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Biochemical Markers in Neurocritical Care

Omidvar Rezae, Kurosh Gharagozli, Hosseinali Jelvehmoghadam, Reza Goharani, Mohammadreza Hajiesmaeili




During the past two decades, a variety of serum or cerebrospinal fluid (CSF) biochemical markers in daily clinical practice have been recommended to diagnose and monitor diverse diseases or pathologic situations. It will be essential to develop a panel of biomarkers, to be suitable for evaluation of treatment efficacy, representing distinct phases of injury and recovery and consider the temporal profile of those. Among the possible and different biochemical markers, S100b appeared to fulfill many of optimized criteria of an ideal marker. S100b, a cytosolic low molecular weight dimeric calciumbinding protein from chromosome 21, synthesized in glial cells throughout the CNS, an homodimeric diffusible, belongs to a family of closely related protein, predominantly expressed by astrocytes and Schwann cells and a classic immunohistochemical marker for these cells, is implicated in brain development and neurophysiology. Of the 3 isoforms of S-100, the BB subunit (S100B) is present in high concentrations in central and peripheral glial and Schwann cells, Langerhans and anterior pituitary cells, fat, muscle, and bone marrow tissues. The biomarker has shown to be a sensitive marker of clinical and subclinical cerebral damage, such as stroke, traumatic brain injury, and spinal cord injury. Increasing evidence suggests that the biomarker plays a double function as an intracellular regulator and an extracellular signal of the CNS. S100b is found in the cytoplasm in a soluble form and also is associated with intracellular membranes, centrosomes, microtubules, and type III intermediate filaments. Their genomic organization now is known, and many of their target proteins have been identified, although the mechanisms of regulating S100b secretion are not completely understood and appear to be related to many factors, such as the proinflammatory cytokines, tumor necrosis factor alpha (TNF-a), interleukin (IL)-1b, and metabolic stress.



biochemical markers, hypoxic brain injury, cerebrovascular attacks, neurocritical care,


Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet (London, England). 2012 Dec 15;380(9859):2197-223.

Chin JH, Vora N. The global burden of neurologic diseases. Neurology. 2014;83(4):349-51.

Shubhakaran KP, Chin JH. The global burden of neurologic diseases. Neurology. 2015;84(7):758-.

Bloom DE, Chisholm D, Jané-Llopis E, Prettner K, Stein A, Feigl A. From burden to" best buys": reducing the economic impact of non-communicable disease in low-and middle-income countries. Program on the Global Demography of Aging, 2011.

Wang G, Cheng X, Zhang X. Use of various CT imaging methods for diagnosis of acute ischemic cerebrovascular disease. Neural regeneration research. 2013 5;8(7):655-61.

Guan X, Yu X, Liu X, Long J, Dai J. CT perfusion imaging and CT subtraction angiography in the diagnosis of ischemic cerebrovascular disease within 24 hours. Chinese medical journal. 2003;116(3):368-72.

Kochanek PM, Berger RP, Fink EL, Au AK, Bayir H, Bell MJ, et al. The potential for bio-mediators and biomarkers in pediatric traumatic brain injury and neurocritical care. Frontiers in neurology. 2013;4:40.

Johnsson P. Markers of cerebral ischemia after cardiac surgery. Journal of cardiothoracic and vascular anesthesia. 1996;10(1):120-6.

Rodriguez-Rodriguez A, Egea-Guerrero JJ, Leon-Justel A, Gordillo-Escobar E, Revuelto-Rey J, Vilches-Arenas A, et al. Role of S100B protein in urine and serum as an early predictor of mortality after severe traumatic brain injury in adults. Clinica chimica acta; international journal of clinical chemistry. 2012 Dec 24;414:228-33.

Kulbe JR, Geddes JW. Current status of fluid biomarkers in mild traumatic brain injury. Experimental neurology. 2016;275:334-52.

Jeter CB, Hergenroeder GW, Hylin MJ, Redell JB, Moore AN, Dash PK. Biomarkers for the diagnosis and prognosis of mild traumatic brain injury/concussion. Journal of neurotrauma. 2013;30(8):657-70.

Jeter CB, Hergenroeder GW, Ward III NH, Moore AN, Dash PK. Human mild traumatic brain injury decreases circulating branched-chain amino acids and their metabolite levels. Journal of neurotrauma. 2013;30(8):671-9.

Yokobori S, Hosein K, Burks S, Sharma I, Gajavelli S, Bullock R. Biomarkers for the clinical differential diagnosis in traumatic brain injury—a systematic review. CNS neuroscience & therapeutics. 2013;19(8):556-65.

Green A, Harvey R, Thompson E, Rossor M. Increased S100β in the cerebrospinal fluid of patients with frontotemporal dementia. Neuroscience letters. 1997;235(1):5-8.

Vaage J, Anderson R. Biochemical markers of neurologic injury in cardiac surgery: The rise and fall of S100β. The Journal of thoracic and cardiovascular surgery. 2001;122(5):853-5.

Brunnekreef G, Heijmen R, Gerritsen W, Schepens M, ter Beek H, van Dongen E. Measurements of Cerebrospinal Fluid Concentrations of S100β Protein During and After Thoracic Endovascular Stent Grafting. European journal of vascular and endovascular surgery. 2007;34(2):169-72.

Quintard H, Leduc S, Ferrari P, Petit I, Ichai C. Early and persistent high level of PS 100beta is associated with increased poor neurological outcome in patients with SAH: is there a PS 100beta threshold for SAH prognosis? Critical care (London, England). 2016;20(1):33.

Liu W, Huo X, Liu D, Zeng X, Zhang Y, Xu X. S100β in heavy metal-related child attention-deficit hyperactivity disorder in an informal e-waste recycling area. Neurotoxicology. 2014;45:185-91.

Qin B, Panickar KS, Anderson RA. Cinnamon polyphenols attenuate the hydrogen peroxide-induced down regulation of S100β secretion by regulating sirtuin 1 in C6 rat glioma cells. Life sciences. 2014;102(1):72-9.

Qin B, Panickar KS, Anderson RA. Cinnamon polyphenols regulate S100β, sirtuins, and neuroactive proteins in rat C6 glioma cells. Nutrition. 2014;30(2):210-7.

Donato R, Sorci G, Riuzzi F, Arcuri C, Bianchi R, Brozzi F, et al. S100B's double life: intracellular regulator and extracellular signal. Biochimica et Biophysica Acta (BBA)-Molecular Cell Research. 2009;1793(6):1008-22.

de Souza DF, Leite MC, Quincozes-Santos A, Nardin P, Tortorelli LS, Rigo MM, et al. S100B secretion is stimulated by IL-1β in glial cultures and hippocampal slices of rats: likely involvement of MAPK pathway. Journal of neuroimmunology. 2009;206(1):52-7.

Gerlach R, Demel G, König H-G, Gross U, Prehn J, Raabe A, et al. Active secretion of S100B from astrocytes during metabolic stress. Neuroscience. 2006;141(4):1697-701.

Kunihara T, Shiiya N, Yasuda K. Changes in S100β protein levels in cerebrospinal fluid after thoracoabdominal aortic operations. The Journal of thoracic and cardiovascular surgery. 2001;122(5):1019-20.

Jagoda AS, Bazarian JJ, Bruns JJ, Cantrill SV, Gean AD, Howard PK, et al. Clinical policy: neuroimaging and decisionmaking in adult mild traumatic brain injury in the acute setting. Journal of Emergency Nursing. 2009;35(2):e5-e40.

Undén J, Ingebrigtsen T, Romner B. Scandinavian guidelines for initial management of minimal, mild and moderate head injuries in adults: an evidence and consensus-based update. BMC medicine. 2013;11(1):1.

LeMaire SA, Bhama JK, Schmittling ZC, Oberwalder PJ, Köksoy C, Raskin SA, et al. S100β correlates with neurologic complications after aortic operation using circulatory arrest. The Annals of thoracic surgery. 2001;71(6):1913-9.

DOI: https://doi.org/10.22037/jcma.v1i3.11742


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