Glial fibrillary acidic protein, S100B and NSE as an indicator of severity of brain injury in children

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Name	S100B Human ELISA
Cat. No.	RD192090100R RUO
Product category	Neural tissue damage markers
Assay format	Sandwich ELISA, Biotin-labelled antibody
Calibration range	0.05 - 2 ng/ml
Limit of detection	15 pg/ml
Applications	Cerebrospinal fluid, Plasma-Heparin, Serum
Sample requirements	25 µl/well
Storage/Shipping	2-8°C

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Name	Glial Fibrillary Acidic Protein Human ELISA (GFAP)
Cat. No.	RD192072200R RUO
Other names	GFAP
Product category	Neural tissue damage markers
Assay format	Sandwich ELISA, Biotin-labelled antibody
Calibration range	0.25 - 25 ng/ml
Limit of detection	0.045 ng/ml
Applications	Cerebrospinal fluid, Plasma-Citrate, Plasma-EDTA, Plasma-Heparin, Serum
Sample requirements	35 µl/well
Storage/Shipping	2-8°C

J. Zurek 1, P. Kosut 1, L. Marek 1, L. Bartlová 2, M. Kýr 3, M. Fedora 1

1Department of Anesthesia and Intensive Care, 2Department of Pediatric Neurology, Faculty of Medicine, Masaryk University, University Children´s Hos­pital, 3Institute for Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic

Objectives: The aim of the study was to determine whether serum levels of biomarkers – glial fibrillary acidic protein (GFAP), S100B protein and NSE – correlated with severity of brain injury and outcome in children with traumatic brain injury (TBI).

Methods: Twenty five patients with TBI were enrolled into the prospective study. TBI was verified by computed tomography according to the Marshall classification. Venous blood samples were taken after admission and every 24 h for a maximum of 6 consecutive days. Serum GFAP concentrations were quantified by enzyme-linked immunosorbent assay, S100B and NSE by electrogenerated chemiluminescence immunoassay. The outcome was evaluated 6 months after TBI using the Glasgow Outcome Scale (GOS) in all patients.

Results: Serum concentration of GFAP (median 13.4 ng/ml vs. 0.3 ng/ml; p 0.003), S100B (median 3.5 ng/ml vs. 0.7 ng/ml; p 0,009), NSE (median 162.4 ng/ml vs. 41.2 ng/ml; p 0.01) were higher in non-survivors than survivors. Serum GFAP (median 0.2 ng/ml vs.10.4 ng/ml; p 0.009), S100B (median 0.6 ng/ml vs. 2.5 ng/ml; p 0.021) and NSE (median 40.6 ng/ml vs. 59.0 ng/ml; p 0.027) were significantly lower in patients with the Marshall CT classification type I-II vs. type III-IV. Serum GFAP (median 13.4 ng/ml vs. 0.3 ng/ml; p 0.003), S100B (median 3.5 ng/ml vs. 0.7 ng/ml; p 0.014) and NSE (median 62.5 ng/ml vs. 41.2 ng/ml; p 0.048) was significantly higher in patients with unfavourable outcome (GOS >3 vs. GOS ≤3).

Conclusions: Plasma levels of GFAP, S100B and NSE correlate with the severity of TBI and may be useful as predictors of outcome in children with TBI.

Key Words: Children, traumatic brain injury, biomarkers, GFAP, S100B, NSE, outcome.

The results were presented at the 20th ESPNIC Medical & Nursing Annual Congress 2009, June 14–17, 2009, Verona, Italy and the CSARIM2009 – XVIth National Congress of the Czech Society of Anaesthesiology and Intensive Care Medicine, September 9–11, 2009, České Budějovice, the Czech Republic