Traumatic spinal cord injury (SCI) leads to lifelong impairment and disability due to the lack of spontaneous nerve regeneration. Neuroregenerative therapies are being investigated in search for effective interventions to improve clinical outcomes for SCI patients. The current patient stratification and neurological outcome assessment in SCI clinical trials involves the use of the American Spinal Injury Association Impairment Scale (AIS). However, AIS grades are unable to distinguish different neurological impairments. Therefore, it often fails to reflect clinically important differences in severity and recovery, especially in people with cervical SCI. To address this, proteome of cerebrospinal fluid and blood serum from NISCI trial (ClinicalTrials.gov, NCT03935321), which tests the effectiveness of a nogo-A antibody in acute SCI, have been evaluated. This longitudinal integrated CSF-serum proteomic profiling identified underlying pathways of SCI severity and recovery and molecular predictors of neuronal improvement, which could be used to stratify patients with SCI.

Co-authors: Norbert Weidner, Giada Sandrini, Katalin Barkovits, Andreas Hug, Junyan Lu