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

BACKGROUND: 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. OBJECTIVE: To investigate longitudinal changes in serum taurine concentrations following acute traumatic SCI, evaluate their diagnostic performance, and examine their association with functional recovery. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.