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Serum S100B concentrations are increased after closed head injury in children: a preliminary study
Rachel Pardes Berger1, Mary Clyde Pierce, Stephen R Wisniewski
1Department of Pediatrics, University of Pittsburgh School of Medicine, Graduate School of Public Health, Pittsburgh, Pennsylvania, USA. rberger@pitt.edu
Insights
Serum S100B protein levels increase in nearly half of children with traumatic brain injury (TBI). This biomarker elevation is transient, lasting under 12 hours, except in severe pediatric TBI cases.
Area of Science:
- Pediatric Traumatology
- Neuroscience
- Biomarker Discovery
Background:
- Traumatic brain injury (TBI) is a significant cause of childhood mortality and disability.
- Current diagnostic methods for TBI, especially inflicted injuries, have limitations.
- S100B protein, specific to astrocytes, is elevated in adults post-TBI, but its role in pediatric TBI is understudied.
Purpose of the Study:
- To measure serum S100B concentrations in children with varying severities of closed head injury (CHI).
- To compare S100B levels in inflicted versus non-inflicted pediatric CHI.
- To investigate the temporal profile of S100B elevation after pediatric CHI.
Main Methods:
- Prospective enrollment of 45 children (0-13 years) with mild, moderate, or severe CHI.
- Serum S100B levels measured serially for up to 5 days post-injury.
- Control samples from 16 children with long-bone fractures.
Main Results:
- 49% of pediatric CHI patients exhibited abnormal initial serum S100B concentrations.
- Elevated S100B was observed in both inflicted and non-inflicted CHI cases.
- S100B remained detectable beyond 12 hours only in severe CHI cases.
Conclusions:
- Serum S100B is elevated in a significant proportion of children following CHI.
- The elevation is generally transient, with exceptions in severe injuries.
- Serum S100B shows potential as a screening tool for inflicted pediatric TBI.
Abstract:
Traumatic brain injury (TBI) is a leading cause of death and disability in children. The current gold standards for diagnosis of TBI after closed head injury (CHI) have limitations, particularly in cases of inflicted injury. S100B is a protein that is specific to astrocytes. Serum S100B concentrations are increased in adults after CHI; there are no studies of serum S100B after CHI in children. The goal of this study was to measure the serum concentrations of S100B in children inflicted and noninflicted mild, moderate, and severe CHI. CHI severity was defined by initial Glasgow Coma Scale score. Forty-five children aged 0-13 years with mild (n = 27), moderate (n = 6), and severe (n = 12) CHI were enrolled prospectively. Blood was obtained as soon as possible after injury (range: 0.5-15.25 h) and every 12 h for up to 5 days when vascular access was available. Single control samples were obtained from 16 children aged 0-11 years with isolated long-bone fractures. Twenty-two patients (49%), including both patients with inflicted CHI, had an abnormal initial serum S100B concentration where an abnormal concentration was defined as greater than mean control concentration plus two standard deviations. S100B was detectable more than 12 h after injury only in patients with severe CHI. We conclude that serum S100B is increased in almost half of children after mild, moderate, and severe inflicted and noninflicted CHI. The increase is transient, lasting less than 12 h after injury, except in children with severe injury. Future research will focus on the possibility of using serum S100B as a screening test for inflicted CHI.