title: Elevated Serum Insulin-Like Growth Factor 1 Levels in Patients with Neurological Remission after Traumatic Spinal Cord Injury.
abstract: After traumatic spinal cord injury, an acute phase triggered by trauma is followed by a subacute phase involving inflammatory processes. We previously demonstrated that peripheral serum cytokine expression changes depend on neurological outcome after spinal cord injury. In a subsequent intermediate phase, repair and remodeling takes place under the mediation of growth factors such as Insulin-like Growth Factor 1 (IGF-1). IGF-1 is a promising growth factor which is thought to act as a neuroprotective agent. Since previous findings were taken from animal studies, our aim was to investigate this hypothesis in humans based on peripheral blood serum. Forty-five patients after traumatic spinal cord injury were investigated over a period of three months after trauma. Blood samples were taken according to a fixed schema and IGF-1 levels were determined. Clinical data including AIS scores at admission to the hospital and at discharge were collected and compared with IGF-1 levels. In our study, we could observe distinct patterns in the expression of IGF-1 in peripheral blood serum after traumatic spinal cord injury regardless of the degree of plegia. All patients showed a marked increase of levels seven days after injury. IGF-1 serum levels were significantly different from initial measurements at four and nine hours and seven and 14 days after injury, as well as one, two and three months after injury. We did not detect a significant correlation between fracture and the IGF-1 serum level nor between the quantity of operations performed after trauma and the IGF-1 serum level. Patients with clinically documented neurological remission showed consistently higher IGF-1 levels than patients without neurological remission. This data could be the base for the establishment of animal models for further and much needed research in the field of spinal cord injury.
authors.affiliation: Heidelberg Trauma Research Group, Department of Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Arash
authors.initials: A
authors.lastname: Moghaddam
authors.affiliation: Heidelberg Trauma Research Group, Department of Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: André
authors.initials: A
authors.lastname: Sperl
authors.affiliation: Heidelberg Trauma Research Group, Department of Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Raban
authors.initials: R
authors.lastname: Heller
authors.affiliation: Institute for Medical Biometry and Informatics, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Kevin
authors.initials: K
authors.lastname: Kunzmann
authors.affiliation: Heidelberg Trauma Research Group, Department of Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Viola
authors.initials: V
authors.lastname: Graeser
authors.affiliation: Heidelberg Trauma Research Group, Department of Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Akbar
authors.affiliation: Heidelberg Trauma Research Group, Department of Trauma and Reconstructive Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Heidelberg, Germany.
authors.forename: Hans Jürgen
authors.initials: HJ
authors.lastname: Gerner
authors.affiliation: BG Trauma Centre Ludwigshafen, Department of Paraplegiology, Ludwigshafen, Germany.
authors.forename: Bahram
authors.initials: B
authors.lastname: Biglari
mesh_terms: D000328:Adult; D015415:Biomarkers; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D012372:ROC Curve; D013119:Spinal Cord Injuries / Q000097:blood* / Q000209:etiology / Q000534:rehabilitation*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D007334:Insulin-Like Growth Factor I