S100β protein levels as a parameter to assess the clinical development of adult patients with mild traumatic brain injury in Dr. Moewardi Public Hospital, Surakarta

Abstract

Background: Mild traumatic brain injury (mTBI) is a health problem with an increasing incidence in many developed countries. The standard for examining mTBI is a CT scan, but it is costly, is not always available in all hospitals, and carries a risk of radiation. Meanwhile, S100β is a protein component produced by central nervous system cells. This study aims to determine the presence of changes in S100β protein in adult patients with mTBI during treatment as an alternative to examination. Methods: This research is an analytic observational quantitative study with a cross-sectional study approach to investigate changes in S100β protein levels in blood serum using the ELISA method of mTBI patients in the first 3 h posttrauma (pretest) and treatment on day 1 (27 h posttrauma/posttest). The research sample consisted of 22 people. This research was conducted in the Surgery Section, Sub-Division of Neurosurgery, Dr. Moewardi Public Hospital, during September–December 2019. The data were then analyzed using a discrimination test (comparing t-test means) and a nonparametric test (Wilcoxon). Results: There was a significant difference in mean S100β change between the pretest and posttest treatments. The S100β examination results at posttest decreased to 0.0223 + 0.0029 μg/l or decreased S100β by 21.7% after treatment. Previously, it was known that the mean of S100β at pretest was 0.0285 + 0.0137 μg/l. Conclusion: There was a significant change in S100β protein levels at each examination time. Changes in S100β levels that occurred were in the form of decreased levels from 3 h to 27 h posttrauma. Thus, S100β protein can be used as a parameter to assess the clinical development of adult patients with mTBI. Moreover, none of the patients with an S100β value >0.1 μg/l was found to be the cutoff value set by SNC in adult patients with mTBI for head CT scan.

S100B protein as a biomarker and predictor in traumatic brain injury

“…Statistically, the highest S100B value was observed at the initial sampling within 3 h. Wijanarko et al in their study point to changes in S100B levels in the form of decreased levels 3 h of trauma 14 . Elevated levels of S100B protein are caused by releasing from injured brain cells 15 and it is the continuous release from injured brain tissue that leads to the protein being detectable beyond the expected half-life 16 .…”

“…The diagnostic gold standard in TBI is CT scan of the brain. A negative factor in the use of CT scan is the exposure to ionizing radiation, which can result in fatal malignancies 2 . These factors have led to progress in the development and availability of blood-or peripheral fluid-based biomarkers of brain injury, but in addition, they offer implications for medical decision-making and therapeutic strategies 3 .…”