Serum neuron-specific enolase as early predictor of outcome after cardiac arrest

Fogel, W.; Krieger, Derk; Veith, Michael; Adams, Hans-Peter; Hund, Ernst; Storch-Hagenlocher, B.; Buggle, Florian; Mathias, Dietger; Hacke, Werner

doi:10.1097/00003246-199707000-00012

Cited by 142 publications

(87 citation statements)

References 32 publications

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“…Alternatively, high serum NSE levels may reflect the extent of the neuronal damage. One piece of evidence which can support this hypothesis is the relationship between the degree of neuronal damage and the serum NSE level following a cerebral stroke (Cunningham et al, 1991(Cunningham et al, , 1996DeGiorgio et al, 1995DeGiorgio et al, , 1999Fogel et al, 1997;Missler et al, 1997;Martens et al, 1998;Buttner et al, 1999;Schoerkhuber et al, 1999;Wunderlich et al, 1999) or other neuronal brain damage (DeGiorgio et al, 1995(DeGiorgio et al, , 1999Fogel et al, 1997;Martens et al, 1998; Buttner et al, 1999;Schoerkhuber et al, 1999). In these diseases, the serum NSE level exhibits a prognostic indication inasmuch as studies have found a close relationship between the volume of affected neuronal tissue and the serum NSE level (Cunningham et al, 1991(Cunningham et al, , 1996Missler et al, 1997;Wunderlich et al, 1999).…”

Section: Discussionmentioning

confidence: 98%

Brain metastases at the time of presentation of non-small cell lung cancer: a multi-centric AERIO* analysis of prognostic factors

et al. 2001

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Patients with lung cancer frequently suffer from brain metastases at the time of presentation. This condition affects approximately 10% of non-small cell lung cancer (NSCLC) patients (Newman and Hansen, 1974;Sorensen et al, 1988). Surgery is feasible only for a small proportion of these patients. Whole brain radiotherapy has been, hitherto, the generally recommended treatment in inoperable patients. The survival of NSCLC patients with brain metastases is poor, reported to be between 3 to 6 months in patients treated with medical therapies, either radiotherapy or chemotherapy (compared to 6-10 months in other advanced NSCLC (Paesmans et al, 1995;Shepherd, 1999)). Furthermore, brain metastases at the time of presentation of lung cancer seems to be a worse prognosis (Sorensen et al, 1988) than metachronous brain metastases.New therapeutic strategies are needed to improve the outcome of these patients. The knowledge of prognostic determinants might be important in both clinical trials and routine practice (Komaki et al, 1993;Charloux et al, 1997;Paesmans et al, 1997;Merrill et al, 1999). In the former setting, prognostic co-variables must be taken into account in survival analyses; by way of illustration, in a given randomized trial, the statement that a difference in survival is related to the effects of the treatment must be supported by a proportional hazards model demonstrating that this effect does not depend on well-known prognostic determinants (Depierre et al, 1999;Furuse et al, 1999). In the second setting, a therapeutic decision might be influenced by the state of prognostic variables (Komaki et al, 1993).Here we especially take a look at the prognostic significance of 2 specific serum markers, CYFRA 21-1 and neuron-specific enolase (NSE). The prognostic value of CYFRA 21-1 (a fragment of cytokeratin subunit 19) in this disease has been suggested (Pujol et al, 1993;Wieskopf et al, 1995;Brechot et al, 1997). NSE, the γ-subunit of enolase, has been widely investigated as a marker of small cell lung cancer (SCLC;Jorgensen et al, 1989). Although only a small proportion of NSCLC presented with a high NSE level, this marker might indirectly reflect; i) a neuroendocrine component of the disease in favour of tumour heterogeneity; ii) a Summary A multi-centre retrospective study involving 4 French university institutions has been conducted in order to identify routine pretherapeutic prognostic factors of survival in patients with previously untreated non-small cell lung cancer and brain metastases at the time of presentation. A total of 231 patients were recorded regarding their clinical, radiological and biological characteristics at presentation. The accrual period was January 1991 to December 1998. Prognosis was analysed using both univariate and multivariate (Cox model) statistics. The median survival of the whole population was 28 weeks. Univariate analysis (log-rank), showed that patients affected by one of the following characteristics proved to have a shorter survival in comparison with the opposite status...

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Section: Discussionmentioning

confidence: 98%

Brain metastases at the time of presentation of non-small cell lung cancer: a multi-centric AERIO* analysis of prognostic factors

et al. 2001

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“…11 Therefore, recent attention focuses on biochemical markers of hypoxic brain damage. [13][14][15][16]22 To be an ideal marker for brain injury, the marker should be proved to be released from neurons or glial cells in experimental settings, for example cell cultures. Such proofs exist for NSE 32 but not for S-100.…”

Section: Discussionmentioning

confidence: 99%

“…NSE, however, also exists in platelets and in erythrocytes, and there is a constant turnover of NSE in blood, making changes specifically associated with brain damage in serum levels difficult to evaluate. 14,16 Moreover, it is well known that platelets are markedly activated and hemolysis may occur during early reperfusion after cardiac arrest. 33 Therefore, even though at least a proportion of NSE is released from neurons, the determination of NSE, particularly during early reperfusion after cardiac arrest, may not be brain specific.…”

Section: Discussionmentioning

confidence: 99%

“…Biochemical markers of hypoxic brain damage such as neuron-specific enolase (NSE), however, have also shown promising results only at later stages (ie, Ͼ24 hours after cardiac arrest). [13][14][15][16] Recently, S-100 has been found to be a promising marker for central nervous system injury. [17][18][19][20][21][22][23][24] Protein S-100 is part of a large family of calcium-binding proteins, and evidence exists that S-100 regulates calciumdependent cellular signaling in neuronal differentiation, outgrowth, and apoptosis through different concentrations.…”

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Astroglial Protein S-100 Is an Early and Sensitive Marker of Hypoxic Brain Damage and Outcome After Cardiac Arrest in Humans

et al. 2001

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Background-The results of early conventional tests do not correlate with cerebral outcome after cardiac arrest. We investigated the serum levels of astroglial protein S-100 as an early marker of brain damage and outcome after cardiac arrest. Methods and Results-In 66 patients undergoing cardiopulmonary resuscitation after nontraumatic cardiac arrest, blood samples for the evaluation of S-100 were drawn immediately after and 15, 30, 45, and 60 minutes; 2, 8, 24, 48, and 72 hours; and 7 days after initiation of cardiopulmonary resuscitation. Moreover, the serum levels of neuron-specific enolase were determined between 2 hours and 7 days. If patients survived for Ͼ48 hours, brain damage was assessed by a combination of neurological, cranial CT, and electrophysiological examinations. Overall, 343 blood samples were taken for the determination of S-100. Maximum S-100 levels within 2 hours after cardiac arrest were significantly higher in patients with documented brain damage (survivors and nonsurvivors, 3.70Ϯ0.77 g/L) than in patients without brain damage (0.90Ϯ0.29 g/L). Significant differences between these 2 groups were observed from 30 minutes until 7 days after cardiac arrest. In addition, the positive predictive value of the S-100 test at 24 hours for fatal outcome within 14 days was 87%, and the negative predictive value was 100% (PϽ0.001). With regard to neuron-specific enolase, significant differences between patients with documented brain damage and those with no brain damage were found at 24, 48, and 72 hours and 7 days. Conclusions-Astroglial protein S-100 is an early and sensitive marker of hypoxic brain damage and short-term outcome after cardiac arrest in humans.

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“…A NSE tem meia-vida de aproximadamente 24h 29 . Um estudo importante que marcou o início da investigação da NSE como indicador de prognóstico da extensão da isquemia cerebral em pacientes em coma pós-PCR foi o de Fogel e col. no final da década de 1990 30 . Nesse estudo, foram feitas dosagens diárias de NSE durante sete dias pós-reanimação em 43 pacientes coronarianos.…”

Section: A Enolase Específica Do Neurôniounclassified

Valor da enolase específica do neurônio como indicador de prognóstico pós-parada cardiorrespiratória

Rech¹,

Vieira²,

Brauner³

2006

Rev. bras. ter. intensiva

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RESUMO JUSTIFICATIVA E OBJETIVOS: A parada cardíaca é um estado de grave hipoperfusão cerebral. Os pacientes que sobrevivem a uma reanimação cardiorrespiratória estão sob grande risco de vir a morrer ou desenvolver lesão cerebral incapacitante, inclusive estado vegetativo persistente. Uma definição precoce do prognóstico desses pacientes tem implicações éticas e econômicas. O objetivo desse estudo foi revisar o valor prognóstico da Enolase Específica do Neurônio (NSE) em predizer precocemente os desfechos de pacientes após uma parada cardíaca. CONTEÚDO: A lesão cerebral permanente é a complicação mais temida de uma reanimação cardíaca prolongada. Muitos estudos têm tentado isolar fatores prognósticos que possam estar associados com desfechos clínicos em pacientes sobreviventes de parada cardíaca. Indicadores bioquímicos de morte neuronal parecem promissores nesse cenário. Nesse contexto, a NSE vem sendo estudada em pacientes reanimados de paradas cardíacas e níveis elevados dessa enzima

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Serum neuron-specific enolase as early predictor of outcome after cardiac arrest

Cited by 142 publications

References 32 publications

Brain metastases at the time of presentation of non-small cell lung cancer: a multi-centric AERIO* analysis of prognostic factors

Brain metastases at the time of presentation of non-small cell lung cancer: a multi-centric AERIO* analysis of prognostic factors

Astroglial Protein S-100 Is an Early and Sensitive Marker of Hypoxic Brain Damage and Outcome After Cardiac Arrest in Humans

Valor da enolase específica do neurônio como indicador de prognóstico pós-parada cardiorrespiratória

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