Comparison of Serum and Cerebrospinal Fluid Protein S-100b Levels After Severe Head Injury and Their Prognostic Importance

Uçar, Tanju; Baykal, Aslı; Akyuz, Mahmut; Döşemeci, L; Toptas, Behiye

doi:10.1097/01.ta.0000071352.95491.75

Cited by 18 publications

(14 citation statements)

References 24 publications

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“…For this analysis, we collapsed GOS scores into three groups (1, 2/3, and 4/5). For DRS, subjects were analyzed in three groups: none-to-partial disability (score, 0-3); moderate-to-severe disability (score, [4][5][6][7][8][9][10][11][12][13][14], and extremely severe disability to death (score, [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30]. 41 …”

Section: Outcome Variablesmentioning

confidence: 99%

“…25 Another early study demonstrates that CSF S100b levels are more predictive of outcome than serum S100b levels, citing that serum S100b may be derived more from an impaired BBB than intraparenchymal pathology. 26,27 However, it is not yet fully understood whether serum S100b levels are primarily associated with extent of brain damage or BBB integrity. A second limitation of S100b is that the peripheral origins, or source contributions, of serum S100b are not fully elucidated, and serum levels may be attributed to extracerebral injuries, such as bone fracture, burns, and muscle injury.…”

Section: Introductionmentioning

confidence: 99%

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S100b as a Prognostic Biomarker in Outcome Prediction for Patients with Severe Traumatic Brain Injury

Goyal

Failla

Niyonkuru

et al. 2013

Journal of Neurotrauma

155

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As an astrocytic protein specific to the central nervous system, S100b is a potentially useful marker in outcome prediction after traumatic brain injury (TBI). Some studies have questioned the validity of S100b, citing the extracerebral origins of the protein as reducing the specificity of the marker. This study evaluated S100b as a prognostic biomarker in adult subjects with severe TBI (sTBI) by comparing outcomes with S100b temporal profiles generated from both cerebrospinal fluid (CSF) (n = 138 subjects) and serum (n = 80 subjects) samples across a 6-day time course. Long-bone fracture, Injury Severity Score (ISS), and isolated head injury status were variables used to assess extracerebral sources of S100b in serum. After TBI, CSF and serum S100b levels were increased over healthy controls across the first 6 days post-TBI (p ≤ 0.005 and p ≤ 0.031). Though CSF and serum levels were highly correlated during early time points post-TBI, this association diminished over time. Bivariate analysis showed that subjects who had temporal CSF profiles with higher S100b concentrations had higher acute mortality (p < 0.001) and worse Glasgow Outcome Scale (GOS; p = 0.002) and Disability Rating Scale (DRS) scores (p = 0.039) 6 months post-injury. Possibly as a result of extracerebral sources of S100b in serum, as represented by high ISS scores (p = 0.032), temporal serum profiles were associated with acute mortality (p = 0.015). High CSF S100b levels were observed in women (p = 0.022) and older subjects (p = 0.004). Multivariate logistic regression confirmed CSF S100b profiles in predicting GOS and DRS and showed mean and peak serum S100b as acute mortality predictors after sTBI.

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Section: Outcome Variablesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

S100b as a Prognostic Biomarker in Outcome Prediction for Patients with Severe Traumatic Brain Injury

Goyal

Failla

Niyonkuru

et al. 2013

Journal of Neurotrauma

155

View full text Add to dashboard Cite

show abstract

“…Some studies have used average biomarker levels to predict TBI outcome. 4,6,7,11 Others have used peak levels, 8,18 levels obtained during the first day after injury, 5,19,20 whereas others have used arbitrary cutoffs. 5,[9][10][11]20 Recent research from our group has assessed temporal biomarker profiles in evaluating TBI prognosis.…”

Section: Introductionmentioning

confidence: 98%

“…Several cerebrospinal fluid (CSF) and serum biomarkers have shown promise in predicting long-term outcome after severe TBI. [3][4][5][6][7][8][9][10][11][12][13] One particular marker of interest in TBI is S100 calcium-binding protein B (S100b), a protein expressed in mature astrocytes whose foot processes contribute to the bloodbrain barrier (BBB). S100b easily extravasates into the serum as a result of BBB compromise, making it a potentially logical choice as a candidate biomarker for TBI diagnosis and prognosis.…”

Section: Introductionmentioning

confidence: 99%

Group-Based Trajectory Analysis Applications for Prognostic Biomarker Model Development in Severe TBI: A Practical Example

Niyonkuru

Wagner

Ozawa

et al. 2013

Journal of Neurotrauma

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Over the last decade, biomarker research has identified potential biomarkers for the diagnosis, prognosis, and management of traumatic brain injury (TBI). Several cerebrospinal fluid (CSF) and serum biomarkers have shown promise in predicting long-term outcome after severe TBI. Despite this increased focus on identifying biomarkers for outcome prognostication after a severe TBI, several challenges still exist in effectively modeling the significant heterogeneity observed in TBI-related pathology, as well as the biomarker-outcome relationships. Biomarker data collected over time are usually summarized into single-point estimates (e.g., average or peak biomarker levels), which are, in turn, used to examine the relationships between biomarker levels and outcomes. Further, many biomarker studies to date have focused on the prediction power of biomarkers without controlling for potential clinical and demographic confounders that have been previously shown to affect long-term outcome. In this article, we demonstrate the application of a practical approach to delineate and describe distinct subpopulations having similar longitudinal biomarker profiles and to model the relationships between these biomarker profiles and outcomes while taking into account potential confounding factors. As an example, we demonstrate a group-based modeling technique to identify temporal S100 calcium-binding protein B (S100b) profiles, measured from CSF over the first week post-injury, in a sample of adult subjects with TBI, and we use multivariate logistic regression to show that the prediction power of S100b biomarker profiles can be superior to the prediction power of single-point estimates.

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“…Therefore, CSF S-100B is used as a marker protein in humans to detect brain damage. Increased concentrations of CSF S-100B have been reported in patients with brain injury [10] or with Creutzfeldt-Jakob disease [4,6]. In veterinary diagnosis, Green et al [2] first used this CSF protein in the assessment of cattle with suspected bovine spongiform encephalopathy (BSE).…”

mentioning

confidence: 99%

Cerebrospinal Fluid S-100B Concentrations in Normal and Diseased Cattle

Shimada

Inoue²,

Murata

2005

The Journal of Veterinary Medical Science

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ABSTRACT. We measured the concentrations of S-100B, a marker protein used in humans to detect brain damage, in the cerebrospinal fluid (CSF) of clinically normal cattle (n=15, mean age ± SD: 31.8 ± 37.5 months) and of cattle with various inflammatory disorders (n=43, 70.6 ± 31.9 months). The mean ± SD CSF S-100B level was 2.9 ± 1.6 ng/ml in the normal group and 7.0 ± 7.4 ng/ml in the diseased group. Thirteen diseased cattle that had developed no obvious neurological signs showed abnormally high S-100B concentrations (> 8.0 ng/ml), whereas the two cattle with neurological disorders did not. No particular disease could be related to the S-100B rise. Therefore, it remains inconclusive whether measurement of CSF S-100B concentration is useful in veterinary neurological diagnosis. KEY WORDS: cattle, cerebrospinal fluid, S-100B.J. Vet. Med. Sci. 67(6): 621-623, 2005 S-100B is a calcium-binding protein found in the central nervous system [1]. This neurotrophic protein is primarily synthesized in the brain by astrocytes [7] and appears in the cerebrospinal fluid (CSF), the fluid within the subarachnoid space, the central canal of the spinal cord, and the brain ventricles. Therefore, CSF S-100B is used as a marker protein in humans to detect brain damage. Increased concentrations of CSF S-100B have been reported in patients with brain injury [10] or with Creutzfeldt-Jakob disease [4,6]. In veterinary diagnosis, Green et al. [2] first used this CSF protein in the assessment of cattle with suspected bovine spongiform encephalopathy (BSE). However, to our knowledge, no further veterinary application of this protein has been reported since.In this study we measured CSF S-100B concentrations in normal cattle and in cattle with various inflammatory diseases in order to elucidate the diagnostic relevance of CSF S-100B.CSF samples representing a normal group were obtained from 15 clinically healthy Holstein calves and cows ranging in age from 0.25 to 114 months (mean ± SD: 31.8 ± 37.5 months). These animals had been kept at our institute and were sacrificed to serve as controls for other experiments. Just before euthanasia, a sample was collected from the cerebellomedullary cistern of each sedated animal with an 18 G × 70 mm needle, by the method of Sato et al. [9]. CSF samples representing a disease group (43 cattle, largely cows ranging in age from 6 to 168 months, mean ± SD: 70.6 ± 31.9 months) were kindly supplied by five livestock hygiene centers. Disease types were classified on the basis of clinicopathological observations, and included locomotive disorders such as chronic arthritis (n=9); parturient recumbency due to parturient paresis or physical injury (n = 8); neurological disorders (n= 2); mastitis (n=8), miscellaneous diseases including pneumonia, leukemia and abomasal torsion (n=13), and unclassified conditions (n=3). The cattle were euthanatized for autopsy and pathological examination at the hygiene centers. CSF samples were collected immediately from the medullary cavity of the ventral median fissure. All ani...

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Comparison of Serum and Cerebrospinal Fluid Protein S-100b Levels After Severe Head Injury and Their Prognostic Importance

Abstract: The results show that CSF S-100b levels clearly are superior to serum S-100b levels for predicting outcome after severe head injury.

Cited by 18 publications

References 24 publications

S100b as a Prognostic Biomarker in Outcome Prediction for Patients with Severe Traumatic Brain Injury

S100b as a Prognostic Biomarker in Outcome Prediction for Patients with Severe Traumatic Brain Injury

Group-Based Trajectory Analysis Applications for Prognostic Biomarker Model Development in Severe TBI: A Practical Example

Cerebrospinal Fluid S-100B Concentrations in Normal and Diseased Cattle

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