Critical Illness Clinical Trial
Official title:
S100B in Intensive Care Patients With and Without Traumatic Brain Injury: Implications for Neuromarker Assessment
The neurotrophic protein S100B has been promoted as a neuromarker for decades, and to reflect
the severity of brain injury. On the other hand, S100B is a tumor marker. The interpretation
of its serum levels may be altered by a contribution from extracerebral sources and its renal
elimination.
In the present study we investigate the relevance of S100B as a prognostic factor, as well as
the correlation with different CT classifications in a large cohort of patients with and
without brain injury. Furthermore, we examine whether S100B is elevated in brain tumors.
Patients of the Department of Neurosurgery, University of Erlangen-Nuremberg, undergoing
surgery for sellar lesions were prospectively included. The study protocol was approved by
the local Ethical Committee. Informed written consent was given by the participants or the
next-of-kin in each case. Exclusion criteria comprised of those below 18 years of age,
pregnancy and a drug intolerance.
Patients baseline information included age, gender, clinical presentation, and preexisting
medical conditions. In four different cohorts of patients, S100B was measured:
1. ICU TBI, patients treated on the ICU with brain injury
2. ICU tumor, patients treated on the ICU because of an intracranial tumor
3. ICU surgery, patients treated on the ICU following surgery without brain injury
4. ICU control, patients treated on the ICU without TBI, tumor or surgery
The performed diagnostic tests included blood, cerebrospinal fluid and urine samples. In all
subjects, blood (4 mL), cerebrospinal fluid (4mL) and urine (4mL) samples were collected
daily as part of the clinical routine at 6:00 AM.
Samples were immediately centrifuged for 10min at 1.300xG and 4°C and stored at a temperature
of -80°C until the assays were performed. Analysis was performed with commercially available
kits on automated immunoanalyzers (LIAISON® Sangtec®100 by chemiluminescence immunoassay,
Diasorin). The sensitivity of the assay was 0.02ng/ml.
In all cohorts the clinical status was documented with Glasgow Coma Score (GCS), and the
outcome was assessed applying the Glasgow Outcome Score (GOS) or the Karnofsky Status Scale.
The radiological work-up included a computed tomography (CT) or a magnetic resonance imaging
(MRI). In brain injured patients, the CT was classifiied by the Marshall and Rotterdam Score.
Extracranial injuries or surgical procedures were documented
Statistical analysis was performed with SPSS, and p<0.05 was accepted as significant.
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