Serial plasma DNA levels as predictors of outcome in patients with acute traumatic cervical spinal cord injury

Hung Chen Wang, Yu Tsai Lin, Shih Yuan Hsu, Nai Wen Tsai, Yun Ru Lai, Ben Yu Jih Su, Chia Te Kung, Cheng Hsien Lu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

10 Scopus citations

Abstract

Background: Acute traumatic cervical spinal cord injury (SCI) is a leading cause of disability in adolescents and young adults worldwide. Evidence from previous studies suggests that circulating cell-free DNA is associated with severity following acute injury. The present study determined whether plasma DNA levels in acute cervical SCI are predictive of outcome. Methods: In present study, serial plasma nuclear DNA (nDNA) and mitochondrial DNA (mtDNA) levels were obtained from 44 patients with acute traumatic cervical SCI at five time points from day 1 to day 180 post-injury. Control blood samples were obtained from 66 volunteers. Results: Data showed a significant increase in plasma nDNA and mtDNA concentrations at admission in SCI patients compared to the control group. Plasma nDNA levels at admission, but not plasma mtDNA levels, were significantly associated with the Japanese Orthopaedic Association (JOA) score and Injury Severity Score in patients with acute traumatic cervical SCI. In patients with non-excellent outcomes, plasma nDNA increased significantly at days 1, 14 and 30 post-injury. Furthermore, its level at day 14 was independently associated with outcome. Higher plasma nDNA levels at the chosen cutoff point (> 45.6 ng/ml) predicted poorer outcome with a sensitivity of 78.9% and a specificity of 78.4%. Conclusions: These results indicate JOA score performance and plasma nDNA levels reflect the severity of spinal cord injury. Therefore, the plasma nDNA assays can be considered as potential neuropathological markers in patients with acute traumatic cervical SCI.

Original languageEnglish
Article number329
JournalJournal of Translational Medicine
Volume17
Issue number1
DOIs
StatePublished - 01 10 2019

Bibliographical note

Publisher Copyright:
© 2019 The Author(s).

Keywords

  • Japanese Orthopaedic Association score
  • Outcome
  • Plasma DNA
  • Traumatic spinal cord injury

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