Detection of serum S100B and NSE helps predict prognosis in children with TBI

Ref: Park SH and Hwang SK.World Neurosurg.
 2018 Oct;118:e534-e542doi: 10.1016/j.wneu.2018.06.234Epub 2018 Jul 6.)brain trauma (TBI), the integrity of the brain cell membrane is destroyed, serum S100 calcium binding protein B (S100B), neurospecific eglutase (NSE) and cytokine IL-6 are released into the bloodstreamS100B is a marker of astrocyte injury and death, and its level is closely related to the clinical condition, imaging performance and prognosis of patientsNSE is a biomarker of nerve damageS100B and NSE have secondary peaks in patients with TBI progressive impairmentThe level of IL-6 (a cytokine expressed in small glial cells, astrocytes, and neurons) was associated with the severity of TBI and increased intracranial pressureSeong-Hyun Park, a neurosurgery specialist at Keppo National University School of Medicine in South Korea, analyzed serum S100B, NSE and IL-6 levels in tBI children to assess their relationship to clinical prognosis, published in the October 2018 issue of The Journal of World Neurosurgerya total of 15 cases of TBI children were included in the studyOf these, 11 were maleThe patients were aged 4-18 and the median was 14 years oldOf the 15 cases, 7 cases of epidural hematoma, 5 cases of cerebral bruising, 2 cases of diffuse axial rope injury and 1 case of hematoma under the epiduralare delivered to the hospital within 6 hours of TBIThe Glasgow Coma Score (GCS) was divided into two groups at the time of admission, with GCS ratings of 10-15 divided into good groups and GCS scores 9 in the bad groupThe children were classified as a good group with a GOS score of 4-5 and a bad group with a GOS score of 1-3, based on the Glasgow Prognosis Score (GOS) at the last six months of the TBIPeripheral vein blood was collected within 6 hours and 1 week after TBI to monitor the levels of S100B, NSE and IL-6, respectivelythe most common symptoms in 15 patientswere intracranial damage (66.7%) and headache (33.3%)10 cases of change of consciousness, including 6 cases of coma, 3 cases of shallow coma and 1 case of drowsinessAt the time of admission, 6 cases were good groups and 9 cases were bad groupsAt 6 months, 12 cases had a good GOS score and 3 cases had a bad GOS score5 cases of hematoma removal in children6 cases were accompanied by a variety of extracranial injuries, including lung, bone, liver, spleen and bowel damageThree children eventually died, two of them due to severe cerebral edema and one from pneumoniathe median serum S100B was 178.12pg/mL, the median NSE was 16.54 ng/mL and IL-6 was 15.48pg/mLIn the 1 week after TBI, the median S100B, NSE and IL-6 were significantly reduced to 40.86 pg/mL, 5.85 ng/mL and 8.63pg/mL, respectivelyGcS score poor group, when admitted to hospital and 1 week after TBI serum S100B, NSE water average was significantly higher than the GCS score good groupAt 6 months, the levels of serum S100B and NSE in the 1 week after injury in the poor GOS scored group were significantly higher than those in the 6-month-old group with good GOS scoressummarized the above results and decreased serum S100B, NSE and IL-6 levels in the 1 week after injurySerum S100B and NSE levels were associated with initial GCS scores when children admitted to the hospital with TBI, and serum S100B and NSE levels after one week of TBI were associated with 6 months' GOS scores Therefore, continuous measurements of serum S100B and NSE help to assess the extent of brain damage and clinical prognosis in TBI children.