Performance Characteristics of Seven Neuron-Specific Enolase Assays

Stern, Petr; Bartoš, Vladimı́r; Uhrová, Jana; Bezdickova, Drahomira; Vaníčková, Zdislava; Tichy, Vojtech; Pelinková, Květa; Průša, Richard; Zima, Tomáš

doi:10.1159/000098441

Cited by 45 publications

(19 citation statements)

References 12 publications

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“…All determinations of NSE were performed at the same laboratory, to eliminate the effect of inter-laboratory variation [30]. When comparing published results using NSE as a biomarker for neuronal injury, variability in results may also include inter-laboratory variation, which was not addressed in the current study.…”

Section: Discussionmentioning

confidence: 99%

Serum neuron specific enolase – impact of storage and measuring method

et al. 2014

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BackgroundNeuron specific enolase (NSE) is a recognized biomarker for assessment of neurological outcome after cardiac arrest, but its reliability has been questioned. Our aim was to investigate what influence storage of samples and choice of measuring methods may have on levels of NSE in peripheral blood.MethodsTwo serum samples were drawn simultaneously from 51 hypothermia treated cardiac arrest patients. One sample (original sample) was analysed when collected, using the Diasorin-method (LIAISON®NSE, LNSE). The other sample was frozen, stored at −70°C (stored sample), and reanalysed in the same laboratory 4–7 years later using both the Diasorin method and a Roche-method (NSE Cobas e601, CNSE). In addition, a comparison of the two methods was performed on 29 fresh samples.ResultsThe paired NSE results in original and stored samples were not significantly different, using the LNSE-method. The two methods produced significantly different results (p < 0.0001) on the paired, stored samples, with the CNSE method yielding higher values than the LNSE-method in 96% of samples. The CNSE method resulted in 36% higher values on average. In the method comparison on fresh samples, the CNSE-method generated on average 15% higher values compared to the LNSE-method, and the difference between the paired results was significant (p < 0.0001).ConclusionThe CNSE method generated consistently higher NSE-values than the LNSE method and this difference was more pronounced when frozen samples were analysed. Tolerability for prolonged freezing was acceptable.

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Section: Discussionmentioning

confidence: 99%

Serum neuron specific enolase – impact of storage and measuring method

et al. 2014

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“…Blood marker thresholds vary because of heterogeneous measurement techniques, [274][275][276] the presence of extraneuronal sources of biomarkers (hemolysis, non-central nervous system sources, and neuroendocrine tumors for neuron-specific enolase [NSE], 277 muscle and adipose tissue breakdown for S100B), 278 and the incomplete knowledge of the kinetics of their blood concentrations in the first few days after ROSC.…”

Section: Blood and Cerebrospinal Fluid Markersmentioning

confidence: 99%

Part 4: Advanced Life Support

Nolan¹,

Hazinski²,

Aickin³

et al. 2015

Circulation

554

125

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Questions to be addressed (using the PICO [population, intervention, comparator, outcome] format) 3 were prioritized by ALS Task Force members (by voting). Prioritization criteria included awareness of significant new data and new controversies or questions about practice. Questions about topics no longer relevant to contemporary practice or where little new research has occurred were given lower priority. The ALS Task Force prioritized 42 PICO questions for review. With the assistance of information specialists, a detailed search for relevant articles was performed in each of 3 online databases (PubMed, Embase, and the Cochrane Library).By using detailed inclusion and exclusion criteria, articles were screened for further evaluation. The reviewers for each question created a reconciled risk of bias assessment for each of the included studies, using state-of-the-art tools: Cochrane for randomized controlled trials (RCTs), 4 Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 for studies of diagnostic accuracy, 5 and GRADE for observational studies that inform both therapy and prognosis questions. 6 GRADE evidence profile tables 7 were then created to facilitate an evaluation of the evidence in support of each of the critical and important outcomes. The quality of the evidence (or confidence in the estimate of the effect) was categorized as high, moderate, low, or very low, 8 based on the study methodologies and the 5 core GRADE domains of risk of bias, inconsistency, indirectness, imprecision, and other considerations (including publication bias). 9 These evidence profile tables were then used to create a written summary of evidence for each outcome (the consensus on science statements). Whenever possible, consensus-based treatment recommendations were then created. These recommendations (designated as strong or weak) were accompanied by an overall assessment of the evidence and a statement from the task force about the values, preferences, and task force insights that underlie the recommendations. Further details of the methodology that underpinned the evidence evaluation process are found in "Part 2: Evidence Evaluation and Management of Conflicts of Interest."The task force preselected and ranked outcome measures that were used as consistently as possible for all PICO questions. Longer-term, patient-centered outcomes were considered more important than process variables and shorter-term outcomes. For most questions, we used the following hierarchy starting with the most important: long-term survival with neurologically favorable survival, long-term survival, short-term survival, and process variable. In general, longterm was defined as from hospital discharge to 180 days or longer, and short-term was defined as shorter than to hospital discharge. For certain questions (eg, related to defibrillation or confirmation of tracheal tube position), process variables such as termination of fibrillation and correct tube placement were important. A few questions (eg, organ donation) required unique outcomes....

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“…Serum S100B was sampled every 12 h and peak serum levels of S100B 12–36 h after trauma were acquired as clinical routine (29), using an electrochemiluminescence assay (Elecsys System ® , Roche Diagnostics, Basel, Switzerland). Peak serum levels of NSE were analyzed using an immunoradiometric assays (LIAISON ® , DiaSorin, Italy) (30). …”

Section: Methodsmentioning

confidence: 99%

Microdialysis Monitoring of CSF Parameters in Severe Traumatic Brain Injury Patients: A Novel Approach

et al. 2014

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Background: Neuro-intensive care following traumatic brain injury (TBI) is focused on preventing secondary insults that may lead to irreversible brain damage. Microdialysis (MD) is used to detect deranged cerebral metabolism. The clinical usefulness of the MD is dependent on the regional localization of the MD catheter. The aim of this study was to analyze a new method of continuous cerebrospinal fluid (CSF) monitoring using the MD technique. The method was validated using conventional laboratory analysis of CSF samples. MD-CSF and regional MD-Brain samples were correlated to patient outcome.Materials and Methods: A total of 14 patients suffering from severe TBI were analyzed. They were monitored using (1) a MD catheter (CMA64-iView, n = 7448 MD samples) located in a CSF-pump connected to the ventricular drain and (2) an intraparenchymal MD catheter (CMA70, n = 8358 MD samples). CSF-lactate and CSF-glucose levels were monitored and were compared to MD-CSF samples. MD-CSF and MD-Brain parameters were correlated to favorable (Glasgow Outcome Score extended, GOSe 6–8) and unfavorable (GOSe 1–5) outcome.Results: Levels of glucose and lactate acquired with the CSF-MD technique could be correlated to conventional levels. The median MD recovery using the CMA64 catheter in CSF was 0.98 and 0.97 for glucose and lactate, respectively. Median MD-CSF (CMA 64) lactate (p = 0.0057) and pyruvate (p = 0.0011) levels were significantly lower in the favorable outcome group compared to the unfavorable group. No significant difference in outcome was found using the lactate:pyruvate ratio (LPR), or any of the regional MD-Brain monitoring in our analyzed cohort.Conclusion: This new technique of global MD-CSF monitoring correlates with conventional CSF levels of glucose and lactate, and the MD recovery is higher than previously described. Increase in lactate and pyruvate, without any effect on the LPR, correlates to unfavorable outcome, perhaps related to the presence of erythrocytes in the CSF.

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Performance Characteristics of Seven Neuron-Specific Enolase Assays

Cited by 45 publications

References 12 publications

Serum neuron specific enolase – impact of storage and measuring method

Serum neuron specific enolase – impact of storage and measuring method

Part 4: Advanced Life Support

Microdialysis Monitoring of CSF Parameters in Severe Traumatic Brain Injury Patients: A Novel Approach

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