S100-B Protein as a Screening Tool for the Early Assessment of Minor Head Injury

Zongo, Drissa; Ribéreau-Gayon, Régis; Masson, F.; Laborey, Magali; Contrand, Benjamin; Salmi, Louis Rachid; Montaudon, Danièle; Beaudeux, Jean Louis; Meurin, A.; Dousset, V.; Loiseau, Hugues; Lagarde, Emmanuel

doi:10.1016/j.annemergmed.2011.07.027

Cited by 138 publications

(100 citation statements)

References 35 publications

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“…83,84 In particular, Zongo et al examined CT scans and plasma S100-B for 1560 patients with mTBI and found that patients with positive CT scan had a higher S100B median relative to patients with negative CT scan results (0.46 vs. 0.22 mg/L, p < 0.001). 85 Furthermore, prior studies have shown IL-6, a pro-inflammatory cytokine, to be an independent predictor of mTBI. 86,87 Interestingly, the findings of a study that evaluated inflammatory markers in 16 pediatric patients demonstrated higher concentrations of IL-6 in patients with mTBI relative to controls without injury, (p < 0.00).…”

Section: Studies Of Tbi and Inflammatory Responsesmentioning

confidence: 99%

Effects of concussion on the blood–brain barrier in humans and rodents

Sahyouni

Gutierrez

Gold

et al. 2017

Journal of Concussion

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Traumatic brain injury and the long-term consequences of repeated concussions constitute mounting concerns in the United States, with 5.3 million individuals living with a traumatic brain injury-related disability. Attempts to understand mechanisms and possible therapeutic approaches to alleviate the consequences of repeat mild concussions or traumatic brain injury on cerebral vasculature depend on several aspects of the trauma, including: (1) the physical characteristics of trauma or insult that result in damage; (2) the time ''window'' after trauma in which neuropathological features develop; (3) methods to detect possible breakdown of the blood-brain barrier; and (4) understanding different consequences of a single concussion as compared with multiple concussions. We review the literature to summarize the current understanding of blood-brain barrier and endothelial cell changes post-neurotrauma in concussions and mild traumatic brain injury. Attention is focused on concussion and traumatic brain injury in humans, with a goal of pointing out the gaps in our knowledge and how studies of rodent model systems of concussion may help in filling these gaps. Specifically, we focus on disruptions that concussion causes to the blood-brain barrier and its multifaceted consequences. Importantly, the magnitude of post-concussion blood-brain barrier dysfunction may influence the time course and extent of neuronal recovery; hence, we include in this review comparisons of more severe traumatic brain injury to concussion where appropriate. Finally, we address the important, and still unresolved, issue of how best to detect possible breakdown in the blood-brain barrier following neurotrauma by exploring intravascular tracer injection in animal models to examine leakage into the brain parenchyma.

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Section: Studies Of Tbi and Inflammatory Responsesmentioning

confidence: 99%

Effects of concussion on the blood–brain barrier in humans and rodents

Sahyouni

Gutierrez

Gold

et al. 2017

Journal of Concussion

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“…Previous studies identified maximum sensitivity for abnormal head CT at an S100B level of 0.10-0.12 lg/L. 9,10,[25][26][27][28][29] In our cohort, the 98% sensitivity level was not reached until the S100B level was below 0.060 lg/L. At a cutoff of 0.10 lg/L, the FIG.…”

Section: Discussionmentioning

confidence: 94%

Classification Accuracy of Serum Apo A-I and S100B for the Diagnosis of Mild Traumatic Brain Injury and Prediction of Abnormal Initial Head Computed Tomography Scan

Bazarian

Blyth

et al. 2013

Journal of Neurotrauma

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The objective of the current study was to determine the classification accuracy of serum S100B and apolipoprotein (apoA-I) for mild traumatic brain injury (mTBI) and abnormal initial head computed tomography (CT) scan, and to identify ethnic, racial, age, and sex variation in classification accuracy. We performed a prospective, multi-centered study of 787 patients with mTBI who presented to the emergency department within 6 h of injury and 467 controls who presented to the outpatient laboratory for routine blood work. Serum was analyzed for S100B and apoA-I. The outcomes were disease status (mTBI or control) and initial head CT scan. At cutoff values defined by 90% of controls, the specificity for mTBI using S100B (0.899 [95% confidence interval (CI): 0.78-0.92]) was similar to that using apoA-I (0.902 [0.87-0.93]), and the sensitivity using S100B (0.252 [0.22-0.28]) was similar to that using apoA-I (0.249 [0.22-0.28]). The area under the receiver operating characteristic curve (AUC) for the combination of S100B and apoA-I (0.738, 95% CI: 0.71, 0.77), however, was significantly higher than the AUC for S100B alone (0.709, 95% CI: 0.68, 0.74, p = 0.001) and higher than the AUC for apoA-I alone (0.645, 95% CI: 0.61, 0.68, p < 0.0001). The AUC for prediction of abnormal initial head CT scan using S100B was 0.694 (95%CI: 0.62, 0.77) and not significant for apoA-I. At a S100B cutoff of < 0.060 lg/L, the sensitivity for abnormal head CT was 98%, and 22.9% of CT scans could have been avoided. There was significant age and race-related variation in the accuracy of S100B for the diagnosis of mTBI. The combined use of serum S100B and apoA-I maximizes classification accuracy for mTBI, but only S100B is needed to classify abnormal head CT scan. Because of significant subgroup variation in classification accuracy, age and race need to be considered when using S100B to classify subjects for mTBI.

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“…It is possible that reactive glia upregulate S100B; however, a study by Marchi et al refutes this possibility and shows that the rise in serum S100B levels is too early after injury to be due to synthesis by glial cells (29). S100B is an important mTBI biomarker candidate, because serum levels of this protein have already been used experimentally to rule out mTBI in emergency room settings (30). In a clinical study of 1,560 patients with minor head injury, initial blood S100B levels had a high negative predictive value of 99.7% (30).…”

Section: Biomarkers Of Bbb Dysfunctionmentioning

confidence: 99%

“…S100B is an important mTBI biomarker candidate, because serum levels of this protein have already been used experimentally to rule out mTBI in emergency room settings (30). In a clinical study of 1,560 patients with minor head injury, initial blood S100B levels had a high negative predictive value of 99.7% (30). This result shows blood S100B levels have great potential as a screening tool for physicians who may not be inclined to perform head CT in certain cases, such as younger patients who might need to avoid radiation or pregnant women.…”

Section: Biomarkers Of Bbb Dysfunctionmentioning

confidence: 99%