{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:08:08Z","timestamp":1792789688689,"version":"4.5.0"},"reference-count":28,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Lundbeckfonden","id":[{"id":"https:\/\/ror.org\/03hz8wd80","id-type":"ROR","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/03hz8wd80","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Aase og Ejnar Danielsens Fond","id":[{"id":"https:\/\/ror.org\/02hcraz70","id-type":"ROR","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/02hcraz70","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Grosserer L.F. Foghts Fond"},{"id":[{"id":"https:\/\/ror.org\/01bn4mn58","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Dagmar Marshalls Fond"},{"id":[{"id":"https:\/\/ror.org\/0215y9j16","id-type":"ROR","asserted-by":"publisher"}]},{"name":"A.P. M\u00f8ller Fonden","id":[{"id":"https:\/\/ror.org\/02kdrgt12","id-type":"ROR","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/02kdrgt12","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Grosserer A.V. Lykfeldt og Hustrus Legat","id":[{"id":"https:\/\/ror.org\/00834cd23","id-type":"ROR","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/00834cd23","id-type":"ROR","asserted-by":"publisher"}]},{"name":"Jascha Fonden","id":[{"id":"https:\/\/ror.org\/05ykzvv97","id-type":"ROR","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/05ykzvv97","id-type":"ROR","asserted-by":"publisher"}]},{"name":"UlykkesPatientForeningen"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Early diagnosis and prognosis after traumatic spinal cord injury (TSCI) remain challenging, and single biochemical biomarkers have shown limited stand-alone utility. Combining different biomarkers may improve prediction. We explored combinations of biomarkers in blood and cerebrospinal fluid (CSF) and their association with injury severity and neurological outcome after TSCI. Methods: In this post hoc analysis of a previously reported prospective cohort, blood and CSF were collected from 15 patients with TSCI at a median of 13 h after injury. Biomarkers comprised 13 inflammatory\/structural proteins measured by quantitative assays and an Olink Target 96 Inflammation panel (92 proteins). Injury severity was classified by the American Spinal Injury Association (ASIA) Motor Score (AMS) at admission (admission injury severity) and at follow-up (follow-up neurological status). LASSO regression with 1000 repetitions identified combinations associated with level-adjusted AMS. Results: Of the quantitative assay biomarkers, interferon-\u03b3 (IFN-\u03b3), interleukin (IL)-6 and IL-8 in blood and IFN-\u03b3 and IL-10 in CSF were frequently selected for admission injury severity, while IL-6, IL-8 and glial fibrillary acidic protein (GFAP) in blood and IFN-\u03b3 in CSF were selected for follow-up neurological status. Olink panel biomarkers varied substantially: Thymic stromal lymphopoietin (TSLP), matrix metalloproteinase-10 (MMP-10) and IL-17A in blood and C-C motif chemokine 3 (CCL3) in CSF were selected in admission injury severity models, and CCL20 and TSLP in blood and CCL3 in CSF were selected for follow-up neurological status. Forcing admission injury severity into the follow-up models reduced internally cross-validated prediction error by approximately 29\u201333% across all panels, suggesting that much of the apparent biomarker signal reflected admission injury severity rather than independent prognostic information. Only GFAP in blood retained a consistent association with follow-up neurological status when accounting for admission injury severity. Conclusions: In this small exploratory study, blood-based combinations of IFN-\u03b3, IL-8 and IL-6 and CSF-based combinations of IFN-\u03b3 and IL-10 were associated with admission injury severity. Only GFAP in blood showed consistent prognostic value beyond admission severity. Selection frequencies and cross-validated estimates are internal and hypothesis-generating, not evidence of clinical utility or generalizability; independent validation is required.<\/jats:p>","DOI":"10.3390\/jcm15197385","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T08:14:39Z","timestamp":1790151279000},"page":"7385","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Biochemical Biomarker Combinations in Human Traumatic Spinal Cord Injury: An Exploratory Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8734-6631","authenticated-orcid":false,"given":"Kristoffer A.","family":"Aagaard","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, 8200 Aarhus N, Denmark"},{"name":"Department of Neurosurgery, The Neuroscience Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark"},{"name":"Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thea O.","family":"Wichmann","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, 8200 Aarhus N, Denmark"},{"name":"Department of Anaesthesiology and Intensive Care, Aalborg University Hospital, Hospitalsbyen 1, 9260 Gistrup, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1740-7555","authenticated-orcid":false,"given":"Claus V. B.","family":"Hviid","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry, Aalborg University Hospital, Hospitalsbyen 1, 9260 Gistrup, Denmark"},{"name":"Department of Clinical Medicine, Aalborg University, Selma Lagerl\u00f8fs Vej 249, 9260 Gistrup, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4768-7255","authenticated-orcid":false,"given":"Mikkel M.","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, 8200 Aarhus N, Denmark"},{"name":"Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200 Aarhus N, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.3171\/2012.4.AOSPINE1245","article-title":"Clinical Predictors of Neurological Outcome, Functional Status, and Survival after Traumatic Spinal Cord Injury: A Systematic Review","volume":"17","author":"Wilson","year":"2012","journal-title":"J. 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