Association between S100B Levels and Long-Term Outcome after Aneurysmal Subarachnoid Hemorrhage: Systematic Review and Pooled Analysis

Abstract

S100 calcium binding protein B (S100B), a well-studied marker for neurologic injury, has been suggested as a candidate for predicting outcome after subarachnoid hemorrhage. We performed a pooled analysis summarizing the associations between S100B protein in serum and cerebrospinal fluid (CSF) with radiographic vasospasm, delayed ischemic neurologic deficit (DIND), delayed cerebral infarction, and Glasgow Outcome Scale (GOS) outcome. A literature search using PubMed, the Cochrane Library, and the EMBASE databases was performed to identify relevant studies published up to May 2015. The weighted Stouffer’s Z method was used to perform a pooled analysis of outcome measures with greater than three studies. A total of 13 studies were included in this review. Higher serum S100B level was found to be associated with cerebral infarction as diagnosed by CT (padj = 3.1 x 10−4) and worse GOS outcome (padj = 5.5 x 10−11). There was no association found between serum and CSF S100B with radiographic vasospasm or DIND. S100B is a potential prognostic marker for aSAH outcome.

The S100B story: from biomarker to active factor in neural injury

“…The evaluation of S100B levels in biological fluids as a biomarker of neural distress has been extensively investigated, is still the goal of active research, and has been the object of recent valuable reviews focusing different disorders (Astrand et al . ; Chong ; Lai and Du ; da Rosa et al . ; Satriano et al .…”

“…In fact, the evaluation of its levels in biological fluids resulted to be an important aid in clinical diagnosis when symptoms are present, in monitoring the trend of the disorder and eventual clinical outcomes, in guiding therapeutic decision making by enabling identification of patients likely to respond to a specific therapy and, as a consequence, in monitoring the response to therapeutic interventions. The evaluation of S100B levels in biological fluids as a biomarker of neural distress has been extensively investigated, is still the goal of active research, and has been the object of recent valuable reviews focusing different disorders (Astrand et al 2013;Chong 2016;Lai and Du 2016;da Rosa et al 2016;Satriano et al 2017;Thelin et al 2017a,b). Intriguingly, following early findings of S100B in melanocytes and melanoma tissue (Cocchia et al 1981) the protein has been extensively used as a biomarker for this disease both in blood (Guo et al 1995;Henze et al 1997) and in pathologic tissue (Springall et al 1983;Cochran et al 1993).…”

Clinical study of adjuvant therapy on ischemic stroke with salviae miltiorrhizae and ligustrazine

“…The S100B in neuronal cells participates in the axon growth and the regulation of neuron differentiation [17,18]. NSE is a class of enolase dimer isozyme.…”

Brain Monitoring in Critically Neurologically Impaired Patients

“…In the area of cardiac arrest, elevated S100B levels in patients correlate with severity of neurologic injury with persistently elevated levels >0.414 ng/mL at 72 h predicting mortality with 100% specificity [ 25 , 26 ]. In aSAH, elevated S100B levels aren’t able to predict delayed cerebral ischemia that can occur from vasospasm but are associated with worse Glasgow Outcome Score at 6 months [ 27 , 28 ]. In severe TBI, S100B levels 12 h from the time of trauma are predictive of Glasgow Outcome Score at 1 year [ 29 ].…”

“…In poor grade aSAH patients, the utility of serum markers of neuronal injury is best within the 24–72 h for predicting unfavorable outcomes [ 20 , 28 , 34 ]. S100B peaks early within 24 h and then decreases [ 27 ].…”