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Kyritsis N, Torres-Espín A, Schupp PG, Huie JR, Chou A, Duong-Fernandez X, Thomas LH, Tsolinas RE, Hemmerle DD, Pascual LU, Singh V, Pan JZ, Talbott JF, Whetstone WD, Burke JF, DiGiorgio AM, Weinstein PR, Manley GT, Dhall SS, Ferguson AR, Oldham MC, Bresnahan JC, Beattie MS. Diagnostic blood RNA profiles for human acute spinal cord injury. J Exp Med 2021; 218:e20201795. [PMID: 33512429 PMCID: PMC7852457 DOI: 10.1084/jem.20201795] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/18/2020] [Accepted: 12/22/2020] [Indexed: 12/14/2022] Open
Abstract
Diagnosis of spinal cord injury (SCI) severity at the ultra-acute stage is of great importance for emergency clinical care of patients as well as for potential enrollment into clinical trials. The lack of a diagnostic biomarker for SCI has played a major role in the poor results of clinical trials. We analyzed global gene expression in peripheral white blood cells during the acute injury phase and identified 197 genes whose expression changed after SCI compared with healthy and trauma controls and in direct relation to SCI severity. Unsupervised coexpression network analysis identified several gene modules that predicted injury severity (AIS grades) with an overall accuracy of 72.7% and included signatures of immune cell subtypes. Specifically, for complete SCIs (AIS A), ROC analysis showed impressive specificity and sensitivity (AUC: 0.865). Similar precision was also shown for AIS D SCIs (AUC: 0.938). Our findings indicate that global transcriptomic changes in peripheral blood cells have diagnostic and potentially prognostic value for SCI severity.
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Affiliation(s)
- Nikos Kyritsis
- Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
| | - Abel Torres-Espín
- Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
| | - Patrick G. Schupp
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
- Brain Tumor Center, University of California, San Francisco, San Francisco, CA
| | - J. Russell Huie
- Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
| | - Austin Chou
- Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
| | - Xuan Duong-Fernandez
- Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
| | - Leigh H. Thomas
- Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
| | - Rachel E. Tsolinas
- Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
| | - Debra D. Hemmerle
- Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
| | - Lisa U. Pascual
- Orthopaedic Trauma Institute, Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA
| | - Vineeta Singh
- Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA
- Department of Neurology, University of California, San Francisco, San Francisco, CA
| | - Jonathan Z. Pan
- Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA
| | - Jason F. Talbott
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA
| | - William D. Whetstone
- Department of Emergency Medicine, University of California, San Francisco, San Francisco, CA
| | - John F. Burke
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
| | - Anthony M. DiGiorgio
- Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
| | - Philip R. Weinstein
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
- Department of Neurology, University of California, San Francisco, San Francisco, CA
- Weill Institute for Neurosciences, Institute for Neurodegenerative Diseases, Spine Center, University of California, San Francisco, San Francisco, CA
| | - Geoffrey T. Manley
- Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
| | - Sanjay S. Dhall
- Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
| | - Adam R. Ferguson
- Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
- San Francisco Veterans Affairs Healthcare System, San Francisco, CA
| | - Michael C. Oldham
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
- Brain Tumor Center, University of California, San Francisco, San Francisco, CA
| | - Jacqueline C. Bresnahan
- Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
| | - Michael S. Beattie
- Weill Institute for Neurosciences, Brain and Spinal Injury Center, University of California, San Francisco, San Francisco, CA
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA
- Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA
- San Francisco Veterans Affairs Healthcare System, San Francisco, CA
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