Abstract
S100B protein is released by astrocytes into the brain extracellular fluid following acute brain injury and elevated levels in CSF and serum have been shown to correlate with patient outcome following traumatic brain injury. A prospective study of brain extracellular fluid (ECF) and serum S100B levels in 12 patients with severe head injury (GCS ≤ 8) was undertaken using intracerebral microdialysis to investigate whether a correlation with ECF S100B and outcome could be confirmed. Patient outcomes were assessed at 6 months using the Glasgow Outcome Scale (GOS) and divided into two outcome groups: group A, 8 survivors with either a good recovery or moderate disability (GOS scores of 4 or 5); and group B, 4 patients who died (GOS 1). Peak serum levels of S100B were significantly greater in group B (mean 6.03 ng/ml) compared with group A (mean 0.73 ng/ml) (P = 0.009). Group A had a mean peak S100B in the extracellular compartment of 186 ng/ml compared to 150 ng/ml in group B. There was no significant difference between the mean peak brain ECF S100B concentrations for the 2 outcome groups (P = 0.932). We confirm that intracerebral microdialysis can be used to sample S100B concentrations from brain extracellular fluid and our results suggest that the ECF S100B levels were variable and that there was no significant difference between the good outcome and poor outcome groups. In contrast, the serum levels of S100B of patients with a poor outcome were significantly higher than those with a good outcome.
Highlights
Traumatic brain injury (TBI) is the leading cause of death and disability among young adults worldwide [1,2]
S100B protein is released by astrocytes into the brain extracellular fluid following acute brain injury and elevated levels in Cerebrospinal fluid (CSF) and serum have been shown to correlate with patient outcome following traumatic brain injury
We confirm that intracerebral microdialysis can be used to sample S100B concentrations from brain extracellular fluid and our results suggest that the ECF S100B levels were variable and that there was no significant difference between the good outcome and poor outcome groups
Summary
Traumatic brain injury (TBI) is the leading cause of death and disability among young adults worldwide [1,2]. Accurate prediction of patient outcome following severe TBI using a peripheral biomarker may add to current prognostication. Such a marker could be used to assess standard treatment regimens and be used as a potential surrogate marker in head injury trials to establish the efficacy of novel neuroprotective drugs. Cerebrospinal fluid (CSF) and serum levels of S100B have been extensively investigated as markers of the severity of brain injury after trauma and stroke. Serum S100B levels correlate with patient outcome after severe TBI [5,6,7] leading to the supposition that the increased level primarily reflects the extent of cellular damage in the brain. We have used intracerebral microdialysis to sample the brain extracellular fluid (ECF), enabling us to OPEN ACCESS
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