Serum S100 Levels Research Articles

Diagnostic value of Elecsys S100 as a marker of acute brain injury in the emergency department

The aim of this study was to evaluate the screening and diagnostic validity of the initial serum S100 levels by Elecsys S100 immunoassay in an emergency department. We measured serum S100 in 101 acute brain injury (ABI) patients, in 40 healthy subjects, and in 41 chronic brain injury (CBI) patients (the control group). The ABI patients were divided in several groups according to the Glasgow Coma Scale (GCS), injury type and findings of brain imaging. Of the 101 patients, the 66 cranial computed tomography (CCT) or brain magnetic resonance imaging (MRI)-positive patients showed higher S100 levels than did the 35 CCT/MRI-negative patients (P=0.028). At a cutoff of 0.105 microg/L, the sensitivity was 84.8% and the specificity 74.3% for all of the ABI patients, and the sensitivity was increased to 96.9% for the traumatic ABI patients for detecting image-positive ABI. There was no significant difference of S100 levels among the groups on the CCT or MRI pathological findings (P=0.478). In conclusion, serum S100 levels can be used in the emergency department as an additional screening tool to identify CCT- or MRI-positive ABI.

Profile of Serum S100β Levels during Maturation in Fetal and Neonatal Sheep

Serum levels of the protein S-100beta are dependent on three factors: rate of production, permeability of the blood-brain barrier, and rate of clearance. In the developing fetus and neonate all of these factors change at different rates. This study was performed to determine how serum S-100 levels varied during fetal and early postnatal life. Blood samples were obtained from 41 fetal and neonatal lambs. The blood was separated in a centrifuge and the serum drawn off and assayed for S-100beta using a commercially available radioimunoassay kit. S-100beta did not appear in the blood until halfway through pregnancy. Thereafter, levels steadily increased until 1 month after birth. Following this, S-100beta levels decreased progressively until by 1 year of age, they had reached a plateau. S-100beta levels change significantly with normal fetal and neonatal maturation. Valid interpretation of other data from subjects of similar developmental stage must take into consideration this physiological variation.

Comparison of serum S-100 protein levels following stroke and traumatic brain injury

Temporal changes in serum S-100 protein levels were compared between patients with ischemic stroke, transient ischemic attack (TIA) and traumatic brain injury (TBI). In addition, S-100 levels were correlated with clinical severity and outcome. Measurements were done with a LIA-mat ® Sangtec ® 100 using an automated immunoluminometric assay. Serum S-100 was measured in 21 stroke patients, 18 TIA patients and ten TBI patients on days 1 (0–24 h), 2, 3, 4, 5 or 6 and 8 or 9. In a control group of 28 healthy volunteers one measurement was done. For the stroke and TIA patients, National Institutes of Health Stroke Scale (NIHSS) scores were obtained on admission and on day 10. For the TBI patients, Glasgow Coma Scale (GCS) scores were obtained on admission and Glasgow Outcome Scale (GOS) scores were obtained after 6 months. Changes in serum S-100 levels over the first 3 days were significantly different between stroke and TBI patients ( P=0.014) and between stroke and TIA patients ( P=0.006). Peak concentrations of S-100 were most often observed on day 3 or 4 after stroke and on day 1 or 2 after TBI. In the stroke patients individual S-100 peak levels correlated well with the NIHSS score on admission ( r=0.58 P=0.014) and the change in NIHSS score between day 10 and day 1 ( r=0.65, P=0.005). In the TBI patients a good correlation between individual peak levels of S-100 and the GCS score on admission ( r=−0.81, P=0.010) and the GOS score 6 months after the trauma was found ( r=−0.87, P=0.004). We conclude that there is a significant difference in temporal changes of S-100 levels between ischemic stroke and TBI patients. This suggests different pathophysiological mechanisms. The results of this study further confirm that peak levels of serum S-100 correlate with neurological deficit resulting from either stroke or TBI.

S-100 after correction of congenital heart defects in neonates: is it a reliable marker for cerebral damage?

Background. Newborns undergoing cardiac operation may acquire some extent of neuronal damage. An early diagnosis is especially hard regarding neonates. In the past years, S-100 has been widely discussed as a marker revealing perioperative damage to the brain.Methods. Sequential blood samples from 33 neonates undergoing repair of congenital heart disease were taken perioperatively. Samples of 12 healthy neonates were taken at birth as a control group. The newborns were divided into four groups: cyanotic and acyanotic disease operated on in deep hypothermic circulatory arrest, operation without deep hypothermic cardiac arrest, and operation without extracorporeal circulation.Results. Even in healthy neonates, serum S-100 levels were at 10-fold values compared with adults. On admission, S-100 values in the operative groups were similar. During extracorporeal circulation, levels rose to a certain degree. Cyanotic newborns operated on in deep hypothermic cardiac arrest had significantly higher S-100 levels compared with acyanotic newborns also operated on in deep hypothermic cardiac arrest (p < 0.001). Two newborns who experienced seizures postoperatively had the highest absolute S-100 levels. One child with a poor neurologic outcome but no seizures did not have different values when compared with her group.Conclusions. In this study, S-100 seemed to be a possible marker for a certain degree of neurologic deficit after cardiac operation in neonates, especially regarding postoperative seizures. The missing peaks of this protein in one newborn with poor neurologic outcome show that it is not possible to exclude damage to the brain with normal postoperative values. These results suggest that the mechanism of cerebral damage and S-100 release into the blood in neonates with a developing central nervous system and blood–brain barrier is not fully understood.

S100 protein serum levels in cutaneous malignant melanoma.

We investigated the utility of serum S100 determined by means of immunoradiometric assay in a cohort of 438 patients affected by cutaneous melanoma (126 untreated and 312 previously treated). Using 0.2 microg/l cut-off value, determined in 134 healthy blood donors, the sensitivity was 4.2% in stage I patients (4/94), 5.3% in stage II patients (1/19), and 38.5% in stage III patients (5/13). Even though the sensitivity increased progressively from stage I to stage II and III, these differences were not statistically significant. The prognostic significance of S100 evaluation at diagnosis was investigated in terms of survival but no statistical correlation between S100 basal levels and survival was found. In the 312 previously treated patients serum S100 levels were correlated to disease extent, high levels of the marker were observed in 42.8% (9/21) of patients with local recurrence, in 32% (16/50) of patients with lymph node and/or in-transit metastases, in 77.3% (17/22) of patients with distant metastases, and in patients with NED, the specificity of the marker was 96.8% (212/219). The difference between these groups were statistically significant. In conclusion, S100 protein was abnormally high in patients with metastatic malignant melanoma. Serial S100 measurements in a follow-up study are necessary to test the importance of the protein in the management of patients with metastatic malignant melanoma.

Correlation Between CSF and Serum S-100 Protein after Cerebral Ischemia in Pigs on Cardiopulmonary Bypass

Introduction: One potential marker of central nervous system damage during cardiac surgery is the astroglial protein S-100, which has been shown to increase with the duration of cardiopulmonary bypass (CPB) [1]. However, recovery of the S-100 protein in blood has not been directly correlated with functional or histopathological outcomes after CPB. Part of the diagnostic problem may be related to whether concentration of this protein marker in the serum correlates with cerebrospinal fluid (CSF). In a porcine model of global cerebral ischemia during CPB, we examined the presence of S-100 in the sagittal sinus after bypass and correlated serum and CSF S-100 levels. Methods: In an approved study, sagittal sinus catheters were placed in 40 anesthetized pigs. Animals were cannulated and placed on CPB. Baseline serum S-100 levels from the sagittal sinus were obtained. Electroencephalographic (EEG) signals from scalp needle electrodes assessed the severity of cerebral ischemia. All animals underwent 15 minutes of global cerebral ischemia produced by temporarily ligating the innominate and left subclavian arteries followed by reperfusion. Thirty minutes after discontinuing CPB, a needle was inserted into the cisterna magna to collect CSF; simultaneously, a sample of sagittal sinus blood was aspirated. S-100 protein contents were analyzed using a monoclonal immunoradiometric assay (Sangtec Medical, Sweden). Results: Cerebral ischemia was confirmed by total loss of EEG activity. Sagittal sinus S-100 levels at baseline were 0.09 +/- 0.06 [micro sign]g/L and increased significantly after ischemia (0.24 +/- 0.22 [micro sign]g/L; p<0.05). After bypass, CSF S100 levels were significantly greater than corresponding serum concentrations: 4.35 +/- 3.1 [micro sign]g/L (p<0.05). There was a weak linear correlation (r=0.37) between serum and CSF S-100 concentrations after CPB (p<0.02; Figure 1).Figure 1Discussion: Serum S-100 protein in the sagittal sinus increased significantly after ischemia, confirming the usefulness this assay to detect cerebral ischemic injury during CPB. However, the variable relationship between blood and CSF sites may indicate short-lived, reversible changes in blood-brain barrier permeability after ischemia on CPB. The amount of ischemic cerebral damage as measured by CSF S-100 protein concentration may not be reflected by serum S-100 values.

Serum S100 – A Marker for Disease Monitoring in Metastatic Melanoma

S100 proteins are low-molecular-weight calcium-binding proteins and appear to play an important role in various cellular processes such as cell division and differentiation. In histopathology, S100 is widely accepted as the marker of choice for immunohistochemical identification of malignant melanoma. When S100 was detected in the serum of patients with malignant melanoma, it was suggested that serum S100 may be a useful marker for the stage of disease. The aim of this study was to examine serum S100 concentrations of patients with different stages of malignant melanoma and to determine the value of serum S100 in the follow-up of melanoma patients during treatment. Sera were obtained from 73 melanoma patients in different stages of the disease. The control group consisted of 130 healthy subjects. In 4 patients with metastatic melanoma, serum S100 was measured serially. Serum levels were measured by a commercially available immunoradiometric assay. While only 1 out of 25 stage I/II patients and 3 of 14 patients with lymph node metastases (stage III, 21.4%) showed detectable serum S100 levels, 27 of 34 patients with disseminated disease (stage IV, 79.4%) had elevated serum S100. Interestingly, rising levels of serum S100 in the serial measurement indicated progression of the disease, and a complete decline reflected 2 patient remissions. The data support the value of serum S100 as a clinical marker for progression of metastatic melanoma and serological monitoring during systemic therapies.

Serum S100 protein: A potential marker for cerebral events during cardiopulmonary bypass

There is no simple method to determine the incidence or severity of brain injury after a cardiac operation. A serum marker equivalent to cardiac enzymes is required. S100 protein leaks from the cerebrospinal fluid to blood after cerebral injury. We sought to determine the pattern of release after extracorporeal circulation (ECC). Thirty-four patients without neurologic problems underwent coronary bypass using ECC. Four had carotid stenoses. Nine others underwent coronary bypass without ECC. Serum S100 levels were measured before, during, and after the operation. S100 was not detected before sternotomy. Postoperative levels of S100 were related to duration of perfusion (r = 0.89, p < 0.001). Patients who did not have ECC had undetectable or fractionally raised levels except in 1 who suffered a stroke. No patient in whom ECC was used suffered an event, but those with carotid stenosis had greater S100 levels. S100 protein leaks into blood during ECC and may reflect both cerebral injury and increased permeability of the blood brain barrier. S100 is a promising marker for cerebral injury in cardiac surgery if elevated levels can be linked with clinical outcome.

Detection of S-100 protein in melanocytic and neurogenic cutaneous tumors.

Quantitative determination of S-100 protein content on human melanoma tissues and in sera of melanoma patients was made possible through radioimmunoassay (RIA). Melanoma tissue extracts prepared from metastatic sites in both skin and lymph nodes contained 0.08-2.80% of S-100 out of the total extractable proteins, and it was also noticed that the tumors obtained from lymph-node metastasis possessed slightly higher levels of S-100 as compared with those obtained from the skin lesions. Serum S-100 levels of 12 melanoma patients with Stage 1 to 3 diseases were also examined by means of RIA, but only two patients showed a slight elevation of serum S-100 levels. When tissue sections prepared from a variety of cutaneous tumors, including pigmented nevus, melanoma and Schwannoma, were stained for S-100 by an immunoperoxidase technique, these tumors of neuroectodermal origin were demonstrated to contain a detectable amount of S-100, whereas other tested nonmelanocytic and non-neurogenic tumors were entirely negative for S-100. These data stress the usefulness of S-100 for the diagnosis of neurogenic and melanocytic tumors, especially melanomas, despite the difficulty of its detection in the sera of the tumor bearers, which might reflect the low tendency of S-100 to be shed from the tumor cells.