Urinary biomarkers indicative of recovery from spinal cord injury: A pilot study

IBRO Neuroscience Reports, 2021 · DOI: https://doi.org/10.1016/j.ibneur.2021.02.007 · Published: February 18, 2021

Spinal Cord Injury Neurology Bioinformatics

Simple Explanation

This study explores whether changes in urine can be used to track recovery from spinal cord injury (SCI). The idea is to find objective markers in urine that reflect how well someone is recovering, potentially improving treatment and outcome prediction. The researchers analyzed urine samples from male SCI patients shortly after their injury and again six months later. They used a technique called NMR to identify and measure different substances in the urine, looking for changes that correlated with recovery. They found that levels of certain substances like caffeine, 3-hydroxymandelic acid, L-valine and N-methylhydantoin in the urine changed in ways that related to the patients' Spinal Cord Independence Measure (SCIM) scores, which assess their functional abilities. This suggests these substances could serve as biomarkers of SCI recovery.

Study Duration

6 Months

Participants

6 male SCI patients

Evidence Level

Pilot study

Key Findings

1
Caffeine, 3-hydroxymandelic acid, and L-valine levels in initial urine samples correlated with functional improvement as measured by SCIM scores.
2
Changes in L-valine and N-methylhydantoin concentrations in urine samples were significantly correlated with changes in SCIM scores, indicating their potential as proxy measures of recovery.
3
Purine metabolism was identified as the most significantly affected metabolic pathway during SCI recovery, followed by tyrosine metabolism.

Research Summary

This pilot study investigated urinary metabolic profiles as potential biomarkers for recovery following spinal cord injury (SCI). Urine samples were collected from male SCI patients at one month and six months post-injury, and analyzed using NMR spectroscopy. The study identified significant correlations between specific urinary metabolites (caffeine, 3-hydroxymandelic acid, L-valine, and N-methylhydantoin) and clinical outcomes measured by the Spinal Cord Independence Measure (SCIM). Metabolic pathway analysis revealed that purine metabolism and tyrosine metabolism were significantly affected during SCI recovery, suggesting potential mechanisms of neural damage and repair. These findings support the potential of urinary metabolomics for prognosticating SCI outcomes.

Practical Implications

Prognostic Biomarkers

Urinary metabolites like caffeine, 3-hydroxymandelic acid, and L-valine may predict recovery outcomes in SCI patients.

Therapeutic Targets

The identified metabolic pathways (purine and tyrosine metabolism) could represent potential targets for neurotherapeutic interventions.

Personalized Medicine

Metabolomics, combined with machine learning, offers a clinically accessible approach to personalize SCI treatment based on individual metabolic profiles.

Study Limitations

1
Small sample size (n=6) limits the generalizability of the findings.
2
Patients' diets were not controlled, potentially confounding the results.
3
Effects of body mass index, drug treatments, and medical history were not controlled for due to the small cohort size.

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