Significance of Elecsys® S100 immunoassay for real-time assessment of traumatic brain damage in multiple trauma patients

Abstract

Background: The neuroprotein S100 released into the circulation has been suggested as a reliable marker for primary brain damage. However, safe identification of relevant traumatic brain injury (TBI) may possibly be hampered by S100 release from peripheral tissue. The objective of this study was to measure early S100 levels using the Elecsys ᮋ S100 immunoassay for real-time assessment of severe TBI in multiple trauma. Methods: Consecutively admitted multiple trauma patients (injury severity score G16 points) were stratified according to the results of the initial cerebral computed tomography (CCT) examination. S100 serum levels were determined at admission and at 6, 12, 24, 48 and 72 h after trauma. Data were correlated to creatine phosphokinase (CK) and lactate dehydrogenase (LDH) serum levels. Using receiver operating characteristic (ROC) analysis, the discriminating power of S100 measurement was calculated for the detection of CCTq findings. Results: Median S100 levels of CCTq patients (ns9;

Prognostic Value of Serum S100 Protein by Elecsys S100 Immunoassay in Patients with Spontaneous Subarachnoid and Intracerebral Hemorrhages

“…Even though the prognostic value of S100 protein has been extensively studied in severe head injury, acute ischemic stroke and cardiac arrest, S100 protein in patient with SAH was less frequently studied 2,3,6,13,16,17,19,[21][22][23] . Furthermore, the role of S100 protein in patient with ICH is lacking 5) .…”

“…Elecsys S100 immunoassay is known to detect both S100ab and S100bb 16,18) . Because small amount of S100 protein have been found in fat tissue, skin, bone, skeletal muscle and heart muscle, as well as in melanoma cells, the S100 protein measurement by Elecsys S100 immunoassay may be false positive in severe head injury, especially in association with adipose tissue injury and long bone fracture 1,2,8,10,18) .…”

“…Because small amount of S100 protein have been found in fat tissue, skin, bone, skeletal muscle and heart muscle, as well as in melanoma cells, the S100 protein measurement by Elecsys S100 immunoassay may be false positive in severe head injury, especially in association with adipose tissue injury and long bone fracture 1,2,8,10,18) . Mussack et al 16) reported that S100 protein measurements using this method were not reliable for the real time detection of severe brain damage in multiple trauma patients, mainly due to the S100 release from peripheral sources. But, in case of spontaneous hemorrhage such as SAH or ICH, S100 protein level by Elecsys S100 immunoassay may reflect neuronal damage quite clearly because there is little chance of S100 release from peripheral sources.…”

“…An early concentration peak of S100 in serum 20 minutes after brain damage seems to reflect both cellular damage and increased permeability of the BBB 2) . Several sensitive assays for the detection of serum S100B have become available 1,15,16,20,22) . Of these, Liaison Sangtec 100 method and Liamat method were commonly used for detection of S100B 18 min over previous LIA-mat S100 system, which requires over 2 hours 6) .…”

“…Of these, Liaison Sangtec 100 method and Liamat method were commonly used for detection of S100B 18 min over previous LIA-mat S100 system, which requires over 2 hours 6) . There have been few reports regarding serum S100 protein and outcome by Elecsys S100 immunoassay in patient with head injury, subarachnoid hemorrhage and carotid stenosis 1,16,18) . Spontaneous ICH is a bleeding from small perforating artery, which is usually caused by hypertension.…”