Longitudinal changes in serum taurine following acute traumatic spinal cord injury: a prospective pilot study of diagnostic performance and functional recovery.

Abstract

Acute traumatic spinal cord injury (SCI) is a devastating neurological condition with limited reliable blood-based biomarkers for assessing injury severity and recovery. Taurine, a neuroprotective amino acid with antioxidant and anti-inflammatory properties, has shown promising effects in experimental studies, but clinical evidence remains limited. To investigate longitudinal changes in serum taurine concentrations following acute traumatic SCI, evaluate their diagnostic performance, and examine their association with functional recovery. This prospective case-control pilot study included 60 patients with acute traumatic SCI and 60 age- and sex-matched healthy controls. Serum taurine concentrations were measured by enzyme-linked immunosorbent assay within 24 h of injury and at 6 months. Patients were classified as complete (n = 30) or incomplete (n = 30) paraplegia. Functional outcomes were assessed using the Spinal Cord Independence Measure (SCIM). Non-parametric tests, receiver operating characteristic (ROC) curve analysis, multivariable linear regression, and Spearman's correlation were performed. Baseline serum taurine concentrations were significantly lower in patients with SCI than in healthy controls (94.80 [56.95-217.30] vs. 478.60 [272.70-985.02] ng/mL; P < 0.001). Taurine concentrations increased significantly at 6 months but remained below control levels (P < 0.001). Patients with incomplete paraplegia had significantly higher taurine concentrations than those with complete paraplegia at both time points (P < 0.001). Baseline serum taurine showed good diagnostic performance (AUC 0.880, 95% CI 0.813-0.933), with 71.2% sensitivity and 89.8% specificity. Serum taurine correlated positively with SCIM self-care, mobility, and total SCIM scores. Serum taurine decreases following acute traumatic SCI, increases during recovery, and demonstrates good diagnostic performance with significant associations with functional outcomes, supporting its potential as a biomarker for injury severity and neurological recovery.