(Stroke. 1997;28:1956-1960.)
© 1997 American Heart Association, Inc.
Articles |
S-100 Protein and Neuron-Specific Enolase Concentrations in Blood as Indicators of Infarction Volume and Prognosis in Acute Ischemic Stroke
From the Department of Neuroradiology, Ludwig Maximilian University, Klinikum Großhadern, Munich (U.M., M.W., C.F.), and the Department of Neurology, Medical University, Lübeck (M.K.), Germany.
Correspondence to Dr Ulrich Missler, Abteilung für Neuroradiologie, Klinikum Großhadern, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377 München, Germany. E-mail missler{at}ikra.med.uni-muenchen.de
Background and Purpose Better techniques are needed to monitor infarction volume and predict neurological outcome after ischemic brain infarction. We evaluated the usefulness of serial measurements of S-100 protein versus neuron-specific enolase (NSE) in blood samples from patients with acute stroke.
Methods Using nonisotopic sandwich immunoassays, we measured plasma concentrations of S-100 protein and NSE on admission and on days 3, 4, 7, and 14 after infarction in 44 patients (age range, 22 to 86 years; mean age, 65.1 years; 12 female, 32 male). Infarct volume was measured by volumetric CT on day 4 after ictus, and clinical outcome was assessed at discharge from hospital with the Activities of Daily Living Scale and 6 months after infarction with the Glasgow Outcome Scale.
Results Peak blood levels of S-100 protein were found on day 2.5±1.3, and peak levels of NSE were found on day 1.9±0.8 after infarction. Peak plasma levels of S-100 protein correlated well with infarct volume (r=.75, P<.001) and with clinical outcome assessed with the Glasgow Outcome Scale (r=.51, P<.001). Serum levels of NSE correlated with infarct volume (r=.37, P<.05) but not with clinical outcome (r=.18, P>.05).
Conclusions The results of our study indicate that measuring blood concentrations of S-100 protein periodically in the first 10 days after cerebral infarction helps to predict infarct volume and the long-term neurological outcome more accurately than periodic measurements of blood concentrations of NSE.
Key Words: blood proteins • cerebral infarction • computed tomography • neuron-specific enolase • prognosis
This article has been cited by other articles:
 |
|
 |
|
  M Olivecrona, M Rodling-Wahlstrom, S Naredi, and L-O D Koskinen S-100B and neuron specific enolase are poor outcome predictors in severe traumatic brain injury treated by an intracranial pressure targeted therapy J. Neurol. Neurosurg. Psychiatry, November 1, 2009; 80(11): 1241 - 1248. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Whiteley, W. L. Chong, A. Sengupta, and P. Sandercock Blood Markers for the Prognosis of Ischemic Stroke: A Systematic Review Stroke, May 1, 2009; 40(5): e380 - e389. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. T. Laskowitz, S. E. Kasner, J. Saver, K. S. Remmel, E. C. Jauch, and BRAIN Study Group Clinical Usefulness of a Biomarker-Based Diagnostic Test for Acute Stroke: The Biomarker Rapid Assessment in Ischemic Injury (BRAIN) Study Stroke, January 1, 2009; 40(1): 77 - 85. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T Molnar, A Peterfalvi, L Szereday, G Pusch, L Szapary, S Komoly, L Bogar, and Z Illes Deficient leucocyte antisedimentation is related to post-stroke infections and outcome J. Clin. Pathol., November 1, 2008; 61(11): 1209 - 1213. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Foerch, M. T. Wunderlich, F. Dvorak, M. Humpich, T. Kahles, M. Goertler, J. Alvarez-Sabin, C. W. Wallesch, C. A. Molina, H. Steinmetz, et al. Elevated Serum S100B Levels Indicate a Higher Risk of Hemorrhagic Transformation After Thrombolytic Therapy in Acute Stroke Stroke, September 1, 2007; 38(9): 2491 - 2495. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. C. Jauch, C. Lindsell, J. Broderick, S. C. Fagan, B. C. Tilley, S. R. Levine, and for the NINDS rt-PA Stroke Study Group Association of Serial Biochemical Markers With Acute Ischemic Stroke: The National Institute of Neurological Disorders and Stroke Recombinant Tissue Plasminogen Activator Stroke Study Stroke, October 1, 2006; 37(10): 2508 - 2513. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C Foerch, I Curdt, B Yan, F Dvorak, M Hermans, J Berkefeld, A Raabe, T Neumann-Haefelin, H Steinmetz, and M Sitzer Serum glial fibrillary acidic protein as a biomarker for intracerebral haemorrhage in patients with acute stroke J. Neurol. Neurosurg. Psychiatry, February 1, 2006; 77(2): 181 - 184. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Foerch, O. C. Singer, T. Neumann-Haefelin, R. du Mesnil de Rochemont, H. Steinmetz, and M. Sitzer Evaluation of Serum S100B as a Surrogate Marker for Long-term Outcome and Infarct Volume in Acute Middle Cerebral Artery Infarction Arch Neurol, July 1, 2005; 62(7): 1130 - 1134. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. A. Kofke, P. Konitzer, Q. C. Meng, J. Guo, and A. Cheung The Effect of Apolipoprotein E Genotype on Neuron Specific Enolase and S-100{beta} Levels After Cardiac Surgery Anesth. Analg., November 1, 2004; 99(5): 1323 - 1325. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Foerch, B. Otto, O. C. Singer, T. Neumann-Haefelin, B. Yan, J. Berkefeld, H. Steinmetz, and M. Sitzer Serum S100B Predicts a Malignant Course of Infarction in Patients With Acute Middle Cerebral Artery Occlusion Stroke, September 1, 2004; 35(9): 2160 - 2164. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. E. Vos, K. J.B. Lamers, J. C.M. Hendriks, M. van Haaren, T. Beems, C. Zimmerman, W. van Geel, H. de Reus, J. Biert, and M. M. Verbeek Glial and neuronal proteins in serum predict outcome after severe traumatic brain injury Neurology, April 27, 2004; 62(8): 1303 - 1310. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. G. Zimmermann-Ivol, P. R. Burkhard, J. Le Floch-Rohr, L. Allard, D. F. Hochstrasser, and J.-C. Sanchez Fatty Acid Binding Protein as a Serum Marker for the Early Diagnosis of Stroke: A Pilot Study Mol. Cell. Proteomics, January 1, 2004; 3(1): 66 - 72. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Kinoshita, H. Iranami, K. Fujii, A. Yamazaki, M. Shimogai, K. Nakahata, Y. Hironaka, and Y. Hatano The Use of Bone Cement Induces an Increase in Serum Astroglial S-100B Protein in Patients Undergoing Total Knee Arthroplasty Anesth. Analg., December 1, 2003; 97(6): 1657 - 1660. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Reynolds, H. J. Kirchick, J. R. Dahlen, J. M. Anderberg, P. H. McPherson, K. K. Nakamura, D. T. Laskowitz, G. E. Valkirs, and K. F. Buechler Early Biomarkers of Stroke Clin. Chem., October 1, 2003; 49(10): 1733 - 1739. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. S. Yadav Protecting the brain:how do we measure success? J. Am. Coll. Cardiol., September 17, 2003; 42(6): 1014 - 1016. [Full Text] [PDF]
|
|
|
|
|
|
K. Becker, D. Kindrick, R. McCarron, J. Hallenbeck, and R. Winn Adoptive Transfer of Myelin Basic Protein-Tolerized Splenocytes to Naive Animals Reduces Infarct Size: A Role for Lymphocytes in Ischemic Brain Injury? Stroke, July 1, 2003; 34(7): 1809 - 1815. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C Foerch, R Du Mesnil de Rochemont, O Singer, T Neumann-Haefelin, M Buchkremer, F E Zanella, H Steinmetz, and M Sitzer S100B as a surrogate marker for successful clot lysis in hyperacute middle cerebral artery occlusion J. Neurol. Neurosurg. Psychiatry, March 1, 2003; 74(3): 322 - 325. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T Chant, J May, and A J B Emmerson Serum S-100 protein does not correlate with cerebral ultrasound scans in preterm infants Arch. Dis. Child. Fetal Neonatal Ed., March 1, 2003; 88(2): F160 - F161. [Full Text] [PDF]
|
|
|
|
|
|
S.-H. Oh, J.-G. Lee, S.-J. Na, J.-H. Park, Y.-C. Choi, and W.-J. Kim Prediction of Early Clinical Severity and Extent of Neuronal Damage in Anterior-Circulation Infarction Using the Initial Serum Neuron-Specific Enolase Level Arch Neurol, January 1, 2003; 60(1): 37 - 41. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-W. Elting, G. A. Sulter, M. Kaste, K. R. Lees, H. C. Diener, M. Hommel, M. Versavel, A. W. Teelken, and J. De Keyser AMPA Antagonist ZK200775 in Patients With Acute Ischemic Stroke: Possible Glial Cell Toxicity Detected by Monitoring of S-100B Serum Levels Stroke, December 1, 2002; 33(12): 2813 - 2818. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Jordan, J. Hagedohm, J. Wiltfang, G. Laier-Groeneveld, H. Tumani, A. Rodenbeck, E. Ruther, and G. Hajak Biochemical markers of cerebrovascular injury in sleep apnoea syndrome Eur. Respir. J., July 1, 2002; 20(1): 158 - 164. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Wong, K. Ess, and M. Landt Cerebrospinal Fluid Neuron-Specific Enolase Following Seizures in Children: Role of Etiology J Child Neurol, April 1, 2002; 17(4): 261 - 264. [Abstract] [PDF]
|
|
|
|
 |
|
 W. Gartner, W. Lang, F. Leutmetzer, H. Domanovits, W. Waldhausl, and L. Wagner Cerebral Expression and Serum Detectability of Secretagogin, a Recently Cloned EF-hand Ca2+ -binding Protein Cereb Cortex, December 1, 2001; 11(12): 1161 - 1169. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. I. Dar, T. Gillott, F. Ciulli, and G. J. Cooper Single aortic cross-clamp technique reduces S-100 release after coronary artery surgery Ann. Thorac. Surg., March 1, 2001; 71(3): 794 - 796. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Herrmann, P. Vos, M. T. Wunderlich, C. H. M. M. de Bruijn, and K. J. B. Lamers Release of Glial Tissue-Specific Proteins After Acute Stroke : A Comparative Analysis of Serum Concentrations of Protein S-100B and Glial Fibrillary Acidic Protein Stroke, November 1, 2000; 31(11): 2670 - 2677. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. S. Ali, M. Harmer, and R. Vaughan Serum S100 protein as a marker of cerebral damage during cardiac surgery Br. J. Anaesth., August 1, 2000; 85(2): 287 - 298. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. Missler, M. Wiesmann, P. Ehlermann, M. Tronnier, A. Notzold, E. Steinmeier, and W. G. Wood Validation and Comparison of Two Solid-Phase Immunoassays for the Quantification of S-100B in Human Blood Clin. Chem., July 1, 2000; 46(7): 993 - 996. [Full Text] [PDF]
|
|
|
|
 |
|
 S. Westaby, K. Saatvedt, S. White, T. Katsumata, W. van Oeveren, N. K. Bhatnagar, S. Brown, and P. W. Halligan IS THERE A RELATIONSHIP BETWEEN SERUM S-100{beta} PROTEIN AND NEUROPSYCHOLOGIC DYSFUNCTION AFTER CARDIOPULMONARY BYPASS? J. Thorac. Cardiovasc. Surg., January 1, 2000; 119(1): 132 - 137. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Georgiadis, A. Berger, E. Kowatschev, C. Lautenschlager, A. Borner, A. Lindner, W. Schulte-Mattler, H.-R. Zerkowski, S. Zierz, and T. Deufel PREDICTIVE VALUE OF S-100{beta} AND NEURON-SPECIFIC ENOLASE SERUM LEVELS FOR ADVERSE NEUROLOGIC OUTCOME AFTER CARDIAC SURGERY J. Thorac. Cardiovasc. Surg., January 1, 2000; 119(1): 138 - 147. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Ettinger, A. B. Laumark, R. M. Ostroff, J. Brundell, W. A. Baumgartner, and A. Y. Razumovsky A new optical immunoassay for detection of S-100B protein in whole blood Ann. Thorac. Surg., December 1, 1999; 68(6): 2196 - 2201. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Takahashi, A. Chamczuk, Y. Hong, and G. Jackowski Rapid and Sensitive Immunoassay for the Measurement of Serum S100B Using Isoform-specific Monoclonal Antibody Clin. Chem., August 1, 1999; 45(8): 1307 - 1311. [Full Text] [PDF]
|
|
|
|
|
|
M. T. Wunderlich, A. D. Ebert, T. Kratz, M. Goertler, S. Jost, and M. Herrmann Early Neurobehavioral Outcome After Stroke Is Related to Release of Neurobiochemical Markers of Brain Damage Stroke, June 1, 1999; 30(6): 1190 - 1195. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. K. Pisa, M. Wiesmann, and U. Missler Serum S-100 Protein in Stroke and Cardiac Surgery • Response Stroke, May 1, 1999; 30 (5): 1153 - 1154. [Full Text] [PDF]
|
|
|
|
|
|
U. Missler, M. Wiesmann, G. Wittmann, O. Magerkurth, and H. Hagenstrom Measurement of Glial Fibrillary Acidic Protein in Human Blood: Analytical Method and Preliminary Clinical Results Clin. Chem., January 1, 1999; 45(1): 138 - 141. [Full Text] [PDF]
|
|
|
|
|
|
C. Wong, R. S. Bonser, U. Missler, and M. Weismann Serum S-100 Protein in Stroke and Cardiac Surgery • Response Stroke, November 1, 1998; 29(11): 2446 - 2447. [Full Text] [PDF]
|
|
|
|
|
|
H. P. Grocott, N. D. Croughwell, D. W. Amory, W. D. White, J. L. Kirchner, and M. F. Newman Cerebral Emboli and Serum S100{beta} During Cardiac Operations Ann. Thorac. Surg., June 1, 1998; 65(6): 1645 - 1649. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Wiesmann, U. Missler, D. Gottmann, and S. Gehring Plasma S-100b Protein Concentration in Healthy Adults Is Age- and Sex-Independent Clin. Chem., May 1, 1998; 44(5): 1056 - 1058. [Full Text] [PDF]
|
|
|
|
|
|
R. J. Butterworth, R. A. Sherwood, P. M. W. Bath, U. Missler, and M. Wismann Serum S-100 Protein in Acute Stroke • Response Stroke, March 1, 1998; 29(3): 730 - 730. [Full Text] [PDF]
|
|