gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2016)

25.10. - 28.10.2016, Berlin

Elevated IGF-1 levels after spinal Cord Injury: A new model to understand the biochemical processes after spinal cord injury

Meeting Abstract

  • presenting/speaker Andre Sperl - Heidelberg Trauma Research Group, Universität Heidelberg, Heidelberg, Germany
  • Arash Moghaddam-Alvandi - Universitätsklinikum Heidelberg, Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie, Unfall- und Wiederherstellungschirurgie, Heidelberg, Germany
  • Raban Heller - Heidelberg Trauma Research Group, Universität Heidelberg, Heidelberg, Germany
  • Bahram Biglari - Klinik für Unfall- und Wiederherstellungschirurgie, Abteilung für Querschnittsgelähmte, Orthopädie und Rehabil., Ludwigshafen, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2016). Berlin, 25.-28.10.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocPO27-676

doi: 10.3205/16dkou747, urn:nbn:de:0183-16dkou7473

Veröffentlicht: 10. Oktober 2016

© 2016 Sperl et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe



Objectives: After traumatic spinal cord injury, an acute phase triggered by trauma is followed by a subacute phase involving inflammatory processes. We previously demonstrated that peripheral serum cytokine expression changes depend on neurological outcome after spinal cord injury. In a subsequent intermediate phase, repair and remodeling takes place under the mediation of growth factors such as Insulin-like Growth Factor 1 (IGF-1). IGF-1 is a promising growth factor which is thought to act as a neuroprotective agent. Since previous findings were taken from animal studies, our aim was to investigate this hypothesis in humans based on peripheral blood serum.

Methods: Forty-five patients after traumatic spinal cord injury were investigated prospectively over a period of three months after trauma. Blood samples were taken according to a fixed schema and IGF-1 levels were determined by ELISA (Enzyme-linked Immunosorbent Assay). Clinical data including AIS scores at admission to the hospital and at discharge were collected and compared with IGF-1 levels. All statistical calculations were performed either with SPSS (IBM SPSS Statistics version 21.0) or R version 3.2.3. For comparison of IGF-1 levels in different subpopulations at certain time points the non-parametric Mann-Whitney U-Test. To determine location shifts between IGF-1 levels within one group at different time points the Wilcoxon Signed Rank Test was used. The Chi-square test was used to assess possible statistically significant differences in clinical parameters Results:

Results: In our study, we could observe distinct patterns in the expression of IGF-1 in peripheral blood serum after traumatic spinal cord injury regardless of the degree of paraplegia. All patients showed a marked increase of levels seven days after injury. IGF-1 serum levels were significantly different from initial measurements at four and nine hours and seven and 14 days after injury, as well as one, two and three months after injury. We did not detect a significant correlation between fracture and the IGF-1 serum level nor between the quantity of operations performed after trauma and the IGF-1 serum level. Patients with clinically documented neurological regression showed consistently higher IGF-1 levels than patients without neurological regression.

Conclusion: Based on these observations, we suspect that changes in IGF-1 serum levels are related to neurological damage and expression of IGF-1 might represent an essential part of recovery after traumatic spinal cord injury. This data could be the base for the establishment of animal models for further and much needed research in the field of spinal cord injury.