Serum S-100 Protein Levels After Pediatric Cardiac Operations: A Possible New Marker for Postperfusion Cerebral Injury

Lindberg, Lars; Ak, Olsson; Anderson, Kelsey; Jögi, Peeter

doi:10.1016/s0022-5223(98)70128-x

Cited by 62 publications

(46 citation statements)

References 15 publications

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“…operations and extracorporeal circulation, demonstrating agerelated concentrations that were highest in neonates and infants with Down's syndrome with a pattern of transient increase similar to adult patients (36). In asphyxia, serum protein S-100 release follows a pattern similar to the transient increase observed after cardiac operations.…”

Section: Early Indicators After Birth Asphyxiamentioning

confidence: 71%

“…We postulate that in case of asphyxia, elevated levels in serum are caused by leakage of protein S-100 into the extracellular fluid after hypoxic damage of glial cell and neuronal membranes and by lower renal excretion. The integrity of the blood-brain barrier seems to influence its levels in serum, which explains why serum protein S-100 concentration is lower in adults than in infants (36). Recent studies detected transient serum elevations of protein S-100 without any relationship to permanent neuronal damage, and the question has arisen as to whether protein S-100 arises from noncerebral sources (37,38).…”

Section: Early Indicators After Birth Asphyxiamentioning

confidence: 99%

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Early Biochemical Indicators of Hypoxic-Ischemic Encephalopathy after Birth Asphyxia

et al. 2001

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Section: Early Indicators After Birth Asphyxiamentioning

confidence: 71%

Section: Early Indicators After Birth Asphyxiamentioning

confidence: 99%

Early Biochemical Indicators of Hypoxic-Ischemic Encephalopathy after Birth Asphyxia

et al. 2001

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“…S100 measured in preterm infants, may be an indicator of white matter lesions (22). In the pediatric population, S100 has been measured after cardiac surgery and correlated with cerebral injury (23).…”

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confidence: 99%

NSE and S100 after Hypoxia in the Newborn Pig

2005

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Perinatal asphyxia is an important cause of neonatal morbidity and mortality. There is the potential to halt cerebral damage if neural rescue strategies are applied within a short period of time after an insult. It is therefore important to be able to accurately identify neonates who may benefit from neural rescue therapies. Recent studies in asphyxiated neonates have correlated S100B and NSE with outcome; however, interpretation of these studies were difficult, as the timing of the measurements were not consistent. We measured NSE and S100 in 1-d-old piglets after a mild or severe hypoxic insult. Measurements were performed at 6 -72 h after the insult and correlated with histologic outcome. There were no differences of the NSE or S100 concentrations between controls and the mild hypoxia group. After 24 h, there was a significant difference of NSE between the control/mild insult group and severe insult group. After 48 h, the S100 concentrations were significantly different between the control/ mild insult group and the severe insult group. Both proteins showed good correlation at these time points with outcome as measured by histology score at 72 h. In conclusion, NSE and S100B measured in the serum of piglets after hypoxia increased significantly and correlated with outcome. This increase occurs too late to be used within the first 24 h but might be helpful for the clinician in determining the timing of an insult. Perinatal asphyxia occurs in 1 in 500 deliveries and is an important cause of neonatal morbidity and mortality. There is the potential of neural rescue therapies to halt cerebral damage when applied within a "window of opportunity" of limited duration. It is therefore especially important to be able to accurately identify those neonates who may benefit from such interventions (1). The early and accurate prediction of the severity of brain damage remains difficult. Several brain-specific proteins have been measured in CSF and serum and correlated with outcome after hypoxic/ischemic reperfusion injury (1-4). S100 is an astroglial specific protein with calcium binding capacity. It is a homo-or heterodimer consisting of two subunits, alpha and beta. S100␤␤ is present in high concentrations in glial and Schwann cells, S100␣␣ in glial cells, and S100␣␤ in striated muscle, heart, and kidney (5). NSE is an isoenzyme of the glycolytic enzyme enolase and is present in high concentrations in neuronal cell bodies, axons, and in cells of neuroendocrine origin (6). After neuronal injury, S100B (S100␤␤) and NSE pass into the CSF and across the blood-brain-barrier (6,7). Recent studies in asphyxiated neonates have correlated S100B and NSE with outcome (3,4,8,9). The results correlated with outcome but measurements had been taken at differing and unknown times after insult and from different bodily fluids (serum or CSF). As the probable beginning and duration of the insult in neonates is often uncertain, correlations with outcome are difficult to interpret as the timeline of the increase of NSE or S100 after an insult...

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“…S100 in serum has been shown to be a possible marker of postperfusion cerebral injury after pediatric cardiac operations (23). In preterm infants with intraventricular hemorrhage concentrations of S100 in blood were elevated, before a radiologic assessment of hemorrhage could be performed (24).…”

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S100 Protein in Serum as a Prognostic Marker for Cerebral Injury in Term Newborn Infants with Hypoxic Ischemic Encephalopathy

et al. 2004

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The astroglial protein S100 is an established biochemical marker for CNS injury in the adult. The aim was to investigate whether S100 in serum is a prognostic marker of cerebral injury in term newborn infants with hypoxic ischemic encephalopathy (HIE) after perinatal asphyxia. Serum S100 was measured on postnatal days 1-4 in 62 term infants with birth asphyxia. The infants were classified for HIE and had follow-up for at least 18 mo. Infants with moderate and severe HIE had significantly higher S100 levels on postnatal day 1 (p ϭ 0.031) and day 2 (p ϭ 0.008) than infants with mild or no HIE. The levels of S100 decreased on days 2 and 3 in all infants with HIE. The median S100 level on postnatal day 1 was higher in nine infants who died neonatally and in 10 infants who developed cerebral palsy (CP), compared with 43 infants with no signs of impairment at follow up, 14.0 (0.5-60.0) g/L, 20.7 (0.2-64.0) g/L and 5.5 (0.7-120.0) g/L, respectively. A level of S100 above 12 g/L the first day of life was significantly more frequent in infants who died or developed CP than in infants with no impairment at follow up (p ϭ 0.02). Increased S100 levels were significantly inversely correlated with perinatal pH in the infants and associated with abnormal CTG at admission to the labor ward. Early determination of serum S100 may reflect the extent of brain damage in infants with HIE after asphyxia. Abbreviations CP, cerebral palsy CSF, cerebrospinal fluid CTG, cardiotocography FHR, fetal heart rate HIE, hypoxic ischemic encephalopathy S100, S100 protein including the subunits ␣␤ and ␤␤ aEEG, amplitude integrated EEG GFAP, glial fibrillary acidic protein Birth asphyxia remains a considerable problem in perinatal medicine with an incidence around 0.6 -0.8% of births (1-3). About half of these infants develop hypoxic ischemic encephalopathy (HIE) (2, 4). Those with moderate and severe HIE are at high risk of developing cerebral palsy (CP) (5-8). Prognostic assessment of brain injury after perinatal asphyxia will become essential for proper selection concerning early cerebroprotective treatment, which might be a likely option in the near future (9, 10). Several biochemical markers in cerebrospinal fluid (CSF) have been associated with cerebral complications in infants after perinatal asphyxia (11-14) and recently also S100 in CSF (15). A prognostic marker in serum would be of great value. S100 is a calcium binding protein present in the CNS. The dimers ␣␤ and ␤␤ of S100 are mainly specific for the nervous system and present chiefly in the astroglial cells of the CNS (16,17). S100 ␣␣ is present in many organs outside the CNS and will not be discussed in this report, where S100 will be used for the brain-specific S100 with subunits ␣␤ and ␤␤.The astroglial protein S100 is an established biochemical marker for CNS injury in the adult, in whom increased levels of S100 in CSF have been reported after cerebral insults (18,19). S100 in blood has been shown to be a marker of brain damage in adult stroke (20, 21) and a potential marker for c...

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Serum S-100 Protein Levels After Pediatric Cardiac Operations: A Possible New Marker for Postperfusion Cerebral Injury

Abstract: These findings emphasize the necessity of using age-matched reference values and taking perfusion time into consideration when S-100 protein levels are evaluated with respect to cerebral postperfusion injuries in pediatric patients undergoing cardiac operations.

Cited by 62 publications

References 15 publications

Early Biochemical Indicators of Hypoxic-Ischemic Encephalopathy after Birth Asphyxia

Early Biochemical Indicators of Hypoxic-Ischemic Encephalopathy after Birth Asphyxia

NSE and S100 after Hypoxia in the Newborn Pig

S100 Protein in Serum as a Prognostic Marker for Cerebral Injury in Term Newborn Infants with Hypoxic Ischemic Encephalopathy

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