Serum S100B Protein Research Articles

Is There Any Relevance Between Serum Heavy Metal Concentration and BBB Leakage in Multiple Sclerosis Patients?

Sharp increase in multiple sclerosis (MS) incidence rate has been observed in Iranian people. In addition, it has been suggested that increased S100B level may be useful as an indicative factor of blood-brain barrier disruption. The propose of this study was to measuring blood arsenic, lead, and cadmium concentration and serum S100B concentration in a group of healthy and multiple sclerosis patients in Tehran as the most polluted city in Iran. All subjects were interviewed regarding age, medical history, possible chemical exposure, acute or chronic diseases, smoking, and dietary habits. Blood heavy metal level was measured by an atomic absorption spectrometer (Varian model 220-Z) conjugated with a graphite furnace atomizer (GTA-110). Also, a serum S100B protein concentration was determined using a commercial ELISA kit. It was observed that all male subjects had higher blood metal level in comparison with healthy controls. Also, MS patients had higher arsenic and cadmium blood concentration in comparison with healthy individuals. Regarding the S100B concentration, it was observed that it had a significant relationship with smoking habit (P value = 0.0001). In addition, arsenic had a greater correlation (63%) with increased serum S100B biomarker level among other elements. BBB leakage was higher in multiple sclerosis than in healthy subjects due to increased S100B release. In addition with regard to the heavy metal exposure especially arsenic and cadmium, these are associated with an increased BBB disruption and it is possible to play a crucial role as a developing agent of multiple sclerosis.

Protein S100B as a Biomarker of Subconcussion Injury

To investigate if serum protein S100B can be used as a biomarker of subconcussion injury in sports.

CAD 3. Using Serum S100-β Protein as a Biomarker for Comparing Silent Brain Injury in Carotid Endarterectomy and Carotid Artery Stenting

CAD 3. Using Serum S100-β Protein as a Biomarker for Comparing Silent Brain Injury in Carotid Endarterectomy and Carotid Artery Stenting

Accuracy of cerebrospinal fluid and serum S100B protein in the diagnosis of bacterial meningitis in children

Background: The diagnosis of bacterial meningitis is very difficult because of the vague clinical presentation primarily in infants and children. The S100B protein is a brain neurochemistry that may a biomarkers of inflammatory process in the brain and it is thought to have relationship with neuron damage and oxidative stress in bacterial meningitis.Methods: In this study, we measured the levels of S100B protein in CSF and serum by using ELISA method, in children with suspected bacterial meningitis. The diagnosis of proven bacterial meningitis based on positive culture that confirmed the causing bacteria. We analyzed the data by using MedCalc-version 17.6 programe.Results: Eighty patients suspected bacterial meningitis included in this study, 47 (58.8%) male, and mean of age was 29.8 months (SD+32.1). Prevalence of proven bacterial meningitis were 21/80 (26.25%). The main clinical symptoms were seizures, decreased of consciousness, clinically sepsis, positive meningeal sign, vomiting and focal neurologic deficits. The comparison of S100BCSF levels between positive culture and negative culture were 31.4 (SD+32.81) and 29.2 (SD+27.13). A comparison of S100Bserum levels between positive culture and negative culture 114.1 (SD+95.67) dan 74.9 (SD+75.84). Area under curve (AUC) of S100BCSF dan S100Bserum were 0.523 and 0.655, respectively. Levels of S100BCSF protein >54 ng/L and S100Bserum >177 ng/L were optimal criteria for diagnosis bacterial meningitis with sensitivity 29% and 19%, specificity 98% and 98%, respectively.Conclusion:  Levels of S100BCSF and S100Bserum protein have prospective value with high specificity to confirm the diagnosis of bacterial meningitis in children. We can use S100Bserum as addition test for the diagnosis of bacterial meningitis in children if there is contraindication for lumbal puncture.

Serum markers and development of delayed neuropsychological sequelae after acute carbon monoxide poisoning: anion gap, lactate, osmolarity, S100B protein, and interleukin-6.

ObjectiveReliable biomarkers of delayed neuropsychological sequelae (DNS) after acute carbon monoxide (CO) poisoning are lacking. This study investigated the associations between potential serum markers and the development of DNS after acute CO poisoning.MethodsRetrospective chart reviews were conducted for patients diagnosed with acute CO poisoning during a 28-month period. The patients were divided into two groups according to the presence or absence of having developed DNS. Multivariate analysis was performed to identify predictors of DNS after CO poisoning.ResultsOf a total of 102 patients, 10 (9.8%) developed DNS. The levels of serum osmolarity, S100B protein, and serum lactate, as well as serum anion gap, were statistically significant in univariate analysis. Multiple logistic regression analysis showed that anion gap (adjusted odds ratio [AOR], 1.36; 95% confidence interval [CI], 1.11 to 1.88), serum lactate level (AOR, 1.74; 95% CI, 1.26 to 2.75), and serum S100B protein level ([AOR, 7.02×105; 95% CI, 4.56×102 to 9.00×1010] in model 1, [AOR, 3.69×105; 95% CI, 2.49×102 to 2.71×1011] in model 2) were independently associated with DNS development.ConclusionBased on our preliminary results, serum lactate level, serum anion gap, and serum S100B protein level in the emergency department could be informative predictors of DNS development in patients with acute CO poisoning. These markers might have the potential to improve early recognition of DNS in patients with acute CO poisoning.

Efficacy of volume therapy guided by stroke volume variability in patients undergoing surgery for severe traumatic brain injury

Objective To evaluate the efficacy of volume therapy guided by stroke volume variability (SVV) in the patients undergoing surgery for severe traumatic brain injury. Methods Thirty patients of both sexes with severe traumatic brain injury, aged 18-64 yr, of American Society of Anesthesiologists physical status Ⅲ, who were admitted to the hospital within 24 h after injury, with Glasgow Coma Scale (GCS) score≤8, were divided into control group (C group, n=15) and SVV group (n=15) using a random number table method.In group C, conventional fluid administration was performed to maintain mean arterial pressure at 65-110 mmHg, central venous pressure at 5-12 cmH2O and urine volume>1 ml·kg-1·h-1.Fluid was given according to SVV, maintaining SVV≤13% and mean arterial pressure at 65-110 mmHg in group SVV.Immediately after skin incision (T0), immediately after opening cerebral dura mater (T1), at 1 h after opening cerebral dura mater (T2), immediately after suturing cerebral dura mater (T3) and at the end of operation (T4), blood samples were collected from the radial artery and internal jugular venous bulb for blood gas analysis, the jugular venous oxygen partial pressure, jugular venous bulb oxygen saturation, blood lactate, arterial oxygen partial pressure, arterial oxygen saturation and Hb were recorded, and the cerebral artery and arteriovenous blood O2 content difference and cerebral O2 extraction rate were calculated.Blood samples were collected from the internal jugular venous bulb at T0-2, T4 and 24 h after operation (T5) for determination of S100β protein concentrations by enzyme-linked immunosorbent assay.The intraoperative volume of fluid intake and output and consumption of vasoactive drugs were recorded.GCS scores were recorded immediately after admission to the operating room, and at 1, 3, 7 and 14 days after operation.The development of postoperative length of hospitalization and complications (pulmonary infection and brain edema) was recorded.Glasgow Outcome Scale Score was used to assess the early postoperative quality of life. Results Compared with group C, the urine volume was significantly increased, the consumption of vasoactive drugs was reduced, jugular venous bulb oxygen saturation was increased at T2, 3, the cerebral O2 extraction rate was decreased at T2-4, the serum S100β protein concentration was decreased at T2, and the GCS score was increased at day 3 after operation (P 0.05). Conclusion SVV-guided volume therapy can improve cerebral oxygen metabolism, ensure adequate tissue perfusion and reduce craniocerebral injury in the patients undergoing surgery for severe traumatic brain injury. Key words: Stroke volume; Fluid therapy; Craniocerebral trauma

Chronic Oral Arsenic Exposure and Its Correlation with Serum S100B Concentration.

Arsenic is one of the most important environmental pollutants especially in drinking water. The S100B protein is presented as a sensitive biomarker for assessment of the blood-brain barrier integrity previously. The objective of this study was to determine the impact of chronic arsenic exposure in drinking water and serum S100B correlation. Fifty-four male BALB/c mice were randomly divided into three groups. Group I and II subjects were treated with arsenic trioxide (1ppm and 10ppm, respectively), while the rest received normal drinking water. Arsenic concentration in serum and brain was measured by an atomic absorption spectrometer (Varian model 220-Z) conjugated with a graphite furnace atomizer (GTA-110). Also, a serum S100B protein concentration was determined using commercial ELISA kit during different times of exposure. It was observed that body weight gain was significantly lower from the 10th week onwards in arsenic-treated subjects. However, it did not induce any visible clinical signs of toxicity. Measured arsenic level in serum and brain was higher in espoused groups as compared to the control subjects (p< 0.001 and p< 0.0001, respectively). In addition, serum S100B content was increased over a period of 3months and had significant differences as compared to the control and 1-ppm group especially after 3months of exposure in the 10-ppm group (p< 0.0001). In conclusion, it could be inferred that long-term arsenic exposure via drinking water leads to brain arsenic accumulation with serum S100B elevated concentration as a probable BBB disruption consequence.

Effect of thoracic paravertebral block combined with general anesthesia on postoperative cognitive dysfunction in elderly patients undergoing pulmonary lobectomy

Objective To evaluate the effect of thoracic paravertebral block combined with general anesthesia on postoperative cognitive dysfunction (POCD) in elderly patients undergoing pulmonary lobectomy. Methods A total of 120 elderly patients of both sexes, aged 65-81 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with New York Heart Association Ⅰor Ⅱ, were divided into 3 groups (n=40 each) using a random number table method: anesthesia group (group GA), epidural block combined with general anesthesia group (group EG), and paravertebral block combined with general anesthesia group (group PG). In group PG, paravertebral block was performed under ultrasound guidance, 0.25% ropivacaine 20 ml was injected after the paravertebral catheter was placed, and anesthesia was induced after confirming the plane of block.In group EG, epidural block was performed with 2% lidocaine 3 ml after epidural puncture was successfully performed at L6, 7 interspace, epidural 0.375% ropivacaine 8-15 ml was intermittently injected, and anesthesia was induced after confirming the height of block.Anesthesia was induced with IV midazolam 0.05-0.10 mg/kg, etomidate 0.3 mg/kg, sufentanil 0.4 μg/kg and rocuronium 0.6 mg/kg.The patients were tracheally intubated and mechanically ventilated.The development of POCD was recorded at 1 day before operation and 7 days after operation.Blood samples were collected from the internal jugular vein before anesthesia, at 15 min after skin incision and at 7 days after operation for determination of serum adiponectin (ADP) and S-100β protein concentrations. Results Compared with group GA, the incidence of POCD was significantly decreased, and the serum S-100β protein concentrations were decreased and serum ADP concentrations were increased at 15 min after skin incision and 7 days after operation in PG and EG groups (P<0.05). Compared with group EG, the incidence of POCD was significantly decreased, and the serum S-100β protein concentrations were increased and serum ADP concentrations were decreased at 15 min after skin incision and 7 days after operation in group PG (P<0.05). Conclusion Thoracic paravertebral block combined with general anesthesia induces better efficacy in decreasing the occurrence of POCD than general anesthesia alone or combination of epidural block and general anesthesia in elderly patients undergoing pulmonary lobectomy, which is related to the decreased concentrations of blood ADP in elderly patients undergoing pulmonary lobectomy. Key words: Nerve block; Pneumonectomy; Cognition disorders; Aged

A Prospective Comparative Study between Three Chemical Markers for Predicting Delayed Neurological Sequelae in Patients with Acute Carbon Monoxide Poisoning of Poison Control Center in Minia University Hospital.

Carbon monoxide poisoning (CO) is a major public health problem. Brain is the most sensitive organ to hypoxia induced by CO poisoning. Delayed Neurological Sequelae (DNS) is considered to be a delayed onset of neuropsychiatric symptoms after apparent recovery from acute CO poisoning. Therefore, this study was aimed to make a prospective comparative study between three markers (serum glutathione reductase, S100b protein and serum neurone- specific enolase) to predict the occurrence of DNS. This study was performed on 57 adult patients with acute CO poisoning. The markers were measured after arrival and the patients were divided into two groups: the DNS group (8 patients) & the non –DNS group (49 patients). There was a statistical difference between the two groups in terms of significant increase in loss of consciousness, syncope, dizziness, ECG changes, pneumonia, carboxyhemoglobin level, creatine phosphokinase, creatine phosphokinase-MB, troponin I, S100b protein, neurone-specific enolase in DNS grouped patiens and significant decrease in glasgow coma scale and glutathione reductase in DNS group. The cut off value of glutathione reductase was ≤ 30 U/L with a percentage of accuracy 94. 74. The cut off value of S100b protein was > 18.94 Pg/ L with 98.25 % percentage of accuracy, while, the cut off value of neurone-specific enolase was > 30.49 ng/ml and its accuracy was 96.49 %. All these cut off values predicted the occurrence of DNS. SO, it is concluded that serum S100b protein may represent the most reliable chemical marker for the prediction of DNS after acute CO poisoning by logistic regression analysis.

Effects of U50488H on postoperative cognitive dysfunction induced by cardiopulmonary bypass in rats

Objective To investigate the effect of U50488H on postoperative cognitive dysfunction induced by cardiopulmonary bypass (CPB) in rats. Methods Forty-eight adult male Sprague-Dawley rats, weighing 400-450 g, were divided into 3 groups (n=16 each) using a random number table: sham operation group (group S), CPB group and CPB plus U50488H group (group U). CPB was performed for 60 min in group CPB.U50488H 1.5 mg/kg was injected into the left lateral cerebral ventricle at 30 min prior to CPB, and then CPB was performed for 60 min in group U. Eight rats in each group were selected at 1 day after CPB, and venous blood samples were collected for determination of serum S100β protein, interleukin-1beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) concentrations (by enzyme-linked immunosorbent assay). Then the rats were sacrificed and right hippocampi were removed for examination of the pathological changes after haematoxylin and eosin staining.Eight rats were selected from each group at 7 days after CPB for assessment of cognitive function. Results Compared with group S, the concentrations of serum S100β protein, IL-1β and TNF-α were significantly increased in group CPB, and the escape latency was prolonged, the number of crossing original platform was reduced, and the swimming distance in target quadrant and time of staying at target quadrant were shortened in CPB and U groups (P<0.05). Compared with group CPB, the concentrations of serum S100β protein, IL-1β and TNF-α were significantly decreased, the escape latency was shortened, the number of crossing original platform was increased, the swimming distance in target quadrant and time of staying at target quadrant were prolonged (P<0.05), and the pathological changes of hippocampal tissues were significantly attenuated in group U. Conclusion U50488H can mitigate the postoperative cognitive dysfunction induced by CPB in rats. Key words: Receptors, opioid, kappa; Cardiopulmonary bypass; Cognition disorders

Effect of Shenfu injection preconditioning on ventilator-induced brain injury in rats

Objective To investigate the effect of Shenfu injection preconditioning on ventilator-induced brain injury in rats. Methods Sixty healthy adult male Sprague-Dawley rats, weighing 300-320 g, were divided into 3 groups (n=20 each) using a random number table: control group (group C), ventilator-induced brain injury group (group VIBI) and Shenfu injection group (group SF). Rats were mechanically ventilated for 6 h with tidal volume of 40 ml/kg in VIBI and SF groups.Rats were mechanically ventilated for 6 h with tidal volume of 10 ml/kg in group C. Shenfu injection 20 ml/kg was injected intraperitoneally at 30 min before ventilation in group SF.Blood samples were collected at 2 and 6 h of ventilation for measurement of the concentrations of serum S100β protein (by enzyme-linked immunosorbent assay). Then the rats were sacrificed at the end of ventilation, and brains were removed for determination of the contents of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) (by enzyme-linked immunosorbent assay) and expression of glutamate decarboxylase (GAD) and γ-aminobutyric acid type A (GABAA) receptor in brain tissues (by Western blot). Results Compared with group C, the serum concentrations of S100β protein at each time point of ventilation and contents of IL-1β and TNF-α in brain tissues were significantly increased, and the expression of GAD and GABAA receptor was down-regulated in VIBI and SF groups (P<0.05). Compared with group VIBI, the serum concentrations of S100β protein at each time point of ventilation and contents of IL-1β and TNF-α in brain tissues were significantly decreased, and the expression of GAD and GABAA receptor was up-regulated in group SF (P<0.05). Conclusion Shenfu injection preconditioning can relieve ventilator-induced brain injury in rats, and the mechanism may be related to inhibiting inflammatory responses and activating GABA signaling pathway. Key words: SHENFU DECOCTION; Respiration, artificial; Brain injuries

Predictive value of partial pressure of end-tidal carbon dioxide on the effect of active abdominal compression-decompression cardiopulmonary resuscitation and serum S100B protein on cerebral function

To explore the predictive value of partial pressure of end-tidal carbon dioxide (PETCO2) on the effect of active abdominal compression-decompression cardiopulmonary resuscitation (AACD-CPR) and serum S100B protein on cerebral function. 142 adult patients with in-hospital cardiac arrest (IHCA) AACD-CPR in Zhengzhou People's Hospital, Affiliated Southern Medical University from September 2014 to December 2017 were enrolled. Patients were divided into successful group and failure group according to restoration of spontaneous circulation (ROSC) or not; and then according to Glasgow-Pittsburgh cerebral performance categories (CPC) one month after ROSC, the successful group was divided into good prognosis group (CPC 1-2) and poor prognosis group (CPC 3-5) further. The variations of hemodynamic, arterial blood gas index, PETCO2 and serum S100B protein level (25 healthy subjects as normal S100B protein level reference value) during the recovery were analyzed. The predictive value of PETCO2 on the effect of AACD-CPR and serum S100B protein on cerebral function of successful resuscitation patients were analyzed by receiver operating characteristic curve (ROC). (1) According to the traditional qualitative indexes, such as pulsation of the large artery, redness of lips and extremities, spontaneous fluctuation of chest, narrowing of pupil, existence of shallow reflex, etc, 54 in 142 patients with IHCA were successfully resuscitated; 57 cases were successfully resuscitated through the guidance of PETCO2, there was no significant difference between the two groups (χ2 = 0.133, P = 0.715). With the AACD-CPR, 142 CA patients' arterial partial pressure of oxygen (PaO2), arterial blood carbon dioxide partial pressure (PaCO2) were all improved with different degrees; heart rate (HR), mean arterial pressure (MAP), PaO2 and PaCO2 were further improved at 20 minutes after ROSC. At beginning of AACD-CPR, PETCO2 of both groups were about 10 mmHg (1 mmHg = 0.133 kPa). PETCO2 was gradually rising to above 20 mmHg in successful group during AACD-CPR process; the failed group increased slightly within 2-5 minutes, then gradually decreased to below 20 mmHg, there was a significant difference in PETCO2 between the two groups at each time. The area under the ROC (AUC) of PETCO2 at CPR 20 minutes in predicting the outcome of the resuscitation was 0.969, 95% confidence interval (95%CI) was 0.943-0.995 (P = 0.000), when the cut-off value of PETCO2 was 24.25 mmHg, the sensitivity was 90.7%, and the specificity was 96.6%. (2) The level of serum S100B protein at 0.5 hour after ROSC in the good prognosis group and the poor prognosis group were significant higher than that of the normal control group; there was no significant difference between poor prognosis group and good prognosis group. S100B protein concentration of the poor prognosis group reached the peak within 3-6 hours, then gradually decreased, and was higher than that of the normal control group at ROSC 72 hours; the good prognosis was gradually decreased and recovered to normal control group within ROSC 72 hours. The AUC of S100B at 3 hours after ROSC on cerebral function prognosis prediction was 0.925, 95%CI was 0.867-0.984 (P = 0.000), when the cut-off value of S100B protein was 1.215 μg/L, the sensitivity was 85.2%, and the specificity was 85.5%. The variation of PETCO2 can be used as an objective index to predict the success of AACD-CPR, and serum S100B protein can be used as an objective clinical index to predict cerebral function after AACD-CPR, both of which have some reference and guiding significance for clinical treatment.

Cerebral Alterations Following Experimental Multiple Trauma and Hemorrhagic Shock.

Multiple trauma (MT) associated with hemorrhagic shock (HS) might lead to cerebral hypoperfusion and brain damage. We investigated cerebral alterations using a new porcine MT/HS model without traumatic brain injury (TBI) and assessed the neuroprotective properties of mild therapeutic hypothermia. Male pigs underwent standardized MT with HS (45% or 50% loss of blood volume) and resuscitation after 90/120 min (T90/T120). In additional groups (TH90/TH120) mild hypothermia (33°C) was induced following resuscitation. Normothermic or hypothermic sham animals served as controls. Intracranial pressure, cerebral perfusion pressure (CPP), and cerebral oxygenation (PtiO2) were recorded up to 48.5 h. Serum protein S-100B and neuron-specific enolase (NSE) were measured by ELISA. Cerebral inflammation was quantified on hematoxylin and eosin -stained brain slices; Iba1, S100, and inducible nitric oxide synthase (iNOS) expression was assessed using immunohistochemistry. Directly after MT/HS, CPP and PtiO2 were significantly lower in T90/T120 groups compared with sham. After resuscitation both parameters showed a gradual recovery. Serum protein S-100B and NSE increased temporarily as a result of MT/HS in T90 and T90/T120 groups, respectively. Cerebral inflammation was found in all groups. Iba1-staining showed significant microgliosis in T90 and T120 animals. iNOS-staining indicated a M1 polarization. Mild hypothermia reduced cerebral inflammation in the TH90 group, but resulted in increased iNOS activation. In this porcine long-term model, we did not find evidence of gross cerebral damage when resuscitation was initiated within 120 min after MT/HS without TBI. However, trauma-related microglia activation and M1 microglia polarization might be a consequence of temporary hypoxia/ischemia and further research is warranted to detail underlying mechanisms. Interestingly, mild hypothermia did not exhibit neuroprotective properties when initiated in a delayed fashion.

Effect of isoflurane preconditioning on brain injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass

Objective To evaluate the effect of isoflurane preconditioning on brain injury in patients undergoing cardiac valve replacement with cardiopulmonary bypass(CPB). Methods Forty patients of both sexes, aged 35-55 yr, with body mass index of 18-25 kg/m2, of American Society of Anesthesiologists physical status Ⅱor Ⅲ(New York Heart Association class Ⅱor Ⅲ), scheduled for elective cardiac valve replacement with CPB, were divided into 2 groups(n=20 each)using a random number table: control group(group C)and isoflurane preconditioning group(group P). After induction of anesthesia, 1.5% isoflurane was inhaled for 30 min followed by 15-min washout, and the end-tidal isoflurane concentration was less than 0.1% at the end of washout in group P. Immediately after internal jugular vein puncture(T1), immediately before beginning of CPB(T2), at 30 min after beginning of CPB(T3), immediately after the end of CPB(T4)and at 6 h and 1 day after the end of CPB(T5, 6), blood samples were collected for determination of serum S100β protein concentrations(by enzyme-linked immunosorbent assay)and the concentration of glutamic acid in serum(by ion exchange chromatography). Mini-Mental State Examination scores were recorded at 1 day before operation and 7 days after operation, and the occurrence of postoperative cognitive dysfunction was recorded. Results The serum concentrations of S100β protein and glutamic acid in the two groups are significantly higher at T3-5 than at T1(P<0.05). Compared with group C, the concentration of S100β protein in serum was significantly decreased at T3-5, and serum glutamic acid concentration was decreased at T4, 5 in group P(P<0.05). No postoperative cognitive dysfunction was found in the two groups. Conclusion Isoflurane preconditioning can reduce brain injury in patients undergoing cardiac valve replacement under CPB, and the mechanism may be related to inhibiting glutamic acid release. Key words: Isoflurane; Ischemic preconditioning; Cardiopulmonary bypass; Brain injuries

Serum S100B protein as a prognostic biomarker for neurological outcome after in-hospital cardiac arrest in children

Background Survivors of cardiac arrest often require lengthy intensive care admission, rehabilitation, and ongoing treatment of chronic complications as a result of poor function outcomes. S100B protein has emerged as a candidate peripheral biomarker of blood–brain barrier permeability and central nervous system injury. Aim This study aimed to evaluate the serum levels of S100B protein as a prognostic biomarker for predicting neurological outcome after in-hospital cardiac arrest and cardiopulmonary resuscitation (CPR) in children.Patients and methods Thirty infants and children underwent CPR after in-hospital cardiac arrest; blood samples for the evaluation of S100B were drawn after 1 and 24 h after initiation of CPR. Neurological assessment for survivors was done 6 months after cardiac arrest using the cerebral performance category (CPC) score, which was used also immediately following CPR for all patients (including those who died 24 h after CPR). Fifteen healthy children were enrolled as a control group.Results There was highly significant increase of serum S100B protein in postarrest patients at 1 and 24 h as compared with the control group (P<0.001); significant increase in patients at 1 h as compared with patients at 24 h (P<0.05); and highly significant increase of serum S100B protein in dead patients (n=25) as compared with survivors (n=5) (P<0.001). There was highly significant positive correlation between the duration of CPR and the CPC score and S100B protein level (P<0.001).The cutoff value of S100B protein at 1 h (as a prognostic biomarker) was 1430 ng/l with 76% sensitivity and 94% specificity, whereas the cutoff value of S100B protein at 24 h was 227 ng/l with 75% sensitivity and 91% specificity.Conclusion S100B protein was potentially useful as a prognostic biomarker (with high sensitivity and specificity) for neurological outcome after cardiac arrest, as its levels significantly correlated with CPC score of the survivors 6 months after cardiac arrest and with the duration of CPR.

Evaluation of rat major celluler prion protein for early diagnosis in experimental rat brain trauma model.

Although traumatic brain injury (TBI) is an important problem, there has been no widespread utilization of neuro-biomarkers to aid the diagnosis of TBI. This study was conducted to evaluate serum S100B and prion protein (PrPC) levels in rats with TBI. In this study, 15 albino rats were categorized into three groups as follows: sham-operated (1), control (6) and trauma (8) groups. The TBI model was based on the modified free falling model. S100B, PrPC levels were measured using ELISA. Brain specimens were obtained for the pathological examination. Serum S100B and PrPC levels were found to increase in T group at both 2h and 24h after trauma (p<0.002, p<0.002, respectively). We also found higher histopathological injury scores of brain tissues in the T group. Only a positive correlation was found between serum PrPC levels and the extent of brain injury (p=0.039, r=0.731). Using ROC analysis, among the two serum markers investigated, both of them revealed the same sensitivity and specificity for diagnosing TBI. The changes in serum S100B and PrPC levels showed good sensitivity in our experimental model. Therefore, PrPC could be helpful in the early prognostic prediction in patients with TBI. Further studies are needed to test our findings in humans following TBI (penetrating bodies, blunt trauma) to definitively acknowledge it as a reliable biomarker and its subsequent diagnostic utility.

Dynamic changes and clinical significance of serum S100B protein and glial fibrillary acidic protein in patients with delayed encephalopathy after acute carbon monoxide poisoning.

Objective:To study the dynamic changes and clinical significance of serum S100B protein and glial fibrillary acidic protein (GFAP) in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP).Methods:This study was conducted among DEACMP patients who were hospitalized from November 2014 to February 2016. Serum levels of S100B and GFAP in 66 DEACMP patients were measured by ELISA. Changes in patient states were examined dynamically using activities of daily living (ADL) scale, information-memory-concentration test (IMCT) and Hasegawa’s dementia scale (HDS), and compared with those of 64 patients without DE after ACMP.Results:Serum S100B [(0.59 ± 0.11) ng/ml] and GFAP [(227.67 ± 12.43) ng/ml] levels of DEACMP group in acute phase were significantly higher than those of ACMP group [(0.48 ± 0.10) ng/ml and (178.91 ± 11.47) ng/ml] and DEACMP group in recovery phase [(0.49 ± 0.12) ng/ml and (179.54 ± 12.32) ng/ml] (all P<0.05). Serum S100B and GFAP levels of DEACMP group were significantly correlated in both acute and recovery phases (r=0.432 in acute phase, P=0.007; r=0.378 in recovery phase, P=0.034). ADL, HDS and IMCT scores of DEACMP group in acute phase were (45.12 ± 3.12), (7.98 ± 1.02) and (9.61 ± 1.41) points respectively, which were significantly different from those of recovery phase [(33.25 ± 3.09), (16.13 ± 1.17) and (19.54 ± 1.43) points respectively] (P<0.05).Conclusions:DEACMP was accompanied by secondary brain injury, for which glial activation may be important. Serum S100B and GFAP levels may be related to prognosis.

Effects of dexamethasone on early cognitive decline after cardiac surgery: A randomised controlled trial.

Postoperative cognitive decline (POCD), a very common complication after cardiac surgery, is characterised by impairment of both memory function and intellectual ability as well as being associated with increased use of healthcare resources. The investigators focused on the role of the inflammatory response to a surgical procedure as a potential factor involved in the pathogenesis of POCD. The use of prophylactic dexamethasone to attenuate the inflammatory response was hypothesised to reduce the risk of POCD. Randomised controlled study. Single university teaching hospital, from March 2015 to January 2016. A total of 169 patients scheduled for elective cardiac surgery were enrolled, and 161 patients were included in the analyses. Patients were randomised to receive a single intravenous bolus of 0.1 mg kg dexamethasone (n = 85) or placebo (n = 84) 10 h before the surgery. The primary outcome measure in both groups was the incidence of POCD on the 6th day after surgery. The investigators also evaluated the effect of dexamethasone on the incidence of systemic inflammatory response syndrome, postoperative C-reactive protein levels and postoperative serum S100β protein levels. Compared to the placebo group, the dexamethasone group showed statistically significant reductions in the incidence of POCD (relative risk, 0.43; 95% confidence interval, 0.21 to 0.89; P = 0.02), the incidence of systemic inflammatory response syndrome (30.0 versus 58.0%, P < 0.001) and postoperative C-reactive protein levels (P < 0.001). Postoperative S100β levels were insignificantly lower (P = 0.56) in the dexamethasone group. Preoperative administration of dexamethasone reduced the inflammatory response and thereby decreased the risk of early POCD after cardiac surgery. Clinicaltrials.gov identifier: NCT02767713.

Changes of serum neuron specific enolase and S100-β protein and their correlations with cognitive impairment in patients with moderate traumatic brain injury

Objective To analyze the correlation of the levels of serum neuron specific enolase (NSE) and S100-β protein with cognitive impairment in patients with moderate traumatic brain injury (mTBI). Methods A retrospective case series study enrolled 87 patients with mTBI treated from January 2015 to October 2016. There were 50 males and 37 females, aged 14-60 years [(37.8±12.6)years]. The Glasgow Coma Score (GCS) was 9-12 points, among which were 9-10 points in 36 cases and 11-12 points in 51. The cognitive function was assessed by the Montreal Cognitive Assessment Scale (MoCA). The patients with MoCA<26 points were assigned into cognitive impairment group (study group, 54 cases), while the patients with MoCA ≥ 26 points was assigned into non-cognitive-impairment group (control group, 33 cases). The levels of serum NSE and S100-β protein were compared, and the correlation of levels of serum NSE and S100-β protein with cognitive dysfunction (assessed by MoCA and GCS) was analyzed. Results The levels of serum NSE and S100-βprotein were (35.7±11.0)ng/L and (1.8±0.5)ng/L, respectively in study group, which were significant higher than that in control group [(22.6±9.4)ng/L and (1.2±0.5)ng/L, respectively] (P<0.01). The levels of NSE [(33.7±10.0)ng/L] and S100-β [(1.7±0.4)ng/L] in patients with GCS 9-10 points were higher than those of NSE [(19.4±9.0)ng/L]and S100-β [(1.3±0.5)ng/L] in patients with GCS 11-12 points (P<0.01). The levels of serum NSE and S100-β protein in mTBI patients were negatively correlated with the MoCA score (r=-0.693, -0.721, P<0.05) and GCS (r=-0.527, -0.796, P<0.05). Conclusion The levels of serum NSE and S100-β protein are increased, and are correlated to the occurrence of cognitive impairment in patient with mTBI. Key words: Craniocerebral trauma; Cognition disorders; S100-β proteins; Neuron specific enolase

The expression of S100B protein in serum of patients with brain metastases from small-cell lung cancer and its clinical significance.

The objective of the present study was to investigate the expression of S100B protein in serum of patients with brain metastases from small cell lung cancer (SCLC), and its clinical significance. A total of 138 patients with SCLC were selected from June 2013 to December 2015. Simultaneously, 138 healthy adult volunteers (healthy controls) were selected in the medical examination center of People's Hospital of Rizhao. Among the 138 patients with SCLC, 48 had liver metastases and 44 had brain metastases. Of the remaining 46 patients, 20 were initially diagnosed with SCLC and 26 underwent surgery and postoperative chemotherapy. The levels of serum S100B in patients and healthy controls were measured by ELISA, and analyzed by SPSS 20.0 statistical software. The serum S100B protein levels in patients with SCLC were significantly higher than those in healthy controls (p<0.05). Among the subgroups of patients with SCLC, the levels of serum S100B in patients with brain metastases were significantly higher than in the other subgroups (p<0.05). No significant differences were found between the other subgroups, except for the brain metastases group. We found that serum S100B protein expression levels were significantly reduced in patients with brain metastases after cobalt-60 radiotherapy (p<0.05). During follow-up, we found that higher expression of S100B protein was usually associated with poorer prognosis, higher mortality rate at 1 year, and lower survival rate. In conclusion, S100B protein can serve as a serological marker for brain metastases from SCLC, which provides important theoretical support for early detection of brain metastases.