S100B protein as a screening tool for computed tomography findings after mild traumatic brain injury: Systematic review and meta-analysis

Heidari, Kamran; Vafaee, Ali; Rastekenari, Alireza Maleki; Taghizadeh, Mehrdad; Shad, Ensieh Ghaffari; Eley, Robert; Sinnott, Michael; Asadollahi, Shadi

doi:10.3109/02699052.2015.1037349

Cited by 40 publications

(22 citation statements)

References 104 publications

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“…The results of our study expand and corroborate those from previous systematic reviews and meta-analyses, [62][63][64] and confirm that the implementation of S100B might allow a reduction of the number of CT scans by *30%. 3 These considerations also have broad financial implications for healthcare costs.…”

supporting

confidence: 89%

Blood-Based Protein Biomarkers for the Management of Traumatic Brain Injuries in Adults Presenting to Emergency Departments with Mild Brain Injury: A Living Systematic Review and Meta-Analysis

Mondello

Sorinola

Czeiter

et al. 2021

Journal of Neurotrauma

119

102

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Accurate diagnosis of traumatic brain injury (TBI) is critical to effective management and intervention, but can be challenging in patients with mild TBI. A substantial number of studies have reported the use of circulating biomarkers as signatures for TBI, capable of improving diagnostic accuracy and clinical decision making beyond current practice standards. We performed a systematic review and meta-analysis to comprehensively and critically evaluate the existing body of evidence for the use of blood protein biomarkers (S100 calcium binding protein B [S100B], glial fibrillary acidic protein [GFAP], neuron specific enolase [NSE], ubiquitin C-terminal hydrolase-L1 [UCH-L1]. tau, and neurofilament proteins) for diagnosis of intracranial lesions on CT following mild TBI. Effects of potential confounding factors and differential diagnostic performance of the included markers were explored. Further, appropriateness of study design, analysis, quality, and demonstration of clinical utility were assessed. Studies published up to October 2016 were identified through a MEDLINE, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) search. Following screening of the identified articles, 26 were selected as relevant. We found that measurement of S100B can help informed decision making in the emergency department, possibly reducing resource use; however, there is insufficient evidence that any of the other markers is ready for clinical application. Our work pointed out serious problems in the design, analysis, and reporting of many of the studies, and identified substantial heterogeneity and research gaps. These findings emphasize the importance of methodologically rigorous studies focused on a biomarker's intended use, and defining standardized, validated, and reproducible approaches. The living nature of this systematic review, which will summarize key updated information as it becomes available, can inform and guide future implementation of biomarkers in the clinical arena.

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supporting

confidence: 89%

Blood-Based Protein Biomarkers for the Management of Traumatic Brain Injuries in Adults Presenting to Emergency Departments with Mild Brain Injury: A Living Systematic Review and Meta-Analysis

Mondello

Sorinola

Czeiter

et al. 2021

Journal of Neurotrauma

119

102

View full text Add to dashboard Cite

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“…For example, the meta‐analysis for the marker ubiquitin carboxy‐terminal hydrolase L1 (UCHL‐1) recently published, stated that in studies with a total of 1,138 TBI cases and 1,373 controls there was a significant increase in serum UCH‐L1 levels in patients with TBI compared to controls (weighted mean difference 0.96, 95% confidence interval [CI] 0.31–1.61; p = 0.004) . Two independent meta‐analyses for S100B in TBI concluded that “Low serum S100B levels accurately predict normal CT findings after mTBI and that S100B sampling within 3 h of injury should be considered when no focal neurological deficit, or significant extracerebral injury is present.” These studies recommend a cut‐off for omitting CT set at <0.10 ng/ml . There is therefore an opportunity to produce a test with high negative predictive value as a point‐of‐care device so that many unnecessary scans can be avoided, and separately, a laboratory‐based positive predictive value test to diagnose complications after TBI.…”

Section: Blood–brain Barriermentioning

confidence: 99%

WONOEP appraisal: Molecular and cellular biomarkers for epilepsy

et al. 2016

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Summary Peripheral biomarkers have myriad potential uses for treatment, prediction, prognostication, and pharmacovigilance in epilepsy. To date, no single peripheral biomarker has demonstrated proven effectiveness, although multiple candidates are in development. In this review, we discuss the major areas of focus including inflammation, blood–brain barrier dysfunction, redox alterations, metabolism, hormones and growth factors.

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“…Many groups have described this variability, and most of the data presented so far has focused on the astrocytic protein S100B [8]. This biomarker has been studied for several years, and investigated as a tool to diagnose non-CNS conditions, mainly malignant melanoma [9].…”

Section: Introductionmentioning

confidence: 99%

Improving the clinical management of traumatic brain injury through the pharmacokinetic modeling of peripheral blood biomarkers

Dadas

Washington

Marchi

et al. 2016

Fluids Barriers CNS

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BackgroundBlood biomarkers of neurovascular damage are used clinically to diagnose the presence severity or absence of neurological diseases, but data interpretation is confounded by a limited understanding of their dependence on variables other than the disease condition itself. These include half-life in blood, molecular weight, and marker-specific biophysical properties, as well as the effects of glomerular filtration, age, gender, and ethnicity. To study these factors, and to provide a method for markers’ analyses, we developed a kinetic model that allows the integrated interpretation of these properties.MethodsThe pharmacokinetic behaviors of S100B (monomer and homodimer), Glial Fibrillary Acidic Protein and Ubiquitin C-Terminal Hydrolase L1 were modeled using relevant chemical and physical properties; modeling results were validated by comparison with data obtained from healthy subjects or individuals affected by neurological diseases. Brain imaging data were used to model passage of biomarkers across the blood–brain barrier.ResultsOur results show the following: (1) changes in biomarker serum levels due to age or disease progression are accounted for by differences in kidney filtration; (2) a significant change in the brain-to-blood volumetric ratio, which is characteristic of infant and adult development, contributes to variation in blood concentration of biomarkers; (3) the effects of extracranial contribution at steady-state are predicted in our model to be less important than suspected, while the contribution of blood–brain barrier disruption is confirmed as a significant factor in controlling markers’ appearance in blood, where the biomarkers are typically detected; (4) the contribution of skin to the marker S100B blood levels depends on a direct correlation with pigmentation and not ethnicity; the contribution of extracranial sources for other markers requires further investigation.ConclusionsWe developed a multi-compartment, pharmacokinetic model that integrates the biophysical properties of a given brain molecule and predicts its time-dependent concentration in blood, for populations of varying physical and anatomical characteristics. This model emphasizes the importance of the blood–brain barrier as a gatekeeper for markers’ blood appearance and, ultimately, for rational clinical use of peripherally-detected brain protein.Electronic supplementary materialThe online version of this article (doi:10.1186/s12987-016-0045-y) contains supplementary material, which is available to authorized users.

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S100B protein as a screening tool for computed tomography findings after mild traumatic brain injury: Systematic review and meta-analysis

Abstract: After MTBI, serum S100B protein levels are significantly associated with the presence of intracranial lesions on CT scan. Measuring the protein could be useful in screening high risk MTBI patients and decreasing unnecessary CT examinations.

Cited by 40 publications

References 104 publications

Blood-Based Protein Biomarkers for the Management of Traumatic Brain Injuries in Adults Presenting to Emergency Departments with Mild Brain Injury: A Living Systematic Review and Meta-Analysis

Blood-Based Protein Biomarkers for the Management of Traumatic Brain Injuries in Adults Presenting to Emergency Departments with Mild Brain Injury: A Living Systematic Review and Meta-Analysis

WONOEP appraisal: Molecular and cellular biomarkers for epilepsy

Improving the clinical management of traumatic brain injury through the pharmacokinetic modeling of peripheral blood biomarkers

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