The Biomarker S100B and Mild Traumatic Brain Injury: A Meta-analysis

Oris, Charlotte; Pereira, Bruno; Durif, Julie; Simon-Pimmel, Jeanne; Castellani, Christoph; Manzano, Sergio; Sapin, Vincent; Bouvier, Damien

doi:10.1542/peds.2018-0037

Cited by 75 publications

(58 citation statements)

References 58 publications

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“…Furthermore, examination of the cerebrospinal fluid revealed significantly lower levels of S100B and NSE, in contrast to the tendency for increased neuroprotein concentrations in both groups, which can be attributed to the experimental setup, for example, the introduction of the laser Doppler probes. The biomarkers S100B and NSE have major clinical relevance for the estimation of neurological damage [30][31][32]. In particular, the timescale for the increase in neuroprotein concentrations caused by neuronal damage is much shorter than damage detection by clinical routine imaging technologies.…”

Section: Discussionmentioning

confidence: 99%

Altered Cerebral Blood Flow and Potential Neuroprotective Effect of Human Relaxin-2 (Serelaxin) During Hypoxia or Severe Hypovolemia in a Sheep Model

Schiffner

Bischoff

Irintchev

et al. 2020

IJMS

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Specific neuroprotective strategies to minimize cerebral damage caused by severe hypoxia or hypovolemia are lacking. Based on previous studies showing that relaxin-2/serelaxin increases cortical cerebral blood flow, we postulated that serelaxin might provide a neuroprotective effect. Therefore, we tested serelaxin in two emergency models: hypoxia was induced via inhalation of 5% oxygen and 95% nitrogen for 12 min; thereafter, the animals were reoxygenated. Hypovolemia was induced and maintained for 20 min by removal of 50% of the total blood volume; thereafter, the animals were retransfused. In each damage model, the serelaxin group received an intravenous injection of 30 µg/kg of serelaxin in saline, while control animals received saline only. Blood gases, shock index values, heart frequency, blood pressure, and renal blood flow showed almost no significant differences between control and treatment groups in both settings. However, serelaxin significantly blunted the increase of lactate during hypovolemia. Serelaxin treatment resulted in significantly elevated cortical cerebral blood flow (CBF) in both damage models, compared with the respective control groups. Measurements of the neuroproteins S100B and neuron-specific enolase in cerebrospinal fluid revealed a neuroprotective effect of serelaxin treatment in both hypoxic and hypovolemic animals, whereas in control animals, neuroproteins increased during the experiment. Western blotting showed the expression of relaxin receptors and indicated region-specific differences in relaxin receptor-mediated signaling in cortical and subcortical brain arterioles, respectively. Our findings support the hypothesis that serelaxin is a potential neuroprotectant during hypoxia and hypovolemia. Due to its preferential improvement of cortical CBF, serelaxin might reduce cognitive impairments associated with these emergencies.

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Section: Discussionmentioning

confidence: 99%

Altered Cerebral Blood Flow and Potential Neuroprotective Effect of Human Relaxin-2 (Serelaxin) During Hypoxia or Severe Hypovolemia in a Sheep Model

Schiffner

Bischoff

Irintchev

et al. 2020

IJMS

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“…Its half‐life in humans has been estimated at 1‐2 hours . Although its utility as an indicator of mild traumatic brain injury is contentious because of its release from other tissues, such as fat and chondrocytes, its predictive power in moderate and severe brain injury has been established . Most human SCI studies have evaluated CSF concentrations of this biomarker, but there are experimental and clinical studies demonstrating an association between S100β serum concentrations and SCI severity .…”

Section: Discussionmentioning

confidence: 99%

Time course and prognostic value of serum GFAP, pNFH, and S100β concentrations in dogs with complete spinal cord injury because of intervertebral disc extrusion

Olby

Lim

Wagner

et al. 2019

Veterinary Internal Medicne

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Background A noninvasive biomarker is needed to predict recovery from severe spinal cord injury (SCI) because of thoracolumbar intervertebral disc extrusion (TL‐IVDE). Proteins released from neural and glial cells can be detected in the blood and show promise as prognostic tools, but their concentration is influenced by time after injury. Hypothesis/Objectives Serum concentrations of glial fibrillary acidic protein (GFAP), phosphorylated neurofilament heavy chain (pNFH), and S100β will follow different time courses; measurement of combinations of these proteins will predict outcome. Animals Thirty‐one dogs with TL‐IVDE causing paralysis with no pain perception. Methods Prospective study. Serum samples were taken at presentation and intervals over 56 days and banked at −80°C. Glial fibrillary acidic protein, pNFH, and S100β concentrations were measured using ELISA tests and plotted against time from onset of nonambulatory status. Outcome was established at 6 months. The association between biomarker concentration and outcome was examined using logistic regression, receiver operator characteristics curve analysis, and model development. Results Thirty‐one dogs participated, 3/31 (10%) developed progressive myelomalacia and 19/31 (62%) recovered ambulation. Glial fibrillary acidic protein and S100β concentrations rose for the first 1 to 3 days, and were undetectable by 14 and 28 days, respectively. Phosphorylated neurofilament heavy chain concentrations peaked at 14 days and were detectable at 56 days. Glial fibrillary acidic protein concentrations in the first 72 hours after onset of nonambulatory status predicted recovery with an accuracy of 76.7%‐89% depending on sample timing. Conclusions and Clinical Importance Serum GFAP concentrations can be used to predict outcome in clinically complete SCI. A rapid inexpensive bedside test is needed.

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“…It constitutes a major public health concern, as it leads to a significant amount of morbidity and mortality worldwide. Although there are differences in criteria used to categorize traumatic brain injuries (1), these injuries are usually stratified using the Glasgow Coma Scale (GCS), which differentiates between severe (score of 3-8), moderate (score of 9-12), and mild brain (mTBI) injuries (score of [13][14][15]. About 70-90% of all treated brain injuries are mTBIs, with an incidence estimated at 100-300 per 100,000 people (2,3).…”

Section: Introductionmentioning

confidence: 99%

“…Although clinical parameters, including headache, nausea, vomiting, amnesia, and seizures, may be correlated with positive CT scans, the number of negative CTs is not significantly reduced when they are present (12)(13)(14). S100 calcium-binding protein B (S100B) is the most commonly studied blood biomarker for its ability to predict abnormal findings in the CT scans of mTBIs in children and adults (15,16). Since 2013, S100B has been implemented in Scandinavian countries for management of mTBI (17).…”

Section: Introductionmentioning

confidence: 99%

S100B Blood Level Determination for Early Management of Ski-Related Mild Traumatic Brain Injury: A Pilot Study

et al. 2020

Self Cite

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Background: Mild traumatic brain injury (mTBI) management in emergency departments is a complex process involving clinical evaluation, laboratory testing, and computerized tomography (CT) scanning. Protein S100B has proven to be a useful blood biomarker for early evaluation of mTBI, as it reduces the required CT scans by one-third. However, to date, the ability of S100B to identify positive abnormal findings in the CT scans of patients suffering from mTBI caused by ski practice has not been investigated. Thus, the primary aim of this study was to investigate the diagnostic performance of S100B as an mTBI management biomarker in patients with ski-related mTBI. Materials and Methods: One hundred and thirty adult mTBI patients presenting to the emergency department of Hôpital du Valais in Sion, Switzerland, with a Glasgow Coma Scale (GCS) score of 13-15 and clinical indication for a CT scan were included in the study. Blood samples for S100B measurement were collected from each patient and frozen in 3-hour post-injury intervals. CT scans were performed for all patients. Later, serum S100B levels were compared to CT scan findings in order to evaluate the biomarker's performance. Results: Of the 130 included cases of mTBI, 87 (70%) were related to ski practice. At the internationally established threshold of 0.1 µg/L, the receiver operating characteristic curve of S100B serum levels for prediction of abnormal CT scans showed 97% sensitivity, 11% specificity, and a 92% negative predictive value. Median S100B concentrations did not differ according to sex, age, or GCS score. Additionally, there was no significant difference between skiers and non-skiers. However, a statistically significant difference was found when comparing the median S100B concentrations of patients who suffered fractures or had polytrauma and those who did not suffer fractures. Kahouadji et al. S100B and Ski-Related mTBI Patient Management Conclusion: The performance of S100B in post-mTBI brain lesion screenings seems to be affected by peripheral lesions and/or ski practice. The lack of neurospecificity of the biomarker in this context does not allow unnecessary CT scans to be reduced by one-third as expected.

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The Biomarker S100B and Mild Traumatic Brain Injury: A Meta-analysis

Abstract: S100B serum analysis as a part of the clinical routine could significantly reduce the number of CT scans performed on children with mTBI. Sampling should take place within 3 hours of trauma. Cutoff levels should be based on pediatric reference ranges.

Cited by 75 publications

References 58 publications

Altered Cerebral Blood Flow and Potential Neuroprotective Effect of Human Relaxin-2 (Serelaxin) During Hypoxia or Severe Hypovolemia in a Sheep Model

Altered Cerebral Blood Flow and Potential Neuroprotective Effect of Human Relaxin-2 (Serelaxin) During Hypoxia or Severe Hypovolemia in a Sheep Model

Time course and prognostic value of serum GFAP, pNFH, and S100β concentrations in dogs with complete spinal cord injury because of intervertebral disc extrusion

S100B Blood Level Determination for Early Management of Ski-Related Mild Traumatic Brain Injury: A Pilot Study

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