Increased Levels of Serum S100B Protein in Critically Ill Patients Without Brain Injury

Routsi, Christina; Stamataki, Elizabeth; Nanas, Seraphim; Roussos, Charis

doi:10.1097/01.shk.0000239757.67464.c6

Cited by 19 publications

(23 citation statements)

References 28 publications

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“…Large numbers of studies evaluated release patterns of damage markers in blood samples, but the interpretation of neurologic injury markers in blood is hampered by many confounding factors, including variable blood-brain barrier passage, clearance rates from blood that are affected by renal or liver failure, and especially for S100B, contribution of extracerebral tissues to blood concentrations (3,4 ). Further questions regarding the validity of cerebral damage markers in blood are raised by the absence of a correlation between and increased serum S100B concentrations in patients without brain injury (27)(28)(29). Because CSF is in communication with cerebral extracellular fluid and is less hampered by confounding factors, it is believed that biochemical parameters in CSF more accurately reflect in cerebro pathological changes.…”

Section: Discussionmentioning

confidence: 99%

Neurobiochemical Markers of Brain Damage in Cerebrospinal Fluid of Acute Ischemic Stroke Patients

et al. 2010

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Background: Ischemic injury to the central nervous system causes cellular activation and disintegration, leading to release of cell-type–specific proteins into the cerebrospinal fluid (CSF). We investigated CSF concentrations of myelin basic protein (MBP), glial fibrillary astrocytic protein (GFAP), the calcium-binding protein S100B, and neuron-specific enolase (NSE) in acute ischemic stroke patients and their relation to initial stroke severity, stroke location, and long-term stroke outcome. Methods: CSF concentrations of MBP, GFAP, S100B, and NSE were assessed in 89 stroke patients on admission (mean 8.7 h after stroke onset) and in 35 controls. We evaluated the relation between CSF concentrations and (a) stroke severity (NIH Stroke Scale [NIHSS] score on admission, infarct volume), (b) stroke location, and (c) stroke outcome (modified Rankin Scale [mRS] score at month 3). Results: MBP concentration was significantly higher in subcortical than in cortical infarcts (median MBP, 1.18 vs 0.66 μg/L, P < 0.001). GFAP and S100B concentrations correlated with the NIHSS score on admission (GFAP, R = 0.35, P = 0.001; S100B, R = 0.29, P = 0.006), infarct volume (GFAP, R = 0.34, P = 0.001; S100B, R = 0.28, P = 0.008), and mRS score at month 3 (R = 0.42, P < 0.001 and R = 0.28, P = 0.007). Concentrations of NSE did not correlate with stroke characteristics. Conclusions: MBP, GFAP, S100B, and NSE display relevant differences in cellular and subcellular origins, which are reflected in their relation to stroke characteristics. MBP is a marker for infarct location. GFAP and S100B correlate with stroke severity and outcome.

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Section: Discussionmentioning

confidence: 99%

Neurobiochemical Markers of Brain Damage in Cerebrospinal Fluid of Acute Ischemic Stroke Patients

et al. 2010

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“…[14][15][16] In critically ill patients without evident brain injury, increased S100b values correlate positively with lactate levels and negatively with mean arterial pressure (MAP) and pH. 17 In patients with sepsis, higher levels of S100b, but not NSE, have been reported in those patients who died early (first 4 days), but not in those who died late. 18 In addition, serum levels of S100b are reliable markers for adverse neurologic outcomes after cardiac surgery.…”

Section: Biomarkers and Mortalitymentioning

confidence: 99%

Lack of association of S100β and neuron-specific enolase with mortality in critically ill patients

Macedo

Tomasi

Giombelli

et al. 2013

Rev. Bras. Psiquiatr.

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Objective: To evaluate the relationship between brain damage biomarkers and mortality in the intensive care unit (ICU). Methods: The sample comprised 70 patients admitted to an ICU. Blood samples were collected from all patients on ICU admission, and levels of S100b and neuron-specific enolase (NSE) were determined by ELISA. Results: Acute Physiologic and Chronic Health Evaluation (APACHE II) score was associated with mortality, but NSE and S100b were not associated with this outcome. In contrast, S100b levels were significantly higher in delirious and non-delirious patients who required mechanical ventilation during ICU stay. Conclusion: Levels of brain biomarkers at the time of ICU admission did not predict mortality in critically ill patients.

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“…Unfortunately, owing to one or more limitations in sensitivity and specificity, none of these has emerged as a widely used diagnostic or prognostic clinical tool or a validated surrogate endpoint measure for irreversible brain damage. For example, although serum levels of S100β change in relation to short-term mortality and morbidity, as well as long-term neurologic outcome, the protein also markedly increases in serum during surgical procedures unrelated to acute brain injuries (Anderson et al, 2001;Routsi et al, 2006) as well as marathon runners (Hasselblatt et al, 2004), from which it is derived from adipose and other extracranial sources (Kleine et al, 2003). Furthermore, acute alterations in serum S100β are not consistently predictive of brain dysfunction resulting from mild brain injury (reviewed by Begaz et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Biomarker evidence for mild central nervous system injury after surgically-induced circulation arrest

et al. 2008

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Previously, we identified 14-3-3 β and ζ isoforms and proteolytic fragments of α-spectrin as proteins released from degenerating neurons that also rise markedly in cerebrospinal fluid (CSF) following experimental brain injury or ischemia in rodents, but these proteins have not been studied before as potential biomarkers for ischemic central nervous system injury in humans. Here we describe longitudinal analysis of these proteins along with the neuron-enriched hypophosphorylated neurofilament H (pNFH) and the deubiquitinating enzyme UCH-L1 in lumbar CSF samples from 19 surgical cases of aortic aneurysm repair, 7 involving cardiopulmonary bypass with deep hypothermic circulatory arrest (DHCA). CSF levels of the proteins were near the lower limit of detection by Western blot or enzyme-linked fluorescence immunoassay at the onset of surgical procedures, but increased substantially in a subset of cases, typically within 12-24 hours. All cases involving DHCA were characterized by >3-fold elevations in CSF levels of the two 14-3-3 isoforms, UCH-L1, and pNFH. Six of 7 also exhibited marked increases in α-spectrin fragments generated by calpain, a protease known to trigger necrotic neurodegeneration. Among cases involving aortic cross-clamping but not DHCA, the proteins rose in CSF preferentially in the subset experiencing acute neurological complications. Our results suggest the neuron-enriched 14-3-3β, 14-3-3ζ, pNFH, UCH-L1, and calpain-cleaved α-spectrin may serve as a panel of biomarkers with clinical potential for the detection and management of ischemic central nervous system injury, including for mild damage associated with surgically-induced circulation arrest.

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Increased Levels of Serum S100B Protein in Critically Ill Patients Without Brain Injury

Cited by 19 publications

References 28 publications

Neurobiochemical Markers of Brain Damage in Cerebrospinal Fluid of Acute Ischemic Stroke Patients

Neurobiochemical Markers of Brain Damage in Cerebrospinal Fluid of Acute Ischemic Stroke Patients

Lack of association of S100β and neuron-specific enolase with mortality in critically ill patients

Biomarker evidence for mild central nervous system injury after surgically-induced circulation arrest

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