Determination Of S100B Research Articles

High S100B Levels Predict Antidepressant Response in Patients With Major Depression Even When Considering Inflammatory and Metabolic Markers.

BackgroundThe relationship between antidepressant response and glial, inflammatory, and metabolic markers is poorly understood in depression. This study assessed the ability of biological markers to predict antidepressant response in major depressive disorder (MDD).MethodsWe included 31 MDD outpatients treated with escitalopram or sertraline for 8 consecutive weeks. The Montgomery-Åsberg Depression Rating Scale (MADRS) was administered at baseline and at week 4 and 8 of treatment. Concomitantly, blood samples were collected for the determination of serum S100B, C-reactive protein (CRP), and high-density lipoprotein cholesterol (HDL)-C levels. Treatment response was defined as ≥50% improvement in the MADRS score from baseline to either week 4 or 8. Variables associated with treatment response were included in a linear regression model as predictors of treatment response.ResultsTwenty-seven patients (87%) completed 8 weeks of treatment; 74% and 63% were responders at week 4 and 8, respectively. High S100B and low HDL-C levels at baseline were associated with better treatment response at both time points. Low CRP levels were correlated with better response at week 4. Multivariate analysis showed that high baseline S100B levels and low baseline HDL-C levels were good predictors of treatment response at week 4 (R2 = 0.457, P = .001), while S100B was at week 8 (R2 = 0.239, P = .011). Importantly, baseline S100B and HDL-C levels were not associated with depression severity and did not change over time with clinical improvement.ConclusionsSerum S100B levels appear to be a useful biomarker of antidepressant response in MDD even when considering inflammatory and metabolic markers.

A simple electrochemical immunosensor based on a chitosan/reduced graphene oxide nanocomposite for sensitive detection of biomarkers of malignant melanoma.

The sensitive and specific detection of tumor biomarkers is crucial for early diagnosis and treatment of malignant melanoma. Immunoassay with a simple sensing interface and high sensitivity is highly desirable. In this work, a simple electrochemical immunosensor based on a chitosan/reduced graphene oxide (CS–rGO) nanocomposite was developed for sensitive determination of an S-100B protein, a tumor marker of malignant melanoma. CS–rGO nanocomposite were prepared by chemical reduction of graphene oxide in the presence of chitosan and modified on glassy carbon electrode (GCE) to provide a biofriendly, conductive, and easily chemically modified matrix for further immobilization of antibodies. Anti-S-100B antibodies were grafted onto the chitosan molecules to fabricate the immunorecognition interface by a simple glutaraldehyde cross-linking method. Electrochemical determination of S-100B was achieved by measuring the decreased current signal of solution phase electrochemical probes, which originated from the increased steric hindrance and insulation caused by the formation of antigen–antibody complexes at the electrode interface. Due to the good conductivity, high surface area, excellent biocompatibility, and good film-forming ability of CS–rGO, the constructed immunosensor exhibited good stability, high selectivity and sensitivity, a wide dynamic range from 10 fg mL−1 to 1 ng mL−1 and a low limit of detection of 1.9 pg mL−1 (S/N = 3). Moreover, the sensor was also applicable for the sensitive detection of S-100B protein in real human serum samples.

Effects of S100B neutralization on the long-term cognitive impairment and neuroinflammatory response in an animal model of sepsis

The nervous system is one of the first systems to be affected during sepsis. Sepsis not only has a high risk of mortality, but could also lead to cerebral dysfunction and cognitive impairment in long-term survival patients. The receptor for advanced glycation end products (RAGE) can interact with several ligands, and its activation triggers a series of cell signaling events, resulting in the hyperinflammatory condition related to sepsis. Recent studies show that elevated levels of S100B (RAGE ligand) are associated with the pathophysiology of neurodegenerative disorders. They also participate in inflammatory brain diseases and may lead to an increased activation of microglia and astrocytes, leading to neuronal death. This study aimed to determine the effect of S100B inhibition on the neuroinflammatory response in sepsis. Sepsis was induced in Wistar rats by cecal ligation and perforation (CLP). There were three groups: Sham, CLP, and CLP +10 μg/kg of monoclonal antibody (Anti-S100B) administered intracerebroventricularly. The animals were killed 30 days after sepsis following behavioral evaluation by open field, novel object recognition, and splash test. The hippocampus, prefrontal cortex, and amydgala were used for the determination of S100B and RAGE proteins by western blotting and for the evaluation of cytokine levels and verification of the number of microglial cells by immunohistochemistry. On day 30, both the Sham and CLP + anti-S100B groups were capable of recovering the habitual memory in the open field task. Regarding novel object recognition, Sham and CLP + anti-S100B groups increased the recognition index during the test session in comparison to the training session. There was a significant increase in the time of grooming in CLP + anti-S100B in comparison to the CLP group. There was a modulation of cytokine levels and immunohistochemistry showed that the CLP + anti-S100B group had a decrease in the number of microglial cells only in the hippocampus. These results helped to understand the role of S100B protein in the pathophysiology of sepsis-associated encephalopathy and could be helpful to further experimental studies regarding this subject.

Double venipuncture is not required for adequate S-100B determination in melanoma patients.

S-100B is used in melanoma follow-up. This serum biomarker is also present in adipocytes; therefore, subcutaneous adipocytes trapped in the needle before performing a venipuncture could contaminate the serum. The aim was to study the influence of adipocyte contamination on blood samples used for S-100B analysis, possibly resulting in falsely elevated S-100B values. A total of 294 serum samples were collected from 147 American Joint Committee on Cancer staging stage III melanoma patients. The mean difference between the first (dummy) and second tubes was 0.003μg/l (p=0.077), with a decrease in the second tube. Compared with the second tube, the S-100B level was higher in the first tube in 33.3% of the samples, equal in 36.8% of the samples and lower in 29.9% of the samples. No significant difference between the two consecutively drawn tubes was found. There seems to be no necessity of implementing a dummy tube system for accurate S-100B determination in melanoma patients.

Could intraoperative magnesium sulphate protect against postoperative cognitive dysfunction?

Although there is much concern about the pathogenesis of postoperative cognitive dysfunction (POCD); no effective prevention strategies are currently described. The aim of this work was to study whether intraoperative magnesium sulphate could have a protective effect against developing POCD and to study its impact on serum level of S100B, a marker of neuronal degeneration. This is a prospective randomized controlled trial carried out on 80 participants undergoing elective laparoscopic cholecystectomy, 40 participants received conventional general anesthesia (conventional anesthesia group) and 40 participants received conventional general anesthesia with extra administration of intraoperative magnesium sulphate (Mg sulphate group). Cognitive assessment for both groups was done preoperatively and 1 week postoperatively using Paired Associate Learning test (PALT) and Benton Visual Retention Test (BVRT). Quantitative determination of serum S100B was done for both groups preoperatively and one week postoperatively by using an enzyme- linked immunoabsorbent assay technique. Postoperative PALT and BVRT were significantly lower than preoperative PALT and BVRT in the conventional anesthesia group (P value =0.043, P value =0.015 respectively), but not in the Mg sulphate group (P value =0.134, P value =0.151 respectively). Postoperative S100B was significantly higher than preoperative S100B in the conventional anesthesia group (P value =0.006), but not in the Mg sulphate group (P value =0.293). Administration of intravenous infusion of magnesium sulphate during conventional general anesthesia can protect against POCD and attenuate the post operative elevation of serum S100B.

Monthly changes in serum levels of S100B protein as a predictor of metastasis development in high-risk melanoma patients.

The role of S100B protein in detecting early melanoma relapses is controversial, since most metastasis occur within normal values of S100B. The aim of this study was to assess the performance of S100B in detecting early disease progression in high-risk melanoma patients. Retrospective cohort study including patients with an initial diagnosis of stage IIB, IIC and III melanoma between January 2003 and July 2013. All patients were followed up in accordance with an intensive protocol based on imaging studies and serum S100B levels every 3-6months. We compared two methods to evaluate changes in S100B. The classic method referring to a single determination of S100B above the cut-off level at the time of metastasis, which was evaluated in all patients. And a new method based on monthly changes of S100, which was used in the setting of patients with S100B levels within the normal range. Overall, 289 of patients were followed up for 44months (IQR 17-73) and 45% developed metastases. During the study period, 129 patients relapsed of which 46 (35.7%) present elevated values of S100B at the time of relapse. The classic method had a sensitivity and specificity of S100B protein of 35.7% and 92.5%, respectively. Furthermore, for the patients that relapsed with normal values of S100B, the new method was applied and showed a sensitivity and specificity of 41.1% and 92.4%, respectively, allowing to detect additional relapses that were missing by the classic method. During follow-up of high-risk melanoma patients, rising serumS100B values within the normal range can be an important clue to disease progression.

High serum S-100B protein levels within the first 36 hours of acute ischemic stroke predicts high NIHSS scores

Aim: The aim of the present study was to evaluate serum levels of S-100B which is an acidic calcium-binding protein within the first 36 hours following an acute ischemic stroke and to determine the correlation between S-100B levels and National Institutes of Health Stroke Scale (NIHSS) scores. Material and Methods: Fifty patients with ischemic stroke (25 male, 25 female; mean age=64) and 30 healthy volunteers (14 male, 16 female; mean age=61) serving as age and sex matched controls were included in this study. Venous blood samples were taken within the first 36 hours following the acute stroke. The quantitative determination of S-100B in serum was carried out using an enzyme linked immunosorbent assay.Results: Patients with acute ischemic stroke had significantly higher serum S-100B protein concentrations (42 pg/ml) than those of normal controls (31.5 pg/ml) (p0.001). S-100B concentrations were correlated with NIHSS scores (r=0.443; p=0.001), which is considered an indicator of the degree of neurological deficit.Conclusion: The present study demonstrates that S-100B concentrations in both the large artery atherosclerosis (LAA), cardio embolic infarct (CEI) subtypes of acute stroke are increased in the early phases of stroke and are correlated with NIHSS scores upon admission. S-100B appears to be a valuable biomarker of ongoing brain injury.

Postoperative cognitive dysfunction and the possible underlying neurodegenerative effect of anaesthesia

Introduction: There is alarming evidence about the involvement of general anaesthesia in the development of postoperative cognitive dysfunction.Aim: To clarify the impact of general anaesthesia on cognitive function and to study the possible effect of general anaesthesia on serum S100B, the marker of neuronal degeneration.Methods: This is a prospective randomised controlled study carried out on 50 patients undergoing elective laparoscopic cholecystectomy under conventional general anaesthesia. Cognitive assessment for selected patients was done preoperative and 1 week postoperative using Paired Associate Learning test (PALT) for assessment of verbal memory and Benton Visual Retention test (BVRT) for assessment of visual memory. Quantitative determination of serum S100B was done for all patients in the basal sample and postoperative sample by applying an enzyme- linked immunoabsorbent assay technique on am automated ELISA platform.Results: Regarding cognitive tests, there was a statistically significant difference between the mean value of preoperative PALT and postoperative PALT (p-value = .012). There was also a statistically significant difference between the mean value of preoperative BVRT and postoperative BVRT (p-value = .011). Regarding S100B, there was a statistically significant difference between preoperative and postoperative serum level (p-value = .002). There was also a statistically significant negative correlation between postoperative S100B serum level and the postoperative scores of both PALT and BVRT.Conclusion: General anaesthesia is incriminated in the development of postoperative verbal and visual memory impairment and in the postoperative increase in serum S100B, the markers of neuronal degeneration.

Measurement of S100B protein: evaluation of a new prototype on a bioMérieux Vidas® 3 analyzer

Background The addition of S100B protein to guidelines for the management of mild traumatic brain injury (mTBI) decreases the amount of unnecessary computed tomography (CT) scans with a significant decrease in radiation exposure and an increase in cost savings. Both DiaSorin and Roche Diagnostics have developed automated assays for S100B determination. Recently, bioMérieux developed a prototype immunoassay for serum S100B determination. For the first time, we present the evaluation of the S100B measurement using a bioMérieux Vidas® 3 analyzer. Methods We evaluated the matrix effects of serum and plasma, and their stability after storage at 2-8 °C, -20 °C and -80 °C. The new measurement prototype (bioMérieux) was compared with an established one (Roche Diagnostics), and a precision study was also conducted. Lastly, clinical diagnostics performance of the bioMérieux and Roche Diagnostics methods were compared for 80 patients referred to the Emergency Department for mTBI. Results Stability after storage at 2-8 °C, -20 °C, and -80 °C and validation of the serum matrix were demonstrated. The bioMérieux analyzer was compared to the Roche Diagnostics system, and the analytical precision was found to be efficient. Clinical diagnosis performance evaluation confirmed the predictive negative value of S100B in the management of mTBI. Conclusions The study's data are useful for interpreting serum S100B results on a bioMérieux Vidas® 3 analyzer.

The Comparative Evaluation of S100B Protein, Glasgow Coma Scale and Neuro-Depiction over Head Injuries in Childhood

Aim: The evaluation of the S100B alterations as a prognostic biomarker of Head Injuries (HI) in childhood. Materials and methods: In this study 74 children (45 boys and 29 girls), 3-14 years old (Average: 7.86 years old) from 1/2017 until 9/2017 involved. 64/74 patients with clear HI and 10/74 witnesses, while no one needed mechanical breathing support or hospitalization in the Emergency Department (ED). Based on the severity of the clinical manifestations they were classified into 4 groups. The determination of the S100B with ECLIA method was carried out in 3, 12, 24 and 48 hours after the HI with cut-off rate the 0.191 μg/L. 64/74 patients were submitted to neuroimaging via head and brain CTs, 6-8 hours after the injury. Results: Though the statistical processing of the results it was ascertained 100% sensitivity, 96.16% specialization, 85.71 positive prognostic value and 100% negative prognostic value of S100B. Conclusions: The early determination of S100B during the initial evaluation of a child with HI can constitute a diagnostic test for the possibility of a coexisting intracranial complication; S100B if applied on a regular basis, can constitute as a detection testing in children who are submitted to the ED due to HI; Calculation of S100B before discharged from the hospital, could be served as an indicator of the improving clinical condition.

Serum levels of S100B from jugular bulb as a biomarker of poor prognosis in patients with severe acute brain injury

Aims/backgroundTo evaluate the correlation between protein S100B concentrations measured in the jugular bulb as well as at peripheral level and the prognostic usefulness of this marker. MethodsA prospective study of all patients admitted to the intensive care unit with acute brain damage was carried out. Peripheral and jugular bulb blood samples were collected upon admission and every 24h for three days. The endpoints were brain death diagnosis and the Glasgow Outcome Scale score after 6months. ResultsA total of 83 patients were included. Jugular protein S100B levels were greater than systemic levels upon admission and also after 24 and 72h (mean difference>0). Jugular protein S100B levels showed acceptable precision in predicting brain death both upon admission [AUC 0.67 (95% CI 0.53–0.80)] and after 48h [AUC 0.73 (95% CI 0.57–0.89)]. Similar results were obtained regarding the capacity of jugular protein S100B levels upon admission to predict an unfavourable outcome (AUC 0.69 (95% CI 0.56–0.79)). The gradient upon admission (jugular-peripheral levels) showed its capacity to predict the development of brain death [AUC 0.74 (95% CI 0.62–0.86)] and together with the Glasgow Coma Scale constituted the independent factors associated with the development of brain death. ConclusionRegional protein S100B determinations are higher than systemic determinations, thus confirming the cerebral origin of protein S100B. The transcranial protein S100B gradient is correlated to the development of brain death.

Clinical Significance of Serum Biomarker S100B to Predict Outcome After Traumatic Brain Injury in Adults

Background: Traumatic brain injury (TBI) is a common cause of death and disability, worldwide. Early recognition of patients with brain cellular damage allows for early rehabilitation and patient outcome improvement. Serum protein S-100B determinations have been widely suggested the most promising biomarker for TBI. It has been proposed that this marker is useful in a Neurointensive Care Unit (NICU) as a monitoring parameter. The main objective of this study is to assess the value of including acute S100B levels in standard clinical data as an early screening tool for brain death after severe TBI. Material and methods: In this prospective study, the clinical conditions of patients with mild to moderate TBI were assessed and patient serum S100B levels measured within 24h of injury were eligible for inclusion in the study using by electro chemiluminescence (ECL). Patients were admitted to The Govt. Trauma Centre, P.B.M. Hospital, Bikaner in NICU and followed up one month later and evaluated for level of consciousness, presence or absence of post-traumatic headache, and daily activity performance (using the Barthel scale). Student’s t-test and the chi-square test were used for the data analysis, which was performed using SPSS software. Result and discussion: The mean serum S100B value was significantly lower for patients with minor TBI than for patients with moderate TBI (20.4 ± 12.6 ng/dl and 124.0 ± 235.0 ng/dl, respectively). Patients with normal CT scans also had statistically significantly lower serum S100B levels than patients with abnormal CT findings. The mean S100B value was statistically significantly higher for patients with suspected diffused axonal injury (596.18 ± 502.1 ng/dl) than for patients with other abnormal CT findings (p=0.000): 20.97 ± 19.9 ng/dl in patients with normal CT results; 39.56 ± 21.7 ng/dl in patients with skull bone fracture; 50.38 ± 22.9 ng/dl in patients with intracranial haemorrhage; and 70.23 ± 31.3 ng/dl in patients with fracture plus intracranial haemorrhage. Conclusion: Serum S100B levels increase in patients with minor to moderate TBIs, especially in those with diffused axonal injury. However, serum S100B values cannot accurately predict one-month neuropsychological outcomes and performance. KEYWORDS: Skull bone fracture, Axonal injury, Haemorrhage, Neuropsychological, SPSS Software, Post-traumatic Headache, Abnormal CT

S100B protein may detect brain death development after severe traumatic brain injury.

Despite improvements in the process of organ donation and transplants, the number of organ donors is progressively declining in developed countries. Therefore, the early detection of patients at risk for brain death (BD) is a priority for transplant teams seeking more efficient identification of potential donors. In the extensive literature on S100B as a biomarker for traumatic brain injury (TBI), no evidence appears to exist on its prognostic capacity as a predictor of BD after severe TBI. The objective of this study is to assess the value of including acute S100B levels in standard clinical data as an early screening tool for BD after severe TBI. This prospective study included patients with severe TBI (Glasgow Coma Scale score [GCS] ≤ 8) admitted to our Neurocritical Care Unit over a 30 month period. We collected the following clinical variables: age, gender, GCS score, pupillary alterations at admission, hypotension and pre-hospital desaturation, CT scan results, isolated TBI or other related injuries, Injury Severity Score (ISS), serum S100B levels at admission and 24 h post-admission, and a final diagnosis regarding BD. Of the 140 patients studied, 11.4% developed BD and showed significantly higher S100B concentrations (p<0.001). Multivariate analysis showed that bilateral unresponsive mydriasis at admission and serum S100B at 24 h post-admission had odds ratios (ORs) of 21.35 (p=0.005) and 4.9 (p=0.010), respectively. The same analysis on patients with photomotor reflex in one pupil at admission left only the 24 h S100B sample in the model (OR=15.5; p=0.009). Receiver operating characteristics (ROC) curve analysis on this group showed the highest area under the curve (AUC) (0.86; p=0.001) for 24 h S100B determinations. The cut off was set at 0.372 μg/L (85.7% sensitivity, 79.3% specificity, positive predictive value [PPV]=18.7% and negative predictive value [NPV]=98.9%). This study shows that pupillary responsiveness at admission, as well as 24 h serum S100B levels, could serve as screening tools for the early detection of patients at risk for BD after severe TBI.

Serum S100B Determination in the Management of Pediatric Mild Traumatic Brain Injury

The place of serum S100B measurement in mild traumatic brain injury (mTBI) management is still controversial. Our prospective study aimed to evaluate its utility in the largest child cohort described to date. Children younger than 16 years presenting at a pediatric emergency department within 3 h after TBI were enrolled prospectively for blood sampling to determine serum S100B concentrations. The following information was collected: TBI severity determined by using the Masters classification [1: minimal or Glasgow Coma Scale (GCS) 15, 2: mild or GCS 13-15, and 3: severe or GCS <13]; whether hospitalized or not; good or bad clinical evolution (CE); whether cranial computed tomography (CCT) was prescribed; and related presence (CCT+) or absence (CCT-) of lesions. For the 446 children enrolled, the median concentrations of S100B were 0.21, 0.31, and 0.44 μg/L in Masters groups 1, 2, and 3, respectively, with a statistically significant difference between these groups (P < 0.05). In Masters group 2, 65 CCT scans were carried out. Measurement of S100B identified patients as CCT+ with 100% (95% CI 85-100) sensitivity and 33% (95% CI 20-50) specificity. Of the 424 children scored Masters 1 or 2, 21 presented "bad CE." S100B identified bad CE patients with 100% (95% CI 84-100) sensitivity and 36% (95% CI 31-41) specificity. Of the 242 children hospitalized, 81 presented an S100B concentration within the reference interval. Serum S100B determination during the first 3 h of management of children with mTBI has the potential to reduce the number of CCT scans, thereby avoiding unnecessary irradiation, and to save hospitalization costs.

Prognostic value of serial blood S100B determinations in stage IIB–III melanoma patients: A corollary study to EORTC trial 18952

S100B is a prognostic factor for melanoma as elevated levels correlate with disease progression and poor outcome. We determined its prognostic value based on updated information using serial determinations in stage IIb/III melanoma patients.211 Patients who participated in the EORTC 18952 trial, evaluating efficacy of adjuvant intermediate doses of interferon α2b (IFN) versus observation, entered a corollary study. Over a period of 36months, 918 serum samples were collected. The Cox time-dependent model was used to assess prognostic value of the latest (most recent) S100B determination.At first measurement, 178 patients had S100B values <0.2μg/l and 33⩾0.2μg/l. Within the first group, 61 patients had, later on, an increased value of S100B (⩾0.2μg/l). An initial increased value of S100B, or during follow-up, was associated with worse distant metastasis-free survival (DMFS); hazard ratio (HR) of S100B⩾0.2 versus S100B<0.2 was 5.57 (95% confidence interval (CI) 3.81–8.16), P<0.0001, after adjustment for stage, number of lymph nodes and sex. In stage IIb patients, the HR adjusted for sex was 2.14 (95% CI 0.71, 6.42), whereas in stage III, the HR adjusted for stage, number of lymph nodes and sex was 6.76 (95% CI 4.50–10.16). Similar results were observed regarding overall survival (OS).Serial determination of S100B in stage IIb–III melanoma is a strong independent prognostic marker, even stronger compared to stage and number of positive lymph nodes. The prognostic impact of S100B⩾0.2μg/l is more pronounced in stage III disease compared with stage IIb.

Neuroprotein s‐100B – a useful parameter in paediatric patients with mild traumatic brain injury?

To examine the correlation of S-100B to cranial computerized tomography (CCT) scan results in children after mild traumatic brain injury (MTBI). One hundred and nine paediatric patients (0-18 years) with MTBI were included in this prospective single-centre study. Serum was collected within 6 h of trauma for determination of serum S-100B. The upper reference of S-100B was set to 0.16 mug/L. A CCT scan was performed in all patients and the results were correlated to the S-100B values. Computerized tomography was abnormal in 36 patients showing intracerebral haemorrhages and/or skull fractures. Serum S-100B level was significantly higher in patients with a pathological condition as shown in CT scan results (p = 0.003). There were no false negative, but 42 false positive test results for S-100B. This resulted in a sensitivity of 1.00, specificity of 0.42, positive predictive value of 0.46 and negative predictive value of 1.00. An area under the receiver operating curve of 0.68 was calculated. S-100B is a valuable tool to rule out patients with pathological CCT findings in a collective of paediatric patients with MTBI. Elevations of S-100B do not necessarily lead to a pathological finding in the CT scan, but values below the cut-off safely rule out the evidence of intracranial lesions.

Isolated vertebral fractures give elevated serum protein S-100B levels

BackgroundSerum protein S-100B determinations have been widely proposed in the past as markers of traumatic brain injury and used as a predictor of injury severity and outcome. The purpose of this prospective observational case series was therefore to determine S-100B serum levels in patients with isolated injuries to the back.MethodsBetween 1 February and 1 May 2008, serum samples for S-100B analysis were obtained within 1 hour of injury from 285 trauma patients. All patients with a head injury, polytrauma, and intoxicated patients were excluded to select isolated injuries to the spine. 19 patients with isolated injury of the back were included. Serum samples for S-100B analysis and CT spine were obtained within 1 hours of injury.ResultsCT scans showed vertebral fractures in 12 of the 19 patients (63%). All patients with fractures had elevated S-100B levels. Amongst the remaining 7 patients without a fracture, only one patient with a severe spinal contusion had an S-100B concentration above the reference limit. The mean S-100B value of the group with fractures was more than 4 times higher than in the group without fractures (0.385 vs 0.087 μg/L, p = 0.0097).ConclusionOur data, although limited due to a very small sample size, suggest that S-100B serum levels might be useful for the diagnosis of acute vertebral body and spinal cord injury with a high negative predictive power. According to the literature, the highest levels of serum S-100B are found when large bones are fractured. If a large prospective study confirms our findings, determining the S-100B level may contribute to more selective use of CT and MRI in spinal trauma.

Prognostic value of S100B levels and LDH levels in melanoma patients

9002 Background: The blood level of S100B has been proposed as a melanoma prognostic marker, and LDH has been incorporated into the current AJCC staging system for patients with stage IV melanoma; however, limited data exist regarding their relative utility. We therefore investigated associations between these markers and survival in a large cohort of prospectively followed melanoma patients. Methods: Patients with all stages of disease underwent simultaneous blood draw for LDH and S100B determination. Clinicians were blinded to S100B but not LDH results. Clinical data was obtained from a comprehensive melanoma patient database; all patients underwent standardized evaluation and prospective follow-up. Stage of disease and overall survival (OS) were determined based on the date of blood draw. An S100B level of >0.2 mcg/L and an LDH level of >618 U/L were considered elevated. Results: Paired S100B and LDH levels were obtained from 574 patients (386 stages I-II, 132 stage III, 56 stage IV). S100B was elevated in 87 patients (15%) and LDH was elevated in 44 (8%); 60 patients (69%) with an elevated S100B had a normal LDH. There were strong correlations between stage and both S100B (p<0.0001) and LDH (p<0.0001): elevations of S100B and LDH were seen in 7% and 2% of stages I-II, 15% and 5% stage III, and 71% and 43% of stage IV patients, respectively. After a median follow-up of 14 months, 94 patients (16%) had progressed, and 59 (10%) had died. Both S100B and LDH levels were independent predictors of OS on multivariate analysis (Table). Furthermore, S100B remained an independent predictor of OS in the subset of patients with a normal LDH (p=0.009, HR=2.7, 95% CI 1.3–5.4). Conclusions: S100B provides prognostic information in melanoma patients that is both independent of and complementary to LDH. While additional follow-up will be necessary to determine the utility of S100B in early-stage melanoma, these data suggest S100B may assist the selection of high-risk patients for more intensive follow-up or for adjuvant therapy trials. Association of stage, S100B, and LDH with OS in 574 melanoma patients Prognostic factor Univariate P Multivariate P HR (95% CI) Age 0.2 - - Gender 0.2 - - Stage <0.0001 S100B <0.0001 0.002 2.6 (1.4–4.9) LDH <0.0001 0.008 2.3 (1.2–4.2) No significant financial relationships to disclose.

S100B protein in benzodiazepine overdose

Background:Severe benzodiazepine overdose can result in coma and respiratory depression that might cause brain hypoxia, necrosis and delayed post-anoxic leucoencephalopathy with permanent neurological sequelae. The aim of this study was...

S100B Serum Level Predicts Computed Tomography Findings After Minor Head Injury

Mild head injury (MHI) implies a risk for traumatic brain injury and even a small risk for development of an intracranial hematoma. Head computed tomography (CT) is recommended for early detection of such pathologic findings. The present multicenter study was performed to investigate whether determination of protein S100B in serum could contribute to the selection of patients for CT scanning. We included 226 patients with a history of head injury and a Glasgow Coma Scale (GCS) score of 13 to 15 at admission to hospital. Blood samples for S100B analysis and head CT were obtained within 12 hours after the injury. The diagnostic properties of S100B measurements for prediction of intracranial injury revealed by CT were tested with receiver operating characteristic (ROC) analysis and cross-table analysis at different cut-off levels. We also included analysis of S100B levels normalized to correspond to blood sampling 1 hour after the injury. CT showed intracranial injury in 21 (9.3%) patients. S100B levels were significantly (p < 0.001) elevated in patients with intracranial injury (mean, 0.36; 95% CI, 0.21-0.50 microg/L) compared with those in patients without intracranial injury (mean, 0.18; 95% CI, 0.16-0.20 microg/L). ROC curve analysis showed a significant (p = 0.001) area under the curve (0.73; 95% CI, 0.62-0.84). Cross-table analysis showed that 20 of 21 (sensitivity 0.95) patients with intracranial injury were detected at a cut-off level of 0.10 microg/L, but 141 of 205 (specificity 0.31) patients with no such injury also had a S100B level above this limit. Exclusion of cases with blood samples collected more than 3 hours after injury or normalization did not improve the diagnostic properties. Determination of serum S100B cannot replace the clinical examination or use of CT for patients with minor head injury, but adding S100B measurement to the clinical evaluation might support selection of patients for CT scanning.