The release of S-100B and NSE in severe traumatic head injury is associated with APOE ε4.
OBJECTIVE
In this article we tested the hypothesis that the level of two biochemical markers of brain injury may be associated with the apolipoprotein E (APOE) ε4 allele.


METHODS
In this prospective consecutive study patients with sTBI were included (n = 48). Inclusion criteria were Glasgow Coma Scale (GCS) score ≤ 8 at the time of intubation and sedation, patient age between 15 and 70 years, an initial cerebral perfusion pressure > 10 mmHg, and arrival to our level-one trauma university hospital within 24 h after trauma. Blood samples for neuron-specific enolase (NSE) and S-100B were collected as soon as possibly after arrival, and then twice daily (12-h intervals) for 5 consecutive days. Venous blood was used for APOE genotype determination. Clinical outcome at 3 months after injury was assessed with the Extended Glasgow Outcome Scale (GOSE).


RESULTS
Significantly higher levels of the maximal S-100B (S-100B(max)) and area under the curve (S-100B(AUC)) were found in subjects with the APOE ε4 allele compared to those with non-ε4. A similar tendency was observed for NSE(max) and NSE(AUC), though not statistically significant.


CONCLUSIONS
Our data indicate that there might be a gene-induced susceptibility to severe traumatic brain injury and that patients with the APOE ε4 allele may be more predisposed to brain cellular damage measured as S-100B and NSE. Thus, it seems to be of importance to consider the APOE genotype in interpreting the levels of the biomarkers.
Department of Pharmacology and Clinical Neuroscience, Section of Neurosurgery, Umeå University, Sweden. zandra.olivecrona@gmail.com
Zandra
Z
Olivecrona
Lars-Owe D
LO
Koskinen
D000293:Adolescent; D000328:Adult; D000368:Aged; D053327:Apolipoprotein E4 / Q000097:blood* / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D001921:Brain / Q000201:enzymology / Q000378:metabolism* / Q000473:pathology; D001930:Brain Injuries / Q000201:enzymology / Q000235:genetics / Q000378:metabolism*; D006259:Craniocerebral Trauma / Q000201:enzymology / Q000235:genetics / Q000378:metabolism*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D009414:Nerve Growth Factors / Q000097:blood / Q000235:genetics / Q000378:metabolism*; D010751:Phosphopyruvate Hydratase / Q000097:blood / Q000235:genetics / Q000378:metabolism*; D011446:Prospective Studies; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood / Q000235:genetics / Q000378:metabolism*; D012720:Severity of Illness Index; D055815:Young Adult
D053327:Apolipoprotein E4; D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D010751:Phosphopyruvate Hydratase