S100B Protein Concentrations Research Articles

Disturbance in Venous Outflow From the Cerebral Circulation Intensifies the Release of Blood-Brain Barrier Injury Biomarkers in Patients Undergoing Cardiac Surgery

Disturbances in venous outflow from the cerebral circulation may result in brain injury. Severe increases in brain venous pressure lead to brain ischemia and, subsequently, brain edema and intracranial hemorrhages. The purpose of this study was to determine the effect of changes in jugular venous bulb pressure (JVBP) on plasma blood brain-barrier biomarkers concentration and disturbances in arteriovenous total and ionized magnesium (a-vtMg and a-viMg) in brain circulation in patients undergoing coronary artery bypass grafting surgery (CABG) with cardiopulmonary bypass (CPB). Prospective observational study. Department of Cardiac Surgery at a Medical University Hospital. Ninety-two adult patients undergoing elective CABG with CPB under general anaesthesia were studied. Central venous pressure (CVP) was measured using a pulmonary artery catheter. The right jugular vein was cannulized retrogradely for jugular venous bulb pressure (JVBP) measurement. Concentrations of plasma S100β protein, matrix metalloproteinase 9 (MMP-9), creatine kinase isoenzyme BB (CK-BB) a-vtMg and a-viMg were measured as the markers of blood-brain barrier dysfunction. All of them were analyzed in comparison with JVBP during surgery and the early postoperative period. Elevated JVBP was noted after CPB and after surgery. Its increase above 12 mmHg intensified release of S100β, MMP-9 and CK-BB as well as disorders in a-vtMg and a-viMg. CVP correlated with JVBP, S100β, and MMP-9. Moreover, JVBP correlated with S100β and MMP-9. Cardiac surgery increased JVBP, and JVBP elevated above 12 mmHg intensified an increase in biomarkers of plasma blood-brain barrier disruption.

Effects of different sedation depths of propofol on brain injury in patients undergoing cardiac valve replacement with cardiopulmonary bypass

Objective To evaluate the effects of different sedation depths of propofol on brain injury in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty-five ASA physical status Ⅲ or Ⅳ patients of both sexes,aged 26-64 yr,weighing 50-85 kg,scheduled for elective cardiac valve replacement with CPB,were divided into 3 groups according to intraoperative sedation depths (n =15each):30 ≤ bispectral index (BIS) value ＜ 40 (group A) ; 40 ≤ BIS value ≤ 50 (group B) ; 50 ＜ BIS value ≤ 60(group C).Anesthesia was induced with iv injection of lidocaine,midazolam,sulfentanil,etomidate and vecuronium.The patients were tracheally intubated and mechanically ventilated.PET CO2 was maintained at 35-45 mm Hg.Anesthesia was maintained with iv infusion of propofol at a rate of 7,5 and 3 mg· kg-1 · h-1 in A,B and C groups,respectively,intermittent iv boluses of sulfentanil and pipecuronium,and intermittent inhalation of sevoflurane.The infusion rate of propofol was adjusted to maintain the corresponding anesthesic depth in each group.Before CPB (T1),at 30 min of CPB (T2),immediately after termination of CPB (T3) and at 1 h after the end of CPB (T4),blood samples were obtained from the jugular bulb vein and radial artery for determination of plasma S-100β protein concentration and for blood gas analysis,and the arterial to venous blood oxygen content difference (Dj-aO2),cerebral O2 extraction rate (CERO2) and jugular bulb venous to arterial blood lactic acid content difference (Dj-aL) were calculated.Results Compared with group C,the plasma S-100β protein concentrations were significantly decreased,SjvO2 was increased,and Dj-aO2 and CERO2 were decreased at T3-4,and Da-jL was decreased at T3 in groups A and B (P ＜ 0.05).Compared with group B,the plasma S-100β protein concentrations were significantly decreased at T3-4,SjvO2 was increased at T2,Da-jO2 and CERO2 were decreased at T2,and DajL was decreased at T3 in group A (P ＜ 0.05).Conclusion Moderately deepened anesthetic depth of propofol (30≤ BIS value ＜ 40) is helpful in attenuating the brain injury in patients undergoing cardiac valve replacement with CPB. Key words: Propofol; Conscious sedation; Cardiopulmonary bypass; Brain injuries

Neuroprotein Dynamics in the Cerebrospinal Fluid: Intraindividual Concomitant Ventricular and Lumbar Measurements

Objective: The measurement of neuromarker/neuroproteins in the cerebrospinal fluid (CSF) is gaining increased popularity. However, insufficient information is available on the rostrocaudal distribution of neuroproteins in the CSF to guarantee an appropriate interpretation of ventricular versus lumbar concentrations. Methods: In 10 patients treated with both an external ventricular and a lumbar CSF drain, we collected concomitant CSF samples. We measured CSF concentrations of the glial S100B protein, the neuron-specific enolase (Cobas e411®; Roche Diagnostics), the leptomeningeal β-trace protein (BN Pro Spec®; Dade Behring/Siemens), and the blood-derived albumin (Immage; Beckman Coulter). Statistical analysis was performed with a paired Wilcoxon signed ranks test. Results: In patients with a free CSF circulation without any recent neurosurgical procedure, S100B and neuron-specific enolase concentrations did not differ between the ventricular and lumbar CSF while β-trace and albumin levels were significantly higher in the lumbar than in the ventricular CSF (p = 0.008 and p = 0.005). Following posterior fossa tumor surgery, all proteins accumulate in the lumbar CSF. Conclusion: For brain-derived proteins, we could not confirm a rostrocaudal CSF gradient while lepto-meningeal and blood-derived proteins accumulate in the lumbar CSF. We conclude that for the interpretation of protein CSF concentrations, the source of the sample is of crucial importance.

The effect of combined hyperbaric oxygen and iloprost treatment on the prevention of spinal cord ischaemia–reperfusion injury: an experimental study

Hyperbaric oxygen (HBO) has been shown to be effective in preventing neurological injuries in animal models of ischaemia, whereas iloprost (IL) prevents ischaemia-related mitochondrial dysfunction and reduces infarction size after focal cerebral ischaemia in animal models. The aim of the present study was to investigate the effect of combined HBO and IL treatment on spinal cord ischaemia-reperfusion (IR) injury by neurological, histopathological and biochemical methods in an experimental study. Eighty New Zealand white male rabbits were randomly allocated into one of five study groups. The HBO group received a single session of HBO treatment and the IL group received an infusion of 25 ng/kg/min IL; the HBO + IL group received both HBO and IL and the control group received only 0.9% saline; the fifth group was the sham group. Levels of S100β protein, neuron-specific enolase (NSE) and nitric oxide (NO) were measured at onset, at the end of ischaemia period and at the 24th and 48th hour of reperfusion. Physical activity was assessed using Tarlov criteria 24, and the spinal cords of the sacrificed rabbits were evaluated histopathologically. Additionally, tissue malondialdehyde (MDA) and antioxidant enzyme activities [total superoxide dismutase (SOD); catalase (CAT) and glutathione peroxidase (GSH-Px) were assessed. Neurological scores in the HBO, IL and HBO + IL groups were statistically significantly better compared with the control group at the 24th (P = 0.001 for all) and 48th hour (P = 0.001 for all). Histopathological scores in the HBO, IL and HBO + IL groups were also significantly better compared with the control group (P = 0.003, 0.001 and 0.001, respectively). Whereas MDA, NSE, S100β protein and NO concentrations were significantly lower, CAT and GSH-PX levels were significantly higher in either sham or treatment groups compared with the control group. Since we demonstrated beneficial effects on spinal cord IR injury, we think that both HBO and IL, either alone or in combination, may be reasonable in the treatment of IR injury. Furthermore, there did not appear to be synergistic effects with combined treatment. More research is needed for practical application in humans, following thoracoabdominal aortic surgery.

Impact of Different Surgical Strategies on Perioperative Protein S100β Release in Elderly Patients Undergoing Coronary Artery Bypass Grafting

This study was designed to compare neurological injury-associated protein S100β release during three different treatment modalities, minimized closed circuit coronary artery bypass grafting (CABG) (MCABG), off-pump CABG (OPCAB), and conventional CABG (CCABG), comprising high-volume prime and cold crystalloid cardioplegia. Our working hypothesis was that fluid restriction as provided by MCABG may decrease neurological injury-associated protein S100β release. In this prospective trial, in a tertiary center, 30 surgical patients (aged >70 years, 25 men and 5 women) undergoing first-time elective CABG were enrolled. The inclusion criteria were three-vessel disease and elective surgery. The exclusion criteria were left ventricular ejection fraction of less than 30%, use of clopidogrel, carotid disease, or needing fewer than three distal anastomoses. Protein S100β concentrations, hematocrit (Ht) levels, and PO2 levels were measured after induction of anesthesia, 10 minutes after reperfusion, upon arrival at the intensive care unit, 3 hours postoperatively at the intensive care unit, and the next morning. Statistics consisted of areas under the curve, peak levels, and correlation and variance tests. A significant negative correlation was found indicating higher S100β release at lower Ht levels and at lower PO2 levels in all study groups. The lowest S100β variance was measured during MCABG (Wilks Λ P = 0.052). The perioperative Ht was significantly higher in the MCABG group and in the OPCAB group compared with the CCABG group (P = 0.04 vs P < 0.01). At all time points, the S100β protein concentration showed no significant differences between the different surgical techniques. The mean (95% confidence interval) values of S100 area under the curve were the following: CCABG, 2.3 (1.06-3.5); MCABG, 1.44 (0.6-2.21); and OPCAB, 1.87 (1.5-2.19) [independent nonparametric Kruskal-Wallis test (P = 0.13)]. The mean (95% confidence interval) peak S100 values (calculated as the maximum value seen in a patient during the research period) were the following: CCABG, 1.07 (0.4-1.68); MCABG, 0.59 (0.28-0.90); and OPCAB, 0.83 (0.59-1.06) [independent nonparametric Kruskal-Wallis test (P = 0.22)]. Despite similar perioperative S100β protein release for all techniques studied, higher Ht and PO2 levels correlated with lower S100β release within all study groups. The low S100β variance during the fluid restrictive MCABG technique may be due to more efficient oxygen transport to the brain provided by significantly higher perioperative Ht levels. Further prospective data are required to better understand this complex issue.

Predictive value of S-100β protein for prognosis in patients with moderate and severe traumatic brain injury: systematic review and meta-analysis

Objectives To determine the ability and accuracy of the S-100β protein in predicting prognosis after a moderate or severe traumatic brain injury.Design Systematic review and meta-analysis of randomised controlled trials...

Summer/winter changes in serum S100B protein concentration as a source of research variance

BackgroundS100B is a calcium binding protein that can be measured in cerebral and extra cerebral biological tissues and fluids. Circadian and seasonal variations have been described in several biological molecules such as melatonin, cortisol and testosterone. Healthy subjects do not have a circadian rhythm of S100B. There is no information on seasonal variations of S100B levels. The aim of this research is to study whether healthy subjects present summer/winter changes in serum S100B protein concentrations. MethodsNinety-eight subjects were studied in summer, of those, 64 participated in the winter evaluation. Blood was drawn by venipuncture at 09:00 h, 12:00 h and 00:00 h in summer and winter. Serum was separated from blood by centrifugation and stored at −70° until analysis. Serum S100B concentrations were measured by ELISA. ResultsSerum S100B concentrations were significantly higher in summer than winter (09:00 h: 43.4 ± 24.6 ng/ml vs. 29.3 ± 22.7 ng/ml, p < 0.001; 12:00 h: 42.8 ± 25.0 ng/ml vs. 23.0 ± 22.1 ng/ml, p < 0.001; 00:00 h: 44.5 ± 23.2 ng/ml vs. 28.5 ± 24.6 ng/ml, p < 0.001). Age, gender, body mass index and time points when blood was extracted did not affect serum S100B concentrations neither in summer nor in winter. ConclusionsOur results point to the fact that there is an important difference in serum S100B concentrations between summer and winter. It is strongly advisable to consider this summer/winter difference in serum S100B concentrations when researching into this area.

A preliminary study of the effects of ulinastatin on early postoperative cognition function in patients undergoing abdominal surgery

PurposeUlinastatin, a urinary trypsin inhibitor, is widely used to treat acute systemic inflammatory disorders. However, its effects on early postoperative cognitive function have not been fully elucidated. The objective of this study was to investigate the effect of ulinastatin on serum IL-6, TNF-α, CRP and S100β protein concentration and early postoperative cognitive function in patients after abdominal surgery. MethodsEighty ASAI-II patients older than 65 years, scheduled for elective abdominal surgery were randomly divided into 2 groups (n=40 each): ulinastatin and control. After induction of anesthesia, the ulinastatin group received 10,000units/kg of ulinastatin intravenously before surgical incision and 5000units/kg on post-op days 1–3. Cognitive function was assessed preoperatively and on post-op day 7 using a battery of nine neuropsychological tests. Serum IL-6, TNF-α, CRP and S100β protein levels were determined preoperatively, at the end of surgery and on post-op days 1–3. ResultsThere were significant decrements in each neuropsychological test, except for the Digit Span Backward Test between groups. Based on neuropsychological testing, the ulinastatin group had a lower incidence of postoperative cognitive dysfunction (POCD) than the control group (2.5% versus 27.5%, p<0.05). In the control group, serum S100β protein and IL-6 concentrations increased at the end of surgery and on post-op days 1 and 2. The ulinastatin group had lower serum S100β protein and IL-6 concentrations than those in the control group (p<0.05). ConclusionUlinastatin may be effective in reducing the incidence of early postoperative cognitive dysfunction.

Association between Cerebrospinal Fluid S100B Protein and Neuronal Damage in Patients with Central Nervous System Infections

PurposeS100B protein is widely used as a measure of glial activity or damage in several brain conditions. Central nervous system (CNS) infections can cause neurological sequelae because of parenchyma invasion. It is difficult to predict further neuronal damage in the CNS infection. The present study is aimed to evaluate the role of the cerebrospinal fluid (CSF) S100B protein as an indicator of neuronal damage in CNS infection.Materials and MethodsWe measured the concentration of CSF S100B protein in 62 patients with a CNS infection using an Enzyme-Linked Immunosorbent Assay. The patients with CNS infections were classified as having no neuronal damage (CNS-N) or as having neuronal damage (CNS+N) according to the presence of neurological change or structural lesions on brain MRI.ResultsThe CSF S100B protein level of the CNS+N group (n=22, 0.235 µg/L, 0.10-2.18) was significantly higher than that of the CNS-N group (n=40, 0.087 µg/L, 0.06-0.12) and control group (n=40, 0.109 µg/L, 0.07-0.14, p<0.01). Using an arbitrary cut off value, S100B-positive CSF was detected in 2.5% of the CNS-N group and in 50% of the CNS+N group (p<0.05).ConclusionThese findings suggest that increased S100B protein levels in the CSF may be associated with the neuronal damage following CNS infections.

S100b Protein Levels In Patients Admitting To Emergency Unit Due To Seizures

Objectives: Various levels of dysfunction and damage can occur in the central nervous system of patients experiencing seizures. It is known that these impairments can be assessed by measurement of biochemical markers. S100B proteins have been extensively studied in recent years. We have assessed whether there is a change in serum S100B protein levels during seizures which lead to cerebral hypoperfusion and/or hypoxia.Patients and Methods: A total of 56 patients admitted to an emergency service due to seizures and more than 18 years of age were included in the study. The control group consisted of 20 patients who were admitted to the emergency service due to complaints other than seizures. Results: There was a significant difference between the groups in terms of gender, hemoglobin levels and S100B levels, whereas there was no significant difference in terms of glucose, sodium and potassium levels. The S100B levels were significantly lower in the patient group compared to the control group. Hemoglobin levels was significantly lower in the control group compared to the patient group.Conclusion: Serum S100B protein concentration was found to be significantly lower in patients compared to controls

Elevated serum S-100B levels in children with temporal lobe epilepsy

PurposeAn elevated level of S-100B in serum is generally considered to be a biochemical marker of nervous tissue damage. According to our knowledge, no studies have evaluated the serum S-100B protein concentration in children with temporal lobe epilepsy. The objective of this study was to measure the serum levels of S-100B protein in pediatric cases with temporal epilepsy. MethodsThis case-controlled cross-sectional study was performed at the Department of Pediatric Neurology, Harran University School of Medicine, Sanliurfa, in Turkey. Serum S-100B protein levels were studied in 19 (12 females, 7 males) children with temporal lobe epilepsy and in 25 (15 females, 10 males) healthy control subjects. Serum samples were collected within 30min after a complex partial seizure, and serum S-100B protein levels were measured with an electrochemiluminescence immunoassay for the quantification of protein (ECLIA kit, Roche® Diagnostics, Germany). ResultsThe mean serum concentration of S-100B protein was 0.12±0.02μg/L in the temporal lobe epilepsy group and 0.07±0.01μg/L in the control group. The patients showed significantly elevated S-100B protein levels compared with healthy controls (P<0.001). ConclusionOur data suggest that increased S-100B protein levels in the serum might reflect neuronal damage in the brains of children with temporal lobe epilepsy. These results do confirm the previous findings of elevated S-100B protein levels in adult patients with temporal lobe epilepsy.

Level of S100B protein, neuron specific enolase, orexin A, adiponectin and insulin-like growth factor in serum of pediatric patients suffering from sleep disorders with or without epilepsy

BackgroundParoxysmal sleep disorders in children are important from both pathophysiological and clinical point of view. Correct diagnosis is crucial for further management. The aim of the present study was to identify peripheral markers of paroxysmal sleep disorders in children, which could improve diagnostics of these disorders. We compared serum levels of several putative biomarkers of neurological disorders, such as S100B protein, neuron specific enolase (NSE), orexin A, adiponectin, and insulin-like growth factor 1 (IGF-1) in pediatric patients suffering from sleep disturbances with those who additionally to parasomnia revealed also epilepsy. MethodsFifty six children from 1 month to 18 years of age hospitalized in the Pediatric Neurology Clinic, Chair of Children and Adolescent Neurology, participated in this study. Polysomnographic diagnostics was indicated due to sleep disturbances. Examination was performed with the use of polysomnography and videoelectroencephalography Grass device. Blood samples were taken before registration of sleep, after 2.5h of sleep or 0.5h after occurrence of clinical seizures. Concentrations of S100B protein, NSE, orexin A, adiponectin, and IGF-1 were measured by specific ELISA methods. ResultsThe obtained data showed that serum S100B level was significantly increased in children with epilepsy and clinical seizure attacks as compared to patients with parasomnia only. A tendency to enhanced serum S100B level was also seen in epileptic children without clinical seizures during polysomnographic recording. The level of orexin Awas significantly decreased in epileptic children without seizures as compared to the hormone level in parasomnic patients, but was elevated in patients who experienced seizures during polysomnographic examination. As S100B is regarded to be a marker of blood brain barrier leakage and astrocyte damage, the data suggest an increase in BBB permeability in epileptic children, especially during seizure fits. Furthermore, the enhanced S100B serum level without changes in NSE activity may be interpreted rather as an evidence of the elevated secretion of this protein during seizures than of the damage of brain tissue. In contrast to S100B and orexin A level, serum concentration of adiponectin and IGF-1 as well as NSE activity did not significantly differ between the studied groups. ConclusionOut of the five putative biomarkers measured, blood concentration of S100B and orexin Amay be helpful in differentiating parasomnic pediatric patients with and without epilepsy.

Serum S-100B levels in children with Subacute Sclerosing Panencephalitis

Objectives: S-100B a protein prevalent in the central nervous system is a peripheral biomarker for blood-brain barrier disruption and neuronal damage. The objective of the study was to investigate the S-100B levels in patients with subacute sclerosing panencephalitis. Materials and methods: A group of 40 patients with SSPE and 40 healthy controls were recruited. Serum S-100B protein concentrations were measured using a commercially available electrochemiluminescence immunoassay (ECLIA) kit, as supplied and according to the manufacturer's standards. Results: Median S-100B levels were 0.095 ± 0.017 μg/L in patients with SSPE and 0.097±0.019 μg/L in the control group. This difference was not statistically significant (p>0.05). The patient group was further subdivided into two subgroups according to the presence or absence of brain atrophy. The S-100B levels were 0.096 ± 0.018 μg/L in the subgroup with atrophy and 0.094±0.014 μg/L in the subgroup without atrophy. This difference was also not statistically significant (p>0.05). Conclusions: Our results suggest that serum S-100B is not a reliable marker for neuronal damage in SSPE.

Jugular venous and arterial concentrations of serum S100B protein in patients with severe head injury

It is important for physicians in intensive care units to be able to predict the presence and severity of central nervous system injury in patients with severe head injury (SHI). The extent of S100B elevation has been found to be useful in predicting clinical outcome after brain injury. However, only two studies were realized with jugular venous blood samples. The purpose of our study is to compare the interest between jugular venous and arterial concentrations evaluation of serum S100B protein in patients with SHI. We recruited 17 patients with a SHI, admitted to the intensive care unit. Paired arterial and jugular venous samples were taken at kinetically after injury. S100B median was 0.16 μg/L in arterial and 0.25 μg/L in jugular. This arterio-jugular difference is significant. However, there was any significant arterio-jugular difference in the patients group showing an unfavourable outcome or for the earlier samples (earlier than 24h). We observed there was no significant decrease of S100B in jugular, unlike in arterial, 24h after the head injury in the patients group showing an unfavourable outcome. Determination of S100B concentration in jugular samples appears to be better than in arterial to predict clinical outcome after brain injury.

Changes in plasma S-100.BETA. protein concentration in patients undergoing cardiac surgery performed with cardiopulmonary bypass

Objective To evaluate the changes in plasma S-100β protein concentration in patients undergoing cardiac surgery performed with cardiopulmonary bypass (CPB).Methods ASA Ⅱ or Ⅲ patients aged 60-77 yr weighing 55-75 kg with national institutes of health stroke scale(NIHSS) ＜ 10 undergoing coronary artery bypass grafting with CPB were enrolled in this study.Cerebral function was evaluated and scored using NIHSS at 2 d after operation.The patients were divided into 3 groups according to NIHSS scores:group A uncomplicated (NIHSS score 0-9),group B mild brain injury (NIHSS score 10-19) and group C moderate and severe brain injury (NIHSS 20-45).Plasma S-100β protein concentration was measured before CPB,at 30 min of CPB,the end of CPB and 1 h,6 h,24 h after CPB.The duration of operation,CPB time,aortic cross-clamping time and length of ICU stay and hospital stay were recorded.Results Ten patients in groups A and B and 12 in group C completed the trial.Plasma S-100β protein concentration was significantly increased during and after CPB as compared with the baseline at T0 and peaked at T3 (groups A,B) and T4 (group C).The plasma S-100β protein concentration was highest in group C and lowest in group A.The duration of operation,CPB time,aortic cross-clamping time and length of ICU stay and hospital stay were longest in group C and shortest in group A.Conclusion Plasma S-100β protein concentration can be used as a marker of cerebral injury after cardiac surgery performed with CPB and the concentration measured at 6 h after CPB is more significant in evaluating the degree of cerebral injury and prognosis. Key words: S100 proteins; Cardiopulmonary bypass; Brain injurys; Cardiac surgical procedures

Accuracy of serum S-100β protein and neuron specific enolase level in prediction of postoperative delirium in different age patients

Objective To investigate the accuracy of serum S-100β protein and neuron specific enolase (NSE) level in predication of postoperative delirium (PD) in patients of different ages.Methods Four hundred ASA Ⅰ -Ⅳ patients of both sexes weighing 40-82 kg undergoing abdominal surgery performed under general anesthesia were divided into 4 age groups:group Ⅰ 18-44 yr; group Ⅱ 45-59 yr; group Ⅲ 60-74 yr and group Ⅳ ≥75 yr.The diagnosis of PD was made by using confusion assessment method.The incidence of PD was recorded within 72 h after operation.Each group was further divided into PD and non-PD subgroups.Blood samples were taken at 1 day before operation (T1),during their stay in PACU (T2) and at 24 and 72 h after operation (T3,4 ) for determination of serum S-100β protein and NSE concentrations.The receiver operating characteristic (ROC) curve for serum S-100β protein concentration in determining the PD efficacy was plotted.Results The incidence of PD was significantly higher and the duration was significantly longer in groups Ⅲ and Ⅳ than in groups Ⅰ and Ⅱ,and in group Ⅳ than in group Ⅲ (P ＜ 0.05).There was no significant difference in the serum S-100β protein concentration between PD subgroup and non-PD subgroup in groups Ⅰ - Ⅲ ( P ＞ 0.05).Compared with that at T1 and in nonPD subgroup,the serum S-100β protein concentration was significantly increased in PD subgroup in group Ⅳ,and the serum NSE concentration was significantly decreased at T2,3 in PD subgroup in group Ⅰ (P ＜ 0.05).There was no significant difference in the serum NSE concentration between PD subgroup and non-PD subgroup in groups Ⅱ -Ⅳ.The analysis results of the ROC curve showed that:the area under the curve for the serum S-100β protein concentration and 95％ confidence interval were 0.329 (0.127-0.531),0.352 (0.168-0.536),0.619 (0.466- 0.772) and 0.921 (0.846-0.995),the sensitivity was 50％,50％,56％ and 88％,and the specificity was 29％,22％,46％ and 86％ in groups Ⅰ-Ⅳ respectively.Conclusion Increase in the serum S-100β protein concentration can be used in predicting the development of PD in patients ≥75 yr,but the serum NSE protein concentration can not be used. Key words: S100 proteins; Phosphopyruvate hydratase; Delirium; Postoperative complications

S100B proteins in febrile seizures

S100B protein concentrations correlate with the severity and outcome of brain damage after brain injuries, and have been shown to be markers of blood–brain barrier damage. In children elevated S100B values are seen as a marker of damage to astrocytes even after mild head injuries. S100B proteins may also give an indication of an ongoing pathological process in the brain with respect to febrile seizures (FS) and the likelihood of their recurrence. To evaluate this, we measured S100B protein concentrations in serum and cerebrospinal fluid from 103 children after their first FS. 33 children with acute infection without FS served as controls for the serum concentrations. In the FS patients the mean S100B concentration in the cerebrospinal fluid samples was 0.21μg/L and that in the serum samples 0.12μg/L. The mean serum concentration in the controls was 0.11μg/L (difference 0.01μg/L, 95% confidence interval −0.02 to 0.04μg/L, P=0.46). There was a correlation between age and serum S100B concentration (r=−0.28, P=0.008) in children under four years, but S100B concentrations did not predict the clinical severity of the FS nor their recurrence. There was no correlation between time of arrival at the hospital after FS and S100B concentration in serum (r=−0.130, P=0.28) or in cerebrospinal fluid samples (r=−0.091, P=0.52). Our findings indicate that FS does not cause significant blood–brain barrier openings, and increase the evidence that these seizures are relatively harmless for the developing brain.

The Use of S100B and Tau Protein Concentrations in the Cerebrospinal Fluid for the Differential Diagnosis of Bacterial Meningitis: A Retrospective Analysis

Background: Patients with meningitis are often difficult to classify into bacterial (BM) or benign viral (VM) meningitis. To facilitate the differential diagnosis, S100B and Tau protein in the cerebrospinal fluid (CSF) were measured and compared with standard laboratory parameters. Methods: S100B_CSF, Tau_CSF, and routine parameters (CSF leukocyte count, protein_CSF, lactate_CSF, serum C-reactive protein, blood leukocyte count and body temperature) were analyzed in 33 patients with microbiologically confirmed BM and in 19 with VM. Their classification accuracy, sensitivity and specificity were studied by receiver operating characteristic (ROC) curves. Results: S100B_CSF concentrations were higher in BM than in VM patients (p = 0.03) and showed a promising accuracy (90%) for the differential diagnosis of BM versus VM. Its discriminative properties were comparable to routine parameters. Of all parameters, S100B_CSF showed the highest specificity (100%) with an optimal cut-off of 3.1 ng/ml. Tau_CSF concentrations were useless for the discrimination (p = 0.64). Conclusions: In contrast to Tau_CSF, S100B_CSF concentrations ≧3.1 ng/ml are promising to discriminate bacterial from viral meningitis.

Concentration changes of serum neuron-specific enolase and S100β protein in response to edaravone in patients with moderate and severe brain injury

Objective To evaluate the effect of edaravone on moderate and severe brain injury patients by observing the change of the serum neuron-specific enolase ( NSE) and S100β protein. Methods A total of 90 patients with acute moderate and severe brain injury were selected and randomly divided into three groups, ie, control group (Group A), postoperative edaravone treatment group (Group B) and preoperative edaravone treatment group (Group C), 30 patients per group. In the meantime, 20 normal persons were set as the healthy control group. The concentrations of serum NSE and S100β protein of each group was measured by using the enzyme-linked immunosorbent assay ( ELISA) on admission and at days 1,3,5 and 7 after operation. Results The serum NSE and S100β protein levels in the Group A, B and C was higher than that in the healthy group on admission and at days 1,3,5 and 7 postoperatively and reached the peak at day 1 after operation (P ＜0.05). The level of serum NSE and S100β protein in the Group C was lower than that in the healthy group, Group A and Group B at day 1 postoperatively (P＜0.05), with no statistical difference between Group B and Group A at day 1 postoperatively (P ＞0.05). The serum NSE and S100β protein levels in the Group C was lower than that in the Group A at days 3, 5 and 7 postoperatively (P ＜0.05). The serum NSE and S100β protein levels in the Group C with severe brain injury was lower than that in the Group B at days 3, 5 and 7 postoperatively (P ＜ 0.05), but there was no statistical difference in moderate injury group between Croup C and Group B. The serum NSE and S100β levels in the Group B was lower than that in the Group A at days 3, 5 and 7 postoperatively ( P ＜ 0. 05). Conclusions Edaravone can effectively reduce the serum NSE and S100β levels in the moderate and severe brain injury patients after operation. The earlier use of edaravone may beget the more significant effect, especially in patients with severe brain injury. The application of edaravone before operation can more effectively reduce the concentration of serum NSE and S100β protein. Key words: Brain injuries; Phosphopyruvate hydratase; S100 proteins; Edaravone

S100B Protein, Brain-Derived Neurotrophic Factor, and Glial Cell Line-Derived Neurotrophic Factor in Human Milk

BackgroundHuman milk contains a wide variety of nutrients that contribute to the fulfillment of its functions, which include the regulation of newborn development. However, few studies have investigated the concentrations of S100B protein, brain-derived neurotrophic factor (BDNF), and glial cell line-derived neurotrophic factor (GDNF) in human milk. The associations of the concentrations of S100B protein, BDNF, and GDNF with maternal factors are not well explored.Methodology/Principal FindingsTo investigate the concentrations of S100B protein, BDNF, and GDNF in human milk and characterize the maternal factors associated with their levels in human milk, human milk samples were collected at days 3, 10, 30, and 90 after parturition. Levels of S100B protein, BDNF, and GDNF, and their mRNAs in the samples were detected. Then, these concentrations were compared with lactation and other maternal factors. S100B protein levels in human milk samples collected at 3, 10, 30, and 90 d after parturition were 1249.79±398.10, 1345.05±539.16, 1481.83±573.30, and 1414.39±621.31 ng/L, respectively. On the other hand, the BDNF concentrations in human milk samples were 10.99±4.55, 13.01±5.88, 13.35±6.43, and 2.83±5.47 µg/L, while those of GDNF were 10.90±1.65, 11.38±1., 11.29±3.10, and 11.40±2.21 g/L for the same time periods. Maternal post-pregnancy body mass index was positively associated with S100B levels in human milk (r = 0.335, P = 0.030<0.05). In addition, there was a significant correlation between the levels of S100B protein and BDNF (z = 2.09, P = 0.037<0.05). Delivery modes were negatively associated with the concentration of GDNF in human milk.ConclusionsS100B protein, BDNF, and GDNF are present in all samples of human milk, and they may be responsible for the long term effects of breast feeding.