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Published on: October 28, 2022
Elevation of serum S100 protein concentration as a marker of ischemic brain damage in extremely preterm infants
Lin-Mei Chiang1, Wei-Yu Chen2, Yi-Chiang Yang3
1Institute 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.
Insights
Serum S100 calcium-binding protein B (S100B) can help identify ischemic brain damage in extremely preterm infants. An early S100B level over 1.0 μg/L strongly suggests brain damage, aiding early diagnosis.
Area of Science:
- Neonatal neurology
- Biomarker research
- Pediatric neuroimaging
Background:
- Periventricular leukomalacia (PVL) is a severe ischemic brain injury affecting extremely preterm infants.
- Cranial echography is the traditional diagnostic method for PVL.
- Early identification of brain damage is crucial for timely intervention in high-risk preterm infants.
Purpose of the Study:
- To investigate the association between serum S100B concentrations and ischemic brain damage in extremely preterm infants.
- To determine a cutoff value for S100B to enable early detection of brain damage.
- To correlate S100B levels with the severity of brain injury assessed by echography.
Main Methods:
- 22 extremely preterm infants (gestational age <33 weeks) were enrolled.
- Serum S100B concentrations and cranial echography (assessed by brain echography index, BEI) were measured at multiple time points.
- Infants were grouped into 'brain damage' (last BEI ≥7) and 'no brain damage' groups.
Main Results:
- Serum S100B concentrations were significantly higher in the brain damage group across all measured time points.
- A strong positive correlation was found between S100B levels and BEI, both on the same day (r=0.738) and 7 days later (r=0.774).
- The receiver operating characteristic curve analysis yielded an area under the curve of 0.985, indicating high diagnostic accuracy.
Conclusions:
- Elevated serum S100B concentrations are strongly linked to ischemic brain damage in extremely preterm infants.
- A serum S100B cutoff value of 1.0 μg/L demonstrated high sensitivity (93.8%) and specificity (90.5%) for diagnosing brain damage.
- Early measurement of serum S100B (>1.0 μg/L) can effectively identify high-risk preterm infants with suspected ischemic brain damage.
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.
Conclusion:
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.
