Serial measurement of S100B and NSE in pediatric traumatic brain injury

Abstract

Increased serum biomakers, such as S100 calcium-binding protein B (S100B) and neuron-specific enolase (NSE), are associated with traumatic brain injury (TBI). The purpose of this study is to investigate the serum levels of S100B and NSE in pediatric TBI patients and to predict a clinical outcome. Peripheral venous blood was collected within 6h of injury and at 1week to measure S100B and NSE. The serum S100B and NSE levels were measured using commercially available enzyme-linked immunosorbent assay kits. The authors divided participants into two groups at admission: a favorable group (patients with Glasgow Coma Scale [GCS] scores of 10-15) and an unfavorable group (patients with GCS scores of less than 9). Both S100B and NSE levels were compared between the two groups at the time of admission and 1week later. Ten pediatric patients were enrolled (5 in the favorable group, 5 in the unfavorable group). The median serum S100B level of 134.21pg/ml (range, 51.00-789.65pg/ml) in patients with TBI at admission dropped to 41.49pg/ml (range, 25.65-260.93pg/ml) after 1week, with significant differences between the traumatic event and 1week later (p = 0.007). The median serum NSE level of 14.76ng/ml (range, 6.48-21.23ng/ml) in patients with TBI at admission was higher than that after 1week (4.96ng/ml, range, 3.01-31.21ng/ml), with significant differences (p = 0.015). A significant difference was observed in S100B after 1week between patients in the favorable and unfavorable groups (p = 0.047). One patient whose serum S100B and NSE levels were elevated 1week after TBI eventually died. Elevated serum S100B and NSE levels in pediatric TBI patients decreased 1week after traumatic events. The serum S100B level 1week after TBI was related to the severity of brain damage. These results indicated that serum S100B and NSE might play a role in predicting the prognosis and monitoring ongoing brain injury in pediatric TBI patients.