S100B Protein Levels Research Articles

Characterisation of plasma proteins and circulating microRNAs in out-of-hospital cardiac arrest patients - approaches for predicting outcome

Abstract Rationale: Early prognostication after out-of-hospital cardiac arrest (OHCA) is an unmet clinical need. There is limited data on serial release kinetics of cardiac, brain and systemic biomarkers such as Neuron Specific Enolase (NSE) and S-100B. miRNAs are sensitive biomarker candidates in acute myocardial infarction (MI). Objective The objective was to characterise circulating biomolecules in the early release kinetics after OHCA, compared with a STEMI control group and assessed with clinical outcome. Methods and Results Serial blood samples of patients with OHCA with STEMI (n=20) and STEMI control (n=20) were collected at baseline and at 6, 12, 24 and 48h after admission. Untargeted plasma proteomics were performed using data-independent acquisition–mass spectrometry (DIA–MS). Candidate proteins and miRNAs were quantified. Proteomics returned n=156 proteins with significantly different kinetics between OHCA and STEMI. Six clusters, depicting distinct biological pathways, with characteristic differences between OHCA and STEMI were identified. The most distinct and significant differences between OHCA and STEMI patients were seen for acute phase reactants LBP, AACT, CRP and the lipid metabolite A2GL as well as endothelial and platelet miR-126 and cardiomyocyte-apoptosis/ischemia-reperfusion related miR-320a. Cardiogenic shock was best characterised by differential kinetics of coagulation and complement related proteins FA9, HRG, FHR1 and inflammation related miR-146. The primary endpoint was poor neurological recovery at 30-days. Individuals with good outcome showed distinct differences in adaptive immune response, complement and coagulation cascades and hemostasis. Circulating plasma levels of hypoxia-associated miR-101, miR-210 and S-100B protein were significantly elevated at baseline in OHCA patients. These molecules further showed higher baseline values in patients with poor outcome. For current prognosis marker NSE, this difference only develops after 48h. Cardiac/muscle miRNAs followed an early release-pattern similar to high-sensitivity cardiac troponin-T (hs-cTnT). Machine learning models were used to calculate the AUC for the prediction of poor neurological outcome at baseline. This was highest for hypoxia-induced miR-210 (AUC: 0.854), which performed significantly better than the protein biomarkers NSE (AUC: 0.646) and S-100B (AUC:0.656). Conclusions Untargeted mass spectrometry reveals distinct biological pathways and candidate biomolecules affected in patients suffering from OHCA compared with STEMI controls, in patients developing cardiogenic shock and in those with adverse versus good neurological outcome. Platelet-, inflammation and hypoxia associated miRNAs are associated with OHCA, cardiogenic shock and prognostication of adverse neurological outcome. Pronounced differences in early release kinetics of RNA and protein biomarkers may improve identification of OHCA patients at risk of poor outcome.

The Effect of sCOX-2 inhibitor on S100B Protein Level, Cognitive Dysfunction and Glasgow Outcome Scale (GOS) in Moderate Traumatic Brain Injury Patients

The aim of this study was to explore the relationship between the protein S100B level, cognitive dysfunction, and Glasgow Outcome Scale (GOS) in moderate traumatic brain injury patients. Thirty patients suffering from head injuries undergoing neurosurgery in Dr. Hasan Sadikin General Hospital Bandung, Indonesia, and who were considered eligible based on the inclusion and exclusion criteria participated in this double-blind experimental Randomized Controlled Trial (RCT). The treatment groups (COX-2) were assigned as COX2-I, COX2II, and COX3-IV, six patients in each group. The treatment group was given another dose of sCOX-2 inhibitor 12 hours, 12 and 24 hours after the first dose, and 12, 24 and 36 hours after pre-induction sCOP-2 inhibitor was administered. The GOS score was obtained during the before the surgery and 1 month, 1.5 months, and 2 months postoperative days. The MMSE was performed preoperatively and then on the first to seventh day after the surgery. The results showed that there was a significant decrease in the protein level in all treatment groups including the control group, where the resulting p-value was less than 0.05. Moreover, the treatment group showed a faster time in reaching GOS 5 or be discharged from the hospital compared to the control. In conclusion, it has been demonstrated that the provision of 3 or 4 times of the sCox-2 inhibitor leads to the achievement of a score of 5, while the recovery of the cognitive dysfunction into the normal level is obtained when the SCox2 inhibitor is given 4 times.

Serum Level of S100B Protein as a Biomarker of Therapeutic Adherence in Parkinson’s Disease Patients

Pharmacological management of Parkinson’s disease (PD) is complex and may negatively impact patients' adherence to therapy. Several objective and subjective approaches are used to assess therapeutic adherence. Measurement of biological markers, that are well correlated with the effect of the medications, and that are distributed into easily accessible body fluids would be feasible approach for measuring therapeutic adherence for these medications. S100B protein has been proposed to be involved in the pathophysiology of PD. The study aims to measure the serum S100B level in PD patients and to assess its potentials to be used as a biomarker to predict therapeutic adherence in PD patients. Sixty-eight adult outpatients, of both genders, who were already diagnosed with PD, receiving different anti-Parkinson medications, were enrolled in this cross-sectional study. Hoehn and Yahr scale was used to determine the stage of disease; while, therapeutic adherence to treatment was assessed using the Arabic version of Morisky Medication Adherence Scale (MMAS-8). Serum S100B level was measured by enzyme-linked immune sorbent assay. Serum S100B level of participants was 10.55 (13.3) ng/l, and there was no significant difference between medians of S100B protein according to disease stages, P =0.975. Serum S100B level in patients with poor therapeutic adherence [14.2 (13.2) ng/l] was significantly higher than that in patients with good therapeutic adherence [3.14 (3.34)]; P = 0.008. Furthermore, serum S100B level with the MMAS-8; (r= -0.414, P = 0.001). Finally, at a cut-off point 3.57 ng/l and above, serum S100B level was shown to have good potential [area under the curve (AUC)= 0.715], as biomarker of therapeutic adherence with 70.6% sensitivity and 70.6%, specificity; P = 0.008. In conclusion, serum S100B level in PD patients is negatively correlated with therapeutic adherence level and has good potentials as biomarker of therapeutic adherence in PD patients to anti-Parkinson medications.

S100b protein as a biological marker of nerve tissue damage in laboratory animals in preclinical studies

Background. For preclinical studies of drugs a relevant task is the selection of specific biochemical markers reflecting damage to the central nervous system, both in toxicological and pharmacological experiments. One of such markers may be protein S100b, the level of which will make it possible to assess the damage of the central nervous system of various genesis. Objective. The aim of the study was to assess changes in the level of S100b protein in the blood and in brain homogenates in brain tissue injuries of various genesis. Design and methods. The study was conducted on males of outbred rats and mice. A total of 62 animals were used: 47 rats and 15 mice. To determine the concentration of S100b protein, ELISA kits Rat S100b/S100 beta Elisa kit (Sandwich Elisa) were used) for rats and Mouse S100b/S100 beta Elisa kit (Sandwich Elisa) for mice. Statistical analysis was performed using licensed GraphPad Prism 9 software. Results: Changes of protein S100B was explored on models of alcohol neuropathy, bilateral and focal cerebral ischemia, traumatic brain injury. Forming of all pa[1]thologies led to increasing of protein S100B both in blood plasma and in brain tissues in case of traumatic brain injury. For alcohol neuropathy, focal and cerebral ischemia and traumatic brain injury changings of this marker level reached statistic meaning. Conclusion. Increased concentration of S100b is a sign of neuronal damage as a result of ischemic, traumatic and toxic factors, as well as in hypoclycemic conditions. Thus, protein S100b can be used in preclinical studies as a marker of brain damage, responding to damage of various genesis in studies of pharmacodynamics and pharmacological safety of drugs.

Neurological Damage Measured by S-100b and Neuron-Specific Enolase in Patients Treated with Electroconvulsive Therapy.

Electroconvulsive therapy (ECT) is considered one of the most effective treatments for psychiatric disorders. ECT has proven effective in the treatment of depression, mania, catatonia and psychosis. It is presumed that seizures induced during ECT administration cause toxicity and potentially neuronal and glial cell death. A broad range of neurological disorders increase cerebrospinal fluid and serum levels of neuron-specific enolase (NSE) and S-100b protein. This study aims to investigate the effect of ECT on NSE and S-100b levels, which, together, serve as a proxy for neuronal cell damage. Serum concentrations of S-100b and NSE of adult patients who received ECT were measured by immunoluminometric analysis before and after treatment. A two-way ANOVA test was used to estimate the statistical differences in marker concentrations between the subgroups of the study population. Results: A total of 55 patients were included in the analysis: 52.73% (n = 29) were diagnosed with depression, 21.82% (n = 12) with schizophrenia or other psychosis, 16.36% (n = 9) with mania and 9.09% (n = 5) with catatonia. There were no statistically significant changes in NSE (p = 0.288) and S-100b (p = 0.243) levels. We found no evidence that ECT induced neuronal damage based on NSE and S-100b protein levels measured in the serum of patients before and after treatment.

Evaluation of the neuroprotective effect of antipsychotics by serum quantification of protein S100B

ObjectiveThis research delves into the intricate interplay between antipsychotic medications and neuroprotection focusing on the S100B protein—a central player in the regulation of neuroapoptotic activity. MethodBlood samples were collected to assess serum S100B protein levels using an immunoassay of immunoelectrochemiluminescence. The first two samples were collected with a 3-month interval between each, and the third sample was obtained 6 months after the previous one. Changes in S100B protein levels throughout the study were assessed using Friedman's ANOVA test. This was followed by the Wilcoxon signed-rank test with Bonferroni correction to account for multiple comparisons. ResultsThis study involved 40 patients diagnosed with severe mental disorders (34 schizophrenia, 4 schizoaffective disorder, 1 bipolar disorder, and 1 borderline personality disorder). These patients had been receiving antipsychotic treatment for an average duration of 17 years. The results revealed that the S100B protein remained within physiological levels (median values 39.0 ng/L for the first sample, median values 41.0 ng/L for the second sample, and median values 40.5 ng/L for the third sample) with no significant changes (p = 0.287), with all anti-psychotic medicaments values consistently below 50 ng/L, a lower value compared to maximum range of 105 ng/L. Importantly, there were no significant differences in S100B protein levels between patients on monotherapy and those on combination antipsychotic therapy (p = 0.873), suggesting that combination therapy did not increase neuroapoptotic activity. ConclusionsThese findings provide compelling evidence for the potential neuroprotective effects of long-term antipsychotic treatment in individuals with severe mental disorders. By maintaining physiological levels of the S100B protein, antipsychotic medications may help protect against neuronal damage and dysfunction. This research contributes valuable insights into the neuroprotective mechanisms of antipsychotic drugs, enhancing our understanding of their potential benefits in the treatment of severe mental disorders.

Clinical effect of external ventricular drainage under intracranial pressure monitoring in the treatment of aneurysmal subarachnoid hemorrhage patients and investigation of the mechanism of miR-146a-5p/STC1 axis in inhibiting early brain injury in aneurys.

Aneurismal subarachnoid hemorrhage (aSAH) is a common disease in the neural system, with high death rate. Our study aimed to explore the clinical effect of external ventricular drainage under intracranial pressure monitoring in the treatment of patients with aSAH and investigate the role along with mechanism of miR-146a-5p in aSAH. Ninety-six aSAH patients were allocated into control group (CG) and study group (SG). The CG was released by lumbar puncture. The SG underwent external ventricular drainage based on intracranial pressure monitoring. The prognosis, daily living ability, neurological function, S100β and NSE (neuron-specific enolase) levels and incidence of complications were monitored. Besides, a rat model of SAH was built to assess the neurobehavioral function, blood-brain barrier permeability, brain water content, neuronal apoptosis as well as inflammation. SAH cell model stimulated by oxyhemoglobin, and cell apoptosis as well as inflammation were measured. Luciferase reporter assay was implemented to explore the interaction between miR-146a-5p and STC1. Results showed higher GOS and BI scores but lower NIHSS scores, S100β and NSE levels and complication rates in SG compared with CG. Additionally, miR-146a-5p presented down-regulation in brain tissues of SAH rat model, and overexpressed miR-146a-5p reduced brain injury along with neuroinflammation in SAH rat model. Oxyhemoglobin-induced nerve cell apoptosis along with inflammation after SAH, and overexpressed miR-146a-5p repressed oxyhemoglobin-induced nerve cell apoptosis along with inflammation. STC1 is the target mRNA of miR-146a-5p, and overexpressed miR-146a-5p represses oxyhemoglobin-induced nerve cell apoptosis along with inflammation via regulating STC1 expression. In conclusion, external ventricular drainage under intracranial pressure monitoring could promote prognosis, promote daily living ability, improve neurological function, reduce S100β protein and NSE levels, and reduce the incidence of complications in patients with aSAH. Meanwhile, miR-146a-5p inhibited early brain injury and neuroinflammation in aSAH via regulating STC1 expression.

The effects of combined acupuncture anesthesia and serratus anterior plane block with ropivacaine on postoperative analgesia in patients undergoing chest surgery

Objective To investigate the effects of combined acupuncture anesthesia and ropivacaine on postoperative analgesia and neuro-related factors in patients undergoing chest surgery. Methods The analgesic drug dosage, postoperative PCIA pressing times, VAS scores at rest and during activity at 6 h (T1), 12 h (T2), 18 h (T3), and 24 h (T4) postoperatively. Results The analgesic drug dosage and postoperative PCIA pressing times were lower in the observation group than in the control group (p < 0.05). The VAS scores at T1–T4 postoperatively were lower in the observation group than in the control group (p < 0.05). The SAS scores at T1–T4 postoperatively were lower in the observation group than in the control group (p < 0.05). The levels of IL-6 and IL-10 on postoperative day 1 were higher than those on preoperative day 1 in both groups, with a smaller change in the observation group (p < 0.05). The levels of S100β protein on postoperative day 1 were higher than those on preoperative day 1 in both groups, while the BDNF levels were lower, with a smaller change in the observation group (p < 0.05). There was no significant difference in the incidence of adverse reactions between the control group (11.36%) and the observation group (15.56%) (p > 0.05). Conclusion Combined acupuncture anesthesia and ropivacaine can effectively improve postoperative analgesia and agitation in patients undergoing chest surgery, reduce the dosage of analgesic drugs, regulate the levels of inflammatory factors and neurotrophic factors in patients, and do not increase the risk of adverse reactions related to patients.

Correlation Study on the Prognostic Value of miR-21 and S-100B Protein Levels in Neonatal Hypoxic-Ischemic Encephalopathy Undergoing Hypothermia Therapy

: Objective To evaluate the variations in serum levels of microRNA-21 (miR-21) and S-100B protein in neonates with hypoxic-ischemic encephalopathy (HIE) after receiving hypothermia therapy and explore the correlation of these biomarkers with the neurodevelopmental prognosis of the infants. Methods This retrospective analysis included 90 neonatal HIE patients diagnosed and treated between January 2019 and December 2022. Real-time quantitative PCR and enzyme-linked immunosorbent assay (ELISA) methods were used to measure miR-21 and S-100B protein levels. Neurodevelopmental assessments were conducted at one year, and follow-up was performed using the Bayley Scales of Infant and Toddler Development third edition. Statistical analysis was carried out using SPSS software, with t-tests for continuous variables, chi-square tests for categorical data, Pearson correlation coefficient for correlation analysis, and multivariate regression analysis to adjust for confounding factors. Results After hypothermia therapy, the observation group showed a significant decrease in miR-21 and S-100B protein levels (P < 0.001), and neurodevelopmental scores were significantly higher than the control group (P < 0.05). Correlation analysis indicated a negative correlation between miR-21 and neurodevelopmental scores (r=-0.62, P < 0.001), as well as a negative correlation between S-100B protein levels (r=-0.76, P < 0.001). Multivariate regression analysis demonstrated that miR-21 levels and S-100B protein levels maintained independent negative correlations with neurodevelopmental scores (P < 0.001). Conclusion Hypothermia therapy significantly reduces serum levels of miR-21 and S-100B protein in neonatal HIE patients and may be associated with better prognosis. miR-21 and S-100B serve as prognostic biomarkers, aiding in predicting and improving the treatment outcomes and long-term prognosis of neonatal HIE.

Serum S100B Level in the Management of Pediatric Minor Head Trauma

Minor head trauma (HT) is one of the most common causes of hospitalization in children. A diagnostic test could prevent unnecessary hospitalizations and cranial computed tomographic (CCT) scans. To evaluate the effectiveness of serum S100B values in reducing exposure to CCT scans and in-hospital observation in children with minor HT. This multicenter, unblinded, prospective, interventional randomized clinical trial used a stepped-wedge cluster design to compare S100B biomonitoring and control groups at 11 centers in France. Participants included children and adolescents 16 years or younger (hereinafter referred to as children) admitted to the emergency department with minor HT. The enrollment period was November 1, 2016, to October 31, 2021, with a follow-up period of 1 month for each patient. Data were analyzed from March 7 to May 29, 2023, based on the modified intention-to-treat and per protocol populations. Children in the control group had CCT scans or were hospitalized according to current recommendations. In the S100B biomonitoring group, blood sampling took place within 3 hours after minor HT, and management depended on serum S100B protein levels. If the S100B level was within the reference range according to age, the children were discharged from the emergency department. Otherwise, children were treated as in the control group. Proportion of CCT scans performed (absence or presence of CCT scan for each patient) in the 48 hours following minor HT. A total of 2078 children were included: 926 in the control group and 1152 in the S100B biomonitoring group (1235 [59.4%] boys; median age, 3.2 [IQR, 1.0-8.5] years). Cranial CT scans were performed in 299 children (32.3%) in the control group and 112 (9.7%) in the S100B biomonitoring group. This difference of 23% (95% CI, 19%-26%) was not statistically significant (P = .44) due to an intraclass correlation coefficient of 0.32. A statistically significant 50% reduction in hospitalizations (95% CI, 47%-53%) was observed in the S100B biomonitoring group (479 [41.6%] vs 849 [91.7%]; P < .001). In this randomized clinical trial of effectiveness of the serum S100B level in the management of pediatric minor HT, S100B biomonitoring yielded a reduction in the number of CCT scans and in-hospital observation when measured in accordance with the conditions defined by a clinical decision algorithm. ClinicalTrials.gov Identifier: NCT02819778.

Effects of Pulsatile and Non-Pulsatile Cardiopulmonary Bypass Techniques in Coronary Artery Bypass Grafting Surgeries on Cerebral Perfusion.

We aimed to evaluate the effects of cardiopulmonary bypass (CPB) machines used in coronary artery bypass grafting surgeries on cerebral perfusion by performing cerebral oximetry monitoring [near-infrared spectroscopy (NIRS)], S100-β protein measurements, and neurocognitive function assessment tests using both pulsatile and non-pulsatile modes. A total of 44 patients, 22 non-pulsatile (Group NP) and 22 pulsatile (Group P), were included in the study. Hemodynamic parameters, arterial blood gas values, NIRS values and blood S100β protein levels were analyzed at five points: pre-induction (T1), initiation of CPB (T2), termination of CPB (T3), end of surgery (T4), and postoperative 24 h (T5). Two different neuropsychological tests were administered to patients in the preoperative and postoperative periods. There were no significant differences between the groups for demographic characteristics such as age, gender, body mass index, aortic cross-clamping, CPB, and operation durations. The mean arterial blood pressure and PaO2 values for the T2 measurements were significantly higher in group NP (P < 0.05). Regional cerebral oxygen saturation (rSO2) (NIRS) values at T3 and T4 were significantly higher in group P (P < 0.05). Serum S100β measurement values at T3 and T5 were significantly higher in group NP than in group P (P < 0.05). Serum S100β protein levels at T3 correlate with rSO2 results. There was no statistically significant difference between the two groups in terms of pH, lactate, glucose, partial pressure of carbon dioxide, and peripheral oxygen saturation values. Despite no difference between the two groups for neurocognitive function tests, we believe that pulsatile perfusion may be more beneficial for cerebral perfusion when S100β protein and NIRS values are considered. Further clinical studies are needed to evaluate the benefits of the pulsatile technique for cerebral perfusion.

Predicting Short- and Long-Term Functional Outcomes Based on Serum S100B Protein Levels in Patients with Ischemic Stroke.

Ischemic stroke is one of the leading causes of mortality and disability. The neuroimaging methods are the gold standard for diagnostics. Biomarkers of cerebral ischemia are considered to be potentially helpful in the determination of the etiology and prognosis of patients with ischemic stroke. This study aimed to investigate the usefulness of serum S100B protein levels as a short- and long-term prognostic factor in patients with ischemic stroke. The study group comprised 65 patients with ischemic stroke. S100B protein levels were measured by immunoenzymatic assay. Short-term functional outcome was determined by the NIHSS score on day 1 and the difference in the NIHSS scores between day 1 and day 9 (delta NIHSS). Long-term outcome was assessed by the modified Rankin Scale (MRS) at 3 months after the stroke. At the end of the study, patients were divided into groups based on the NIHSS score on day 9 (0-8 "good" and >8 "poor"), the delta NIHSS ("no improvement" ≤0 and >0 "improvement"), and the MRS ("good" 0-2 and >2 "poor"). Differences in S100B levels between groups were analyzed with the ROC curve to establish the optimal cut-off point for S100B. The odds ratio was calculated to determine the strength of association. Correlations between S100B levels at three time points and these variables were evaluated. We revealed a statistically significant correlation between S100B levels at each measurement point (<24 h, 24-48 H, 48-72 h) and the NIHSS score on day 9 (R Spearman 0.534, 0.631, and 0.517, respectively) and the MRS score after 3 months (R Spearman 0.620, 0.657, and 0.617, respectively). No statistically significant correlation was found between S100B levels and the delta NIHSS. Analysis of the ROC curve confirmed a high sensitivity and specificity for S100B. The calculated AUC for the NIHSS on day 9 were 90.2%, 95.0%, and 82.2%, respectively, and for the MRS, 83.5%, 83.4%, and 84.0%, respectively. After determining the S100B cut-off, the odds ratio for beneficial effect (NIHSS ≤ 8 at day 9 or MRS 0-2 after 3 months) was determined for each sampling point. S100B is a useful marker for predicting short- and long-term functional outcomes in patients with ischemic stroke.

Effects of parecoxib on postoperative cognitive dysfunction and serum levels of NSE and S100β in elderly patients undergoing surgery.

To investigate the effects of parecoxib on postoperative cognitive dysfunction, and serum levels of neuron-specific enolase (NSE) and S100β protein (S100β) in elderly patients undergoing surgery. The retrospective cohort study method was used to collect the clinical data of 94 elderly patients who underwent elective orthopedic and general anesthesia surgery in our hospital from September 2020 to February 2022. 94 patients were divided into the control group (47 cases) and the study group (47 cases), according to different intervention methods. In the study group, 40 mg of parecoxib was injected intravenously into patients 30 min before the induction of anesthesia, and the patients in the control group were given the same dose of normal saline intravenously before the operation. The basic clinical data of the patients were collected. The levels of the indexes before operation and 6 hours after operation were compared between the two groups, including the Montreal Cognitive Scale (MoCA) score, inflammatory factor indicators [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), interleukin-10 (IL-10), interleukin-1β (IL-1β), monocyte chemokine-1 (MCP-1), and inducible nitric oxide synthase (iNOS)], serum cortisol (CORT), beta-amyloid (β-AP), adiponectin (ADP), NSE, and S100β. No significant differences in the preoperative MoCA score, TNF-α, IL-6, CRP, IL-10, IL-1β, MCP-1, iNOS, CORT, β-AP, ADP, NSE, and S100β levels were observed between the two groups (p>0.05). The postoperative MoCA score in the study group was significantly higher than that in the control group (p<0.05). The postoperative levels of TNF-α, IL-6, CRP and IL-1β in the study group were significantly lower than those in the control group (p<0.05), and the postoperative levels of IL-10, MCP-1 and iNOS in the study group were significantly higher than those in the control group (p<0.05). Parecoxib can notably inhibit the levels of postoperative inflammatory cytokines, improve neurological dysfunction, and reduce the occurrence of postoperative cognitive dysfunction in patients. The contents of serum NSE and S100β have potential value in the diagnosis of postoperative cognitive dysfunction in elderly patients.

Molecular biomarkers in Electrohypersensitivity and Multiple Chemical Sensitivity: How They Can Help Diagnosis, Follow-Up, and in Etiopathologic Understanding.

Electrohypersensitivty (EHS) and multiple chemical sensitivity (MCS) are new worldwide emerging neurologic disorders in the framework of sensitivity-related environmental pathology. We have recently extended and confirmed our previous observation showing that EHS and MCS share clinically identical symptoms and may co-exist as a unique, common, sensitivity-related neurologic syndrome in 25% of the cases. There is presently no published biological study of these disorders, except the one we have previously published as preliminary. In the present study, we show that EHS and MCS and the combined syndrome share identical biochemical changes. More precisely, by measuring levels of peripheral blood and urine molecular biomarkers in a cohort of 2,018 consecutive cases, we show that both disorders and the combined syndrome can be objectively characterized, in about 90% of the cases, by a decrease in the production of 6-hydroxymelatonin sulfate in urine, while in 30-50% they are characterized by increased levels of histamine and of heat shock proteins (HSP) 27 and/or 70, and of protein S100B and nitrotyrosine in the peripheral blood. Increased levels of histamine and HSP are indicators of low grade inflammation while increased levels of protein S100B and nitrotyrosine are indicators of blood-brain barrier disruption/opening. In addition, we show that in about 15% of the cases anti-myelin autoantibodies can be detected in the peripheral blood, accounting for the occurrence of an autoimmune response. Sensitivity, specificity and reproducibility of the biochemical tests are discussed, as well as the role of these indicators used as biomarkers for the diagnosis and follow-up of patients. We also discuss cases with undetectable biological change for which they can be nevertheless diagnosed by cerebral neurotransmitters analysis in urine and brain imaging. On the basis of these biological data it is suggested that EHS and/or MCS are new brain disorders, generated via a common etiopathogenic mechanism.

The usefulness of S100ß protein and fractalkin in predicting traumatic brain injury in pediatric patients with minor head trauma

Aims: In this study it was aimed to demonstrate the effectiveness of S100B protein levels which are biomarkers related to central nervous system, and fractalkin levels, which are known to play a role in inflammation processes in prediction trauma induced brain damage. Methods: Patient aged 2 to 18 years who came to the emergency department due to minor head trauma and underwent brain ct were included in our study. It was investigated whether there was a relationship between the two groups, according to the causes of trauma, symptoms at presentation and the level of serum s100b and FCN according to the lesions detected in CCT. Results: The other symptoms including Vomiting, retrograde amnesia, loss of consciousness, confusion, post traumatic amnesia is significantly higher in patients with brain lesions (p&lt;0,05). Patients with lesions on BCT have significantly low Glassgow coma score. (p&lt;0,05). Patients with lesions on BCT have a significantly high S100B and FKN levels. (p&lt;0,05). S100B area under the curve (CUA) 0.700 sensivity is 55%, spesificity is 87.5%. FKN CUA 0,785, sensitivity is 62.5% specifisity is 85%. Conclusions: As a result, the child patients with BCT lesions from minor cranial trauma levels for S100B and FKN levels are significantly higher and can be a criteria for BCT usage in emergency medicine.

Significance of S100B Protein as a Rapid Diagnostic Tool in Emergency Departments for Traumatic Brain Injury Patients.

Traumatic brain injuries (TBIs) are not only the leading cause of death among people below 44 years of age, but also one of the biggest diagnostic challenges in the emergency set up. We believe that the use of serum biomarkers in diagnosis can help to improve patient care in TBI. One of them is the S100B protein, which is currently proposed as a promising diagnostic tool for TBI and its consequences. In our study, we analyzed serum biomarker S100B in 136 patients admitted to the Emergency Department of the Regional Specialist Hospital in Olsztyn. Participants were divided into three groups: patients with head trauma and alcohol intoxication, patients with head trauma with no alcohol intoxication and a control group of patients with no trauma or with injury in locations other than the head. In our study, as compared to the control group, patients with TBI had a significantly higher S100B level (both with and without intoxication). Moreover, in both groups, the mean S100B protein level was significantly higher in patients with pathological changes in CT. According to our study results, the S100B protein is a promising diagnostic tool, and we propose including its evaluation in routine regimens in patients with TBI.

The role of oxidative stress levels and S100B levels in children with functional neurological disorder

Background/Aim: Although stressors and traumatic life events are known to be predisposing factors for developing functional neurological disorder (FND), the etiology of the disorder has not been fully elucidated. In this study, oxidative stress parameters and serum levels of S100B protein were investigated in pediatric patients with functional neurological disorder. The association of these parameters with stress factors and traumatic life events was investigated. Methods: This case-control study included a control group of 35 patients aged 8-18 years and 32 healthy subjects diagnosed with functional neurological disorder. The Childhood Trauma Scale and Dissociative Experiences Scale were applied to both groups. Serum levels of the patient and control groups were compared by blood sampling: total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and S100B. Results: It was found that the Childhood Trauma Scale total score, emotional neglect, emotional abuse, physical neglect and the Dissociative Experiences Scale were statistically significantly higher in the FND group than in the control group (P˂0.001, P˂0.001, P=0.013, P=0.017, P˂0.001). Stressors were found to be statistically significantly higher in the FND group than in the control group (P=0.020). There was no statistical difference between the FND group and control groups regarding the TAS, TOS, OSI, and S100B levels (P=0.965, P=0.228, P=0.268, P=0.517, respectively). Conclusion: Our study is the first to investigate TOS, TAS, OSI and S100B in children with FND. In our study, although stressors and traumatic experiences were significantly higher in the functional neurological disorder group compared to the control group according to the stress susceptibility model, contrary to expectations, there was no significant difference in oxidative stress parameters and serum S100B levels. It was thought that the interaction between FND, which is characterized by biopsychosocial interaction and can manifest itself with various clinical symptoms, and stress may not be linear as initially thought, and the interaction between genetic predisposition and environmental factors may play a more complex role. The absence of significant differences observed in oxidative stress parameters and serum S100B levels may suggest that we should focus on different pathways and different potential biomarkers that need to be investigated in the future to understand the etiology and diagnosis of FND. However, the limitations noted above may affect the generalizability of the study findings.

Abstract 208: Evaluating the Predictive Power of Serum Biomarkers Neuron-Specific Enolase, S-100B Protein, and Neurofilament Light Chain for Neurological Outcomes Following Cardiac Arrest: A Diagnostic Accuracy Meta-Analysis

Introduction: The assessment of serum biomarkers, specifically Neuron-Specific Enolase, S-100B protein, and Neurofilament Light Chain, at 24 hours post-cardiac arrest is under investigation for its ability to predict brain injury. Aim: This study aims to evaluate the accuracy of serum biomarkers NSE, S-100B protein, and NFL predicting post-cardiac arrest neurological outcomes. Methods: A systematic search up to December 2022 across PubMed, Embase, and Scopus identified studies examining the association between 24-hour serum levels of NSE, S-100B protein, or NFL and neurological outcomes post-cardiac arrest. Statistical analyses were conducted using R software with mada package to pool sensitivity, specificity, false-positive rates, diagnostic odds ratios, and positive and negative likelihood ratios; each expressed with a 95% Confidence Interval. Results: We incorporated 3 studies, with 759 patients in S-100B protein group, 753 in NSE group, and 799 in NFL group. At 24 hours post-cardiac arrest, NSE showed a pooled sensitivity of 37.7% (95% CI: 24.4-53.2%, I2=85.7%) and specificity of 85.5% (95% CI: 81.6-88.7%, I2=0%). S-100B protein demonstrated a pooled sensitivity of 54.7% (95% CI: 32.1-75.5%, I2=94.8%) and specificity of 81% (95% CI: 66.9-90.1%, I2=82.3%). NFL exhibited a pooled sensitivity of 88.1% (95% CI: 47.7-98.4%, I2=93.8%) and specificity of 93.6% (95% CI: 85.4-97.3%, I2=77.7%). The diagnostic odds ratios were 3.57 (95% CI: 1.79-7.15) for NSE, 5.15 (95% CI: 1.55-17.14) for S-100B protein, and 108.65 (95% CI: 11.02-1071.24) for NFL. The positive Likelihood Ratios were 2.61 (95% CI: 1.64-4.14) for NSE, 2.88 (95% CI: 1.37-6.06) for S-100B protein, and 13.87 (95% CI: 5.64-33.69) for NFL, while the negative Likelihood Ratios were 0.73 (95% CI: 0.57-0.93) for NSE, 0.19 (95% CI: 0.9-0.33) for S-100B protein, and 0.06 (95% CI: 0.03-0.15) for NFL. Conclusion: Brain biomarkers NSE, S-100B protein, and NFL, especially NFL, with its superior sensitivity and specificity, are promising in predicting neurological outcomes post-cardiac arrest, aiding clinicians in patient management and family communication. The limited number of studies and heterogeneity in results necessitate further validation and research of their predictability.

Predictive effects of S100β and CRP levels on hemorrhagic transformation in patients with AIS after intravenous thrombolysis: A concise review based on our center experience.

Hemorrhagic transformation (HT) is one of the most dangerous complications after intravenous thrombolysis in patients with acute ischemic stroke (AIS). Therefore, we want to explore the predictive effects of peripheral blood S100β and C-Reactive Protein (CRP) levels on hemorrhagic transformation after intravenous thrombolysis in AIS patients. Ninety-two AIS patients who had been treated in Huai'an Second People's Hospital from January 2018 to December 2021 were retrospectively selected. Patients were divided into hemorrhagic transformation (HT) groups (24 cases) and no HT groups (68 cases) based on whether there was hemorrhagic transformation within 24 h after intravenous thrombolysis. General clinical data from the HT group and no HT group were compared. A multivariate logistic regression model was used to analyze the potential risk factors of HT after intravenous thrombolysis in patients with AIS. A receiver operating curve (ROC) was used to analyze the predictive value of risk factors for HT. High serum S100β, CRP levels, and National Institutes of Health Stroke Scale (NIHSS) scores were found to be risk factors for HT after intravenous thrombolysis in patients with AIS (all P < .05). The ROC curve analysis showed that critical value of S100β, CRP level, and NIHSS score for predicting intravenous thrombolytic HT in AIS patients were 0.335, 8.700, and 14.50, respectively, and their sensitivities were 0.750, 0.971, and 0.333 (P < .05), respectively. High serum S100β and CRP levels are risk factors for HT after intravenous thrombolysis in AIS patients and have predictive influence of the occurrence of HT in AIS patients.

Serum Levels of S100B Protein and Myelin Basic Protein as a Potential Biomarkers of Recurrent Depressive Disorders.

Nowadays, nervous tissue damage proteins in serum are considered promising drug targets and biomarkers of Mood Disorders. In a cross-sectional naturalistic study, the S100B, MBP and GFAP levels in the blood serum were compared between two diagnostic groups (patients with Depressive Episode (DE, n = 28) and patients with Recurrent Depressive Disorder (RDD, n = 21)), and healthy controls (n = 25). The diagnostic value of serum markers was assessed by ROC analysis. In the DE group, we did not find changed levels of S100B, MBP and GFAP compared with controls. In the RDD group, we found decreased S100B level (p = 0.011) and increased MBP level (p = 0.015) in comparison to those in healthy controls. Provided ROC analysis indicates that MBP contributes to the development of a DE (AUC = 0.676; 95%Cl 0.525-0.826; p = 0.028), and S100B and MBP have a significant effect on the development of RDD (AUC = 0.732; 95%Cl 0.560-0.903; p = 0.013 and AUC = 0.712; 95%Cl 0.557-0.867; p = 0.015, correspondingly). The study of serum markers of nervous tissue damage in patients with a current DE indicates signs of disintegration of structural and functional relationships, dysfunction of gliotransmission, and impaired secretion of neurospecific proteins. Modified functions of astrocytes and oligodendrocytes are implicated in the pathophysiology of RDD.