Article

Evaluation of S-100b as a specific marker for neuronal damage due to minor head trauma.

Chirurgische Klinik und Poliklinik/Standort Innenstadt, Ludwig-Maximilians-Universität München, Germany.
World Journal of Surgery (Impact Factor: 2.35). 01/2001; 25(1):93-7. DOI: 10.1007/s002680020370
Source: PubMed

ABSTRACT Management of patients with minor head trauma (MHT) continues to be debated in the literature. Measurement of S-100b in serum has been introduced into the discussion as an additional screening tool for intracerebral injuries because routine cranial computed tomography (CCT) of a large number of patients causes logistic difficulties, and the neurologic examination is often impaired by a high frequency of coincidental intoxication. The aim of our study was to determine the diagnostic value of measuring S-100b in the serum of MHT patients to identify risk groups. Additional validity should be aquired by a comparison with plasma levels of polymorphonuclear neutrophil (PMN) elastase an established general trauma marker. A series of 52 patients with MHT were included in the prospective study. At admission the patients underwent a routine CCT scan to detect intracerebral lesions, and blood samples were drawn to investigate circulating levels of S-100b and PMN elastase. For comparison, data for a positive control group of 10 severe head trauma patients (initial Glasgow Coma Scale score < 8) and for a negative control group with 20 healthy volunteers were obtained. The interval between MHT and admission to our hospital was 73.4 +/- 47.0 minutes. The initial S-100b serum levels of MHT patients were 0.470 +/- 0.099 ng/ml, those of the positive control group were 7.16 +/- 3.77 ng/ml, and those of the negative control group were 0.05 +/- 0.01 ng/ml. Relevant pathologic CCT scans were detected in 28.8% of MHT patients; one patient of that group was subjected to immediate surgical intervention (1.9%). At a cut-off point of 0.1 ng/ml, the sensitivity of positive S-100b levels reached 100% and the specificity 40.5%. Plasma levels of PMN elastase reached 60.52 +/- 10.75 ng/ml in the MHT group, 66.4 +/- 14.92 ng/ml in the severely head-injured group, and 23.26 +/- 1.53 ng/ml in the negative control group. Serum levels of S-100b seem to be a highly sensitive but not very specific marker for isolated neurotrauma. Measurement of this parameter may be helpful as an additional screening tool to identify high risk groups in the cohort of MHT patients.

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    • "In addition, serum S-100B also has demonstrated value as a marker for brain injury [1,8–10]. Elevated concentrations have been reported in patients after both minor and traumatic head injuries [11] [12] [13] [14], subarachnoid hemorrhage [15] [16], and stroke [17] [18], and in cardiac patients with neurological complications [19] [20]. "
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    ABSTRACT: Serum S-100B has clinical value in monitoring malignant melanoma and in monitoring and predicting outcomes in patients with traumatic brain injury. Analytical performance characteristic and split-sample method comparison studies for three commercial S-100B immunoassays (CanAg® S100, Sangtec® 100, YK150 Human S-100 β) were performed. Reference intervals (97.5th percentile) for each assay were established by non-parametric analysis of results from healthy volunteers. Linearity results were slope=1.014, intercept=65.1, r(2)=0.999 for the Sangtec assay; slope=1.038, intercept=31.1, r(2)=0.999 for the CanAg assay; slope=1.123, intercept=-105.4, r(2)=0.997 for the YK150 assay. Within-run CVs were ≤5.7, ≤6.3 and ≤10.8 for the Sangtec, CanAg and YK150 ELISAs, respectively. Between-run CVs were ≤11.3, ≤5.9 and ≤9.5, respectively. Upper reference interval limits of 141, 96 and 735 ng/l S-100B were established for the Sangtec, CanAg and YK150 ELISAs, respectively. Deming regression generated the following: CanAg vs. Sangtec, slope=0.339, intercept=24.1, r(2)=0.932; YK150 vs. Sangtec, slope=0.266, intercept=-140.0, r(2)=0.690; YK150 vs. CanAg, slope=1.376, intercept=-13.1, r(2)=0.860. The configurations, procedures and performance characteristics of the Sangtec and CanAg S-100B ELISAs are comparable and better than those of the YK150 assay. Poor agreement and large biases prevent interchangeable use of results.
    Clinica chimica acta; international journal of clinical chemistry 07/2011; 412(23-24):2122-7. DOI:10.1016/j.cca.2011.07.020 · 2.76 Impact Factor
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    • "One of the best-studied serum markers, S-100B, is a brain astrocyte protein that has been found to be a sensitive, but not specific predictor of outcome. The sensitivity of S-100B for detecting abnormal CT scan has been reported to be 90–100%, with a specificity of 40–60% [9] [10] [11]. The sensitivity and specificity of S-100B for predicting long-term outcome is not clear. "
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    ABSTRACT: To validate a correction factor for the extracranial release of the astroglial protein, S-100B, based on concomitant creatine kinase (CK) levels. The CK- S-100B relationship in non-head injured marathon runners was used to derive a correction factor for the extracranial release of S-100B. This factor was then applied to a separate cohort of 96 mild traumatic brain injury (TBI) patients in whom both CK and S-100B levels were measured. Corrected S-100B was compared to uncorrected S-100B for the prediction of initial head CT, three-month headache and three-month post concussive syndrome (PCS). Corrected S-100B resulted in a statistically significant improvement in the prediction of 3-month headache (area under curve [AUC] 0.46 vs 0.52, p=0.02), but not PCS or initial head CT. Using a cutoff that maximizes sensitivity (> or = 90%), corrected S-100B improved the prediction of initial head CT scan (negative predictive value from 75% [95% CI, 2.6%, 67.0%] to 96% [95% CI: 83.5%, 99.8%]). Although S-100B is overall poorly predictive of outcome, a correction factor using CK is a valid means of accounting for extracranial release. By increasing the proportion of mild TBI patients correctly categorized as low risk for abnormal head CT, CK-corrected S100-B can further reduce the number of unnecessary brain CT scans performed after this injury.
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