title: The developing landscape of diagnostic and prognostic biomarkers for spinal cord injury in cerebrospinal fluid and blood.
abstract: METHODS
  Review study.
  
  
  OBJECTIVE
  The identification of prognostic biomarkers of spinal cord injury (SCI) will help to assign SCI patients to the correct treatment and rehabilitation regimes. Further, the detection of biomarkers that predict permanent neurological outcome would aid in appropriate recruitment of patients into clinical trials. The objective of this review is to evaluate the current state-of-play in this developing field.
  
  
  METHODS
  Studies from multiple countries were included.
  
  
  METHODS
  We have completed a comprehensive review of studies that have investigated prognostic biomarkers in either the blood or cerebrospinal fluid (CSF) of animals and humans following SCI.
  
  
  RESULTS
  Targeted and unbiased approaches have identified several prognostic biomarkers in CSF and blood. These proteins associate with cellular damage following SCI and include components from neurons, oligodendrocytes and reactive astrocytes, that is, neurofilament proteins, glial fibrillary acidic protein, Tau and S100 calcium-binding protein β. Unbiased approaches have also identified microRNAs that are specific to SCI, as well as other cell damage-associated proteins.
  
  
  CONCLUSIONS
  The discovery and validation of stable, specific, sensitive and reproducible biomarkers of SCI is a rapidly expanding field of research. So far, few studies have utilised unbiased approaches aimed at the discovery of biomarkers within the CSF or blood in this field; however, some targeted approaches have been successfully used. Several studies using various animal models and some with small human patient cohorts have begun to pinpoint biomarkers in the CSF and blood with putative prognostic value. An increased sample size will be required to validate these biomarkers in the heterogeneous clinical setting.
authors.affiliation: Institute of Science and Technology in Medicine (ISTM), Keele University, Keele, UK.|Midland Centre for Spinal Injuries, RJAH Orthopaedic Hospital, Oswestry, UK.
authors.forename: C H
authors.initials: CH
authors.lastname: Hulme
authors.affiliation: Institute of Science and Technology in Medicine (ISTM), Keele University, Keele, UK.|Midland Centre for Spinal Injuries, RJAH Orthopaedic Hospital, Oswestry, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Brown
authors.affiliation: Institute of Science and Technology in Medicine (ISTM), Keele University, Keele, UK.
authors.forename: H R
authors.initials: HR
authors.lastname: Fuller
authors.affiliation: Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK.
authors.forename: J
authors.initials: J
authors.lastname: Riddell
authors.affiliation: Midland Centre for Spinal Injuries, RJAH Orthopaedic Hospital, Oswestry, UK.
authors.forename: A
authors.initials: A
authors.lastname: Osman
authors.affiliation: Midland Centre for Spinal Injuries, RJAH Orthopaedic Hospital, Oswestry, UK.
authors.forename: J
authors.initials: J
authors.lastname: Chowdhury
authors.affiliation: Midland Centre for Spinal Injuries, RJAH Orthopaedic Hospital, Oswestry, UK.
authors.forename: N
authors.initials: N
authors.lastname: Kumar
authors.affiliation: Department of Biological Sciences, University of Chester, Chester, UK.
authors.forename: W E
authors.initials: WE
authors.lastname: Johnson
authors.affiliation: Institute of Science and Technology in Medicine (ISTM), Keele University, Keele, UK.|Midland Centre for Spinal Injuries, RJAH Orthopaedic Hospital, Oswestry, UK.
authors.forename: K T
authors.initials: KT
authors.lastname: Wright
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood* / Q000134:cerebrospinal fluid*; D016900:Neurofilament Proteins / Q000097:blood* / Q000134:cerebrospinal fluid*; D011379:Prognosis; D013119:Spinal Cord Injuries / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000175:diagnosis
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D016900:Neurofilament Proteins