydratase