The diagnostic and prognostic value of S-100β protein in traumatic brain injuries
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Date
2017
Authors
Fillion, Daniel
Morissette, Marc
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Abstract
Background: The World Health Organization has stated that traumatic brain injuries (TBI) will be considered one of the most significant causes of death and disability in the near future. High costs to the healthcare system associated with TBI management have been well documented. Studies investigating the diagnostic and prognostic ability of the Glasgow Coma Scale (GCS), computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans for TBI diagnosis are essential, however each has several pitfalls. The use of biomarkers has been proposed as an inexpensive alternative to assist with this clinical dilemma. Therefore, this literature review will examine the diagnostic and prognostic value of the most promising biomarker in TBI research, S-100β. Methods: A review was conducted spanning from 2000- 2017 using the following databases: PubMed, Google Scholar and Scopus. Key search and MeSH terms included “Traumatic Brain Injury,” “Biomarkers,” “Diagnosis,” and “Prognosis.” Supplemental information was acquired by reviewing journals and systematic review bibliographies. Results: Six papers were analyzed and reviewed. S-100β protein was found to be a sensitive biomarker for mild to severe TBIs, while potentially reducing the costs of TBI management through reduced use of CT scans and hospitalizations. Elevated S-100β concentrations on admission were strongly correlated to elevated intracranial pressure and was a predictor of mortality. S-100β is not without its limitations, which includes debatable specificities and poor temporal resolution. Conclusion: It has been demonstrated that S-100β may be a promising biomarker for TBIs, with high sensitivity and negative predictive values, however controversy remains with respect to its relationship with mild TBIs (mTBI). Furthermore, S-100β has shown to reduce healthcare costs by preventing unnecessary CT scans and hospitalizations in those with mTBIs. Elevated levels measured on admission have proven to be a prognostic indicator for increased intracranial pressure and mortality.
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Keywords
Traumatic brain injury, Biomarker, S-100β