Konzentrationen von endogenen immunvermittelten Biomarkern in prä- und postoperativen Liquorproben bei Patienten mit degenerativer zervikaler Myelopathie

In degenerative cervical myelopathy (DCM), degenerative changes in the cervical spine lead to repetitive microtrauma to the cervical spinal cord. Prevalence rates vary widely across different studies, but overall suggest significant health-economic implications. Mechanical damage to the spinal cord induces ischemia and neuroinflammation at the molecular level. The resulting inflammatory pathways in DCM are not fully understood. Thus, the aim of this study was to compare biomarkers in cerebrospinal fluid (CSF) of DCM patients with a neurologically healthy control group to capture a characteristic spectrum of biomarkers. Ultimately, it is noted that this objective was partially achieved. Cytokines were investigated due to their suspected involvement in the pathogenesis of DCM based on pathophysiological parallels with other neuroinflammatory, neurodegenerative, and ischemic diseases. These cytokines included Eotaxin-1, several interleukins, MCP-1, MIF, RAGE, TREM-2, and YKL-40. To address the central question, a patient cohort with DCM (n=47) and a neurologically healthy control group (n=48) were recruited at the University Hospital Aachen. A structured medical history was obtained, comprehensive neurological examination conducted and clinical scores were assessed. CSF was collected from DCM patients preoperatively and three months postoperatively through lumbar puncture. CSF was collected from the neurologically healthy control cohort once via routinely placed lumbar drainages. The cytokines were analyzed using multiplex assays, a specialized form of enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed using IBM SPSS 28.0. Statistical analysis confirmed significant pathological values for the typical clinical symptoms of DCM and clinical scores in the patient group (p < 0.001). There was also a postoperative improvement of pain and daily functioning of these patients. For the biomarkers Eotaxin-1, RAGE, and TREM-2, preoperative values were significantly elevated in the DCM group (p < 0.001), while YKL-40 concentration was significantly decreased (p < 0.001). There was also a significant increase in Eotaxin-1 postoperatively (p = 0.02). In the discussion and interpretation of results, Eotaxin-1 and TREM-2 emerged as biomarkers that could be characteristic of DCM and could have prognostic and therapeutic potential.