Concomitant Traumatic Brain Injury Exacerbates Endotheliopathy in Patients with Spinal Cord Injury

Area of Science:

• Neuroscience
• Biomarkers
• Trauma Research

Background:

• Neurotrauma can lead to endothelial dysfunction, neuroinflammation, and impaired outcomes.
• Endothelial injury and inflammation are critical components of secondary injury after neurotrauma.

Purpose of the Study:

• To investigate the impact of concomitant traumatic brain injury (TBI) on cerebrospinal fluid (CSF) biomarkers of endothelial injury and inflammation in patients with spinal cord injury (SCI).
• To identify potential theranostic biomarkers for stratifying risk and guiding treatment in neurotrauma.

Main Methods:

• CSF samples were collected from patients with isolated SCI and those with SCI + TBI.
• Levels of endothelial damage and inflammatory biomarkers were measured using quantitative assays.
• Correlation analysis was performed between biomarker levels and injury severity scores.

Main Results:

• Patients with SCI + TBI showed significantly higher CSF levels of multiple endotheliopathy and inflammation biomarkers compared to isolated SCI.
• Matrix metalloproteinase 10 (MMP-10), vascular endothelial growth factor A (VEGF-A), and thymic stromal lymphopoietin (TSLP) were notably elevated in SCI + TBI.
• CSF levels of MMP-1, MMP-10, VEGF-A, interferon α2 (IFNα2), and TSLP correlated with injury severity.

Conclusions:

• Concomitant TBI exacerbates endotheliopathy, blood-brain barrier disruption, and neuroinflammation in SCI patients, as indicated by elevated CSF biomarkers.
• Specific biomarkers like MMP-10, VEGF-A, and TSLP may serve as valuable theranostic tools for managing neurotrauma.
• Targeting these biomarkers could help mitigate neurovascular damage and improve clinical outcomes in patients with combined SCI and TBI.