Changes in CSF S100b and Cytokine Concentrations in Early-Phase Severe Traumatic Brain Injury

Abstract

S100B protein (S100B) has been described as a marker of brain injury. Various cytokines also increase in the cerebrospinal fluid (CSF) of patients with severe traumatic brain injury (TBI). Thus, we investigated early changes in the concentrations of CSF S100B and various cytokines after TBI and evaluated the relations of both S100B and cytokines to intracranial pressure (ICP) and prognosis. Twenty-three patients with severe TBI and a Glasgow Coma Scale score of 8 or less on admission were included in this study. CSF and serum samples were obtained on admission and at 6, 12, 24, 48, 72, and 96 h after injury. CSF concentrations of S100B and CSF and serum concentrations of five cytokines (IL-1beta, TNF-alpha, IL-6, IL-8, and IL-10) were measured and compared. The CSF S100B concentration was increased for 6 h after injury and decreased thereafter. The CSF concentrations of IL-6 and IL-8 peaked within 6 h after injury; other cytokines (IL-1beta, TNF-alpha, and IL-10) were elevated for 24 h after injury and gradually decreased thereafter. Peak CSF S100B concentrations correlated significantly with ICP determined at the time CSF samples were taken (r = 0.729, P < 0.0001). For the cytokines investigated, only the peak CSF IL-1beta concentration correlated significantly and positively with the peak CSF S100B concentration (r = 0.397, P < 0.005). Peak CSF concentrations of S100B (1649 +/- 415 microg/L, mean +/- SEM) and IL-1beta (16.5 +/- 3.3 pg/mL) in the 6 patients with high ICP were significantly higher than those (233 +/- 67 microg/L, 7.6 +/- 1.7 pg/mL, respectively) in the 17 patients with low ICP (P < 0.05). The CSF S100B concentration (1231 +/- 378 microg/L) in eight patients with an unfavorable outcome was significantly higher than that (267 +/- 108 microg/L) in 15 patients with a favorable outcome (P < 0.05). The CSF IL-1beta concentration (14.8 +/- 3.4 pg/mL) in eight patients with an unfavorable outcome tended to be higher than that (7.3 +/- 1.5 pg/mL) in 15 patients with a favorable outcome (P = 0.057). CSF concentrations of S100B and cytokines peak within 24 h after severe TBI and decrease gradually thereafter. CSF S100B and IL-1beta may be useful as predictors of outcome in cases of severe TBI.

Transgenerational modification of hippocampus TNF-α and S100B levels in the offspring of rats chronically exposed to morphine during adolescence

“…According to these studies, a close relationship exists between TNF-α and S100B levels in brain tissues, and typically, these levels are altered accordingly (22,55,56). In our study, the hippocampus TNF-α levels were increased while the S100B levels were inversely reduced as a result of chronic morphine exposure.…”

“…The S100B levels in hippocampus tissue and cerebrospinal fluid increase during brain damage or pathophysiological situations, and the consequent behavioral symptoms (28,30,(54)(55)(56)(57) might be induced by glial cell activation through the RAGE-dependent pathway (22,58). According to these studies, a close relationship exists between TNF-α and S100B levels in brain tissues, and typically, these levels are altered accordingly (22,55,56).…”

Cytokine Gene Polymorphisms and Outcome after Traumatic Brain Injury

“…A number of groups have investigated the relationship between cytokine protein measurements, including TNFa, in the CSF with outcome after TBI in relatively small cohorts without demonstrating evidence of a correlation between high TNFa levels and poor outcome. 46,47 It has been shown, however, that serum and CSF TNFa correlate with the occurrence of the secondary complications of intracranial hypertension and decreased cerebral perfusion pressure. 48,49 Alterations in other cytokines have also been studied after TBI with increases in IL-1b and IL-6 correlating with poor outcome 50 or without a clear relationship to outcome.…”

Cerebral microdialysis of interleukin (IL)-1ß and IL-6: extraction efficiency and production in the acute phase after severe traumatic brain injury in rats

“…Conclusions Cerebral microdialysis allows measurement of cytokine secretion in the ECF of brain tissue in rats. [3,8,9,13,16,17,28,[41][42][43]. The exact contribution of these substances to local tissue damage is still not fully understood.…”