Elevation of serum S100 protein concentration as a marker of ischemic brain damage in extremely preterm infants.
BACKGROUND
Periventricular leukomalacia (PVL) is serious ischemic brain damage that occurs in extreme preterm infants. It is traditionally diagnosed by cranial echography. The purpose of this study was to investigate the relationship between serum S100 calcium-binding protein B (S100B) concentrations and ischemic brain damage, and to find the cutoff value for the early identification of ischemic brain damage in high-risk preterm infants.


METHODS
At the age of 3 days, 7 days, 14 days, and 21 days, and before discharge, 22 extremely premature infants (i.e., gestational age <33 weeks) underwent blood sampling to determine the S100B concentrations and cranial echography examinations. The severity of ischemic brain damage in echographic images was scored on a scale of 0-11, and was recorded as the brain echography index (BEI). If the last BEI value was ≥7, the enrolled infants were grouped in the brain damage group.


RESULTS
Eight infants were assigned to the brain damage group and 14 infants were assigned to the no brain damage group. At each age point of the blood samplings, the serum S100B concentrations were significantly higher in the brain damage group than in the no brain damage group. There was a significantly positive correlation between the serum S100B concentrations and the BEI on the same day (r = 0.738, p < 0.001) and 7 days later (r = 0.774, p < 0.001). The receiver operating characteristic curve for the serum S100B concentrations showed that the area under curve was 0.985 (p < 0.001). The cutoff value of serum S100B of 1.0 μg/L had a sensitivity of 93.8% and specificity of 90.5% for the diagnosis of ischemic brain damage.


CONCLUSIONS
An elevation in the serum S100B concentration is highly associated with ischemic brain damage in extreme preterm infants. Ischemic brain damage in a high-risk preterm infant is strongly suggested if the early serum S100B concentration is > 1.0 μg/L.
Institute of Emergency and Critical Care Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC; Division of Pediatric Neurology, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC.
Lin-Mei
LM
Chiang
Institute of Emergency and Critical Care Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC; Department of Pediatrics, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC; Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Wei-Yu
WY
Chen
Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Yi-Chiang
YC
Yang
Institute of Emergency and Critical Care Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC; Department of Pediatrics, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC; Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. Electronic address: mjjeng@vghtpe.gov.tw.
Mei-Jy
MJ
Jeng
D015415:Biomarkers / Q000097:blood; D001921:Brain / Q000000981:diagnostic imaging; D002545:Brain Ischemia / Q000097:blood* / Q000000981:diagnostic imaging; D004453:Echoencephalography; D006801:Humans; D062071:Infant, Extremely Premature / Q000097:blood*; D007231:Infant, Newborn; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood*
D015415:Biomarkers; D064568:S100 Calcium Binding Protein beta Subunit; C579160:S100B protein, human
S100B; brain damage; neonate; periventricular leukomalacia; preterm infant