Could sP-Selectin and sICAM-1 be potential biomarkers in status epilepticus?

Abstract

Objective: To investigate whether soluble P-selectin (sP-selectin) and soluble intercellular adhesion molecule-1 (sICAM-1) might be potential biomarkers that predict the course and prognosis of status epilepticus (SE). Patients and Methods: Fourty-two adult patients with SE between February 2012 and December 2013 were included in the study. Clinical and demographic features of the patients were recorded and surviving patients were followed for 13.6 ± 4.6 months. Serum sICAM-1 and sP-selectin levels were measured during SE or within 24 hours of SE, and compared with 28 subjects in the control group. Results: Levels of serum sP-selectin and sICAM-1 were higher in the SE group compared with the control group (P: 0.04 and P: 0.02, respectively). It was shown that higher levels of serum sICAM-1 correlated with poor outcomes (P: 0.017) and “ROC curve” analysis showed that levels higher than 457 ng/mL predicted poor outcomes with 71% sensitivity and 68% specificity. Levels of serum sP-selectin did not correlate with outcomes. Subgroup analyses revealed levels of serum sICAM-1 were significantly higher in the epilepsia partialis continua (EPC) group compared with the control group (P: 0.012) and levels of serum sP-selectin were not different between subgroups and controls. Levels of serum sP-selectin and sICAM-1 didn’t differ between subgroups of SE and different etiologies. Conclusion: Higher levels of serum sICAM-1 may predict poor outcome in SE, as a result sICAM-1 may be used as a biomarker of the prognosis of SE in clinical practice. The production of sICAM-1 may increase particularly in EPC. However, no correlation was found between etiology of SE and serum level of sICAM-1, even in patients with EPC. Serum level of sP-Selectin is not an appropriate biomarker for the prognosis of SE. Serum levels of sICAM-1 and sP-selectin are not appropriate biomarkers of refractory SE.