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(Stroke. 1998;29:730.)
© 1998 American Heart Association, Inc.

Letters to the Editor

Serum S-100 Protein in Acute Stroke

Richard J. Butterworth, MD, MRCP

Department of Neurology, St Mary's Hospital, London, UK

Roy A. Sherwood, DPhil

Department of Clinical Biochemistry

Philip M. W. Bath, MD, MRCP

Department of Medicine, King's College School of Medicine and Dentistry, London, UK

To the Editor:

We read with interest the work of Missler et al¹ and Büttner and colleagues² and agree with both sets of researchers on the need for reliable, noninvasive markers of neuronal damage following acute stroke. Such markers may allow prognostication of future clinical outcome and may be useful in acute therapy trials as surrogate markers of efficacy.

However, neither study cited our publication on serum S-100 protein levels in acute stroke,^{3 4} a study that examined 81 patients (68 with ischemic stroke and 13 with hemorrhagic stroke) within 48 hours of stroke ictus and compared them with 51 age-, race-, and gender-matched control subjects.³ As with both recent papers in Stroke, we found significantly higher serum S-100 protein levels in the stroke population than in the control group. Furthermore, the highest S-100 protein levels were seen in the hemorrhagic stroke group, and differentiation between the two stroke populations almost reached statistical significance. We also performed a temporal study (24, 48, 72, and 96 hours after ictus) in 13 patients and, unlike the recent Stroke studies, did not find differences between these time points. Convalescent samples were also analyzed in 57 of the 74 patients still alive at 3 months after stroke; S-100 protein levels had significantly fallen (2 P<.0001) at this time but were still above the level seen in the control population, suggesting partial restoration of glial cell integrity.

We have previously shown⁵ that neuron-specific enolase level and carnosinase activity are individually associated with clinical outcome, . . . [Full Text of this Article]

Ulrich Missler, MD; Martin Wismann, MD

Abteilung für Neuroradiologie, Klinikum Großhadern, München, Germany

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