Serum biomarkers in the diagnosis and prognosis of traumatic spinal cord injury: A systematic review and meta-analysis

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Traumatic spinal cord injury (TSCI) is a severe neurological condition that frequently leads to permanent disability. Serum inflammatory markers and structural proteins may serve as potential biomarkers for TSCI. The present study aimed to evaluate the diagnostic and prognostic value of serum biomarkers in TSCI. In this article, a comprehensive literature search was conducted using databases such as Wanfang, VIP Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, PubMed, Cochrane Library, Embase, and Web of Science. Meta-analysis was performed using RevMan 5.4 software to compare serum biomarker concentrations between TSCI patients and healthy controls (diagnostic group) and between patients with favorable and unfavorable prognoses (prognostic group). The quality of the included studies was evaluated using the Newcastle–Ottawa Scale. The results showed that: (1) In the diagnostic group, the meta-analysis revealed that serum levels of NSE, MIF, S100β, TNF-α, IL-1β, IL-4, IL-6, IL-16, CCL2, CCL4, CCL21, CXCL1, CXCL9, CXCL10, and CXCL12 were significantly elevated in TSCI patients compared with healthy controls, while IL-10 levels were decreased. (2) In the prognostic group, meta-analysis indicated that serum GFAP and NSE concentrations were significantly lower in patients with favorable prognoses than in those with poor prognoses. In conclusion, the serum levels of most structural proteins and inflammatory factors in patients with TSCI are elevated compared with healthy controls, and patients with poor prognosis exhibit even higher concentrations than those with favorable outcomes. These findings indicate the potential value of these markers for diagnosing TSCI and assessing prognosis.