Serum levels of neuron-specific enolase and s-100 protein after single tonic-clonic seizures

Serum neuron-specific enolase (s-NSE) and s-100 protein (s-100) are sensitive markers of various brain diseases. We investigated both of these markers in nine patients within 5 min, 6 h, 12 h, and 48 h after a single tonic-clonic seizure. The mean peak s-NSE level was significantly higher after 5 min (11.97 ± 8.56 μg/l) and 48 h (10.31 ± 8.92 μg/l, P < 0.05) than the levels of seizure-free, age-matched controls. Five patients had increased s-NSE levels regarding the upper limit of normal as mean + 3 SD. s-100 was not detected either in controls or epileptic patients. These data indicate that s-NSE in contrast to s-100 may be an in vivo marker after generalized seizures in some patients. Received: 2 April 1997 Received in revised form: 22 September 1998 Accepted: 4 November 1998     

Cerebrospinal fluid levels of S-100b protein and neuron-specific enolase in chronic inflammatory demyelinating polyneuropathy

We measured the cerebrospinal fluid (CSF) concentrations of S-100b protein (S-100b) and neuron-specific enolase (NSE) using enzyme immunoassay methods in 15 patients with chronic inflammatory demyelinating polyneuropathy (CIDP), other three patients with chronic neuropathy with demyelination, eight patients with various axonal neuropathies (AN), and 46 controls, to investigate the clinical usefulness of the determination of these two specific proteins in these neuropathies. S-100b levels were elevated (>the mean ± 2 SD levels of controls) in the majority of patients with clinically progressing CIDP (9/11), but not in the patients with AN (0/8). In parallel with the clinical improvement, S-100b levels were normalized in patients with CIDP (10/10), though total protein levels in the CSF still remained high in some of these patients (5/10). Elevation of NSE levels were seldom seen in clinically worsening patients with CIDP (1/11) or AN (1/8). Thus our results indicated that the level of S-100b in the CSF may be useful to assess the activity of actual disease process in CIDP.     

Protein S-100 and neuron-specific enolase serum levels remain unaffected by electroconvulsive therapy in patients with depression

The mechanism of the reversible cognitive deficits that might occur within an electroconvulsive therapy (ECT) treatment has not been clarified in a substantial way yet. Although the data available so far do not point towards a cause due to any structural or diffuse damage, further clarification, especially of the role of S-100 seems to be necessary before robust conclusions can be drawn. Serum levels of protein S-100 and neuron-specific enolase (NSE) were analysed in 19 patients with depression, who received ECT. The sampling was adjusted for the short half-life of protein S-100. Several outcome parameters such as Hamilton Depression Rating Scale and Mini-mental state examination before and after the ECT, response and remission to the treatment were recorded. S-100 and NSE levels at baseline, 30 and 60 min after the third session and after the end of the ECT remained stable. S-100 and NSE levels were neither associated with antidepressant response or remission nor with alterations in the cognitive performance. Although aiming for detecting potential rise in these established brain damage markers, an increase due to ECT was not observed, which is in line with the previous studies concerning the safety of ECT on a cellular basis.     

Cerebrospinal neuron-specific enolase, S-100 and myelin basic protein in neurological disorders

In this study levels of neuron-specific enolase (NSE), S-100 protein (S-100) and myelin basic protein (MBP) in cerebrospinal fluid (CSF) of children and adults with distinct neurological disorders were examined. A previous study from our department demonstrated age related reference values for these brain-specific proteins in CSF. The median concentration level of the 3 proteins in 17 different neurological disease groups versus the reference group was compared. Significantly higher MBP values were observed in patients with multiple sclerosis (MS), cerebrovascular accident (CVA), metabolic disorder and infection. Furthermore, significantly higher values were demonstrated for S-100 in CVA and for NSE in metabolic diseases. In CVA, the NSE and S-100 values were significantly related with MBP values, whereas in MS the NSE and S-100 were not related with MBP values.     

Serum and CSF neuron-specific enolase in patients with West syndrome

OBJECTIVE: To determine whether frequent seizures and/or hypsarrhythmia may cause neuronal injury in West syndrome. BACKGROUND: West syndrome is an age-related epileptic syndrome of infancy characterized by clusters of epileptic spasms, a peculiar interictal EEG pattern of hypsarrhythmia, and mental deterioration. Recent clinical studies demonstrated that serum and CSF neuron-specific enolase (NSE)-a marker of neuronal injury-were increased after status epilepticus. METHODS: The authors examined serum and CSF NSE levels in 18 newly diagnosed infants (8.4 +/- 2.2 months) with West syndrome (3 cryptogenic, 15 symptomatic). In patients who showed complete resolution of spasms and disappearance of hypsarrhythmia (responders), additional serum NSE levels were determined several weeks after cessation of seizures. Serum NSE levels were obtained from 28 age-matched infants with normal neurologic development (control group), and 10 infants with an acute neurologic insult. RESULTS: There were no significant differences (p > 0.05) in serum NSE levels between the group with West syndrome (12.9 +/- 3.4 ng/mL) and the control group (13.2 +/- 3.1 ng/mL). The serum NSE value in the group with an acute insult (100.3 +/- 67.4 ng/mL) was significantly higher (p < 0.0001) than that for the West syndrome and the control groups. The mean +/- SD CSF NSE level was 7.3 +/- 3.6 ng/mL, which is similar to the reported CSF NSE levels of Japanese infants without neurologic disease. Thirteen responders showed no significant (p > 0.05) change in serum NSE after cessation of epileptic spasms. CONCLUSION: Normal serum and CSF neuron-specific enolase levels provided no evidence that seizures and/or hypsarrhythmia induced neuronal injury in West syndrome.     

Central nervous system disorders in myotonic dystrophy--with special reference to neuron-specific enolase, S-100b protein and creatine kinase BB isoenzyme levels in CSF]

In order to evaluate central nervous system disorders in myotonic dystrophy (MyD), neuron-specific enolase (NSE), S-100b protein and creatine kinase BB (CK-BB) isoenzyme were measured using enzyme immunoassay in MyD. Intelligence quotient (IQ) test (WAIS, 17 cases), electro-encephalography (17 cases) and brain computed tomography (18 cases) were examined. In patients with MyD, NSE level was significantly elevated in comparison with 25 age-sex matched control subjects. In some cases of MyD levels of S-100b protein and CK-BB in CSF were elevated. IQ test disclosed intellectual impairment in 70.6% of the patients examined and EEG study demonstrated slowing of basic rhythm in the majority of the cases. On brain CT both enlarged ventricles and dilated sulci were commonly found. The results of the present study suggest that in MyD the CNS is involved not only functionally but structurally as well. Since NSE, S-100b and CK-BB are localized in neuronal and glia cells, their elevated levels in CSF indicate existence of organic lesions in the central nervous tissue in patients with MyD.     

Neuron-specific enolase and S-100 protein levels in cerebrospinal fluid of patients with various neurological diseases

Neuron-specific enolase (NSE) and S-100 protein (S-100) levels in cerebrospinal fluid (CSF) were determined in 129 patients with various neurological diseases. The chronological changes of these nervous system-specific proteins in CSF were also examined in 3 patients with acute disorders. NSE and S-100 levels were elevated in many cases with acute conditions. These specific proteins did not increase simultaneously but independently. These results suggested that NSE and S-100 in CSF would be useful markers for damage of the nervous system and that measurement of both NSE and S-100 might positively indicate whether the damage was neuronal, glial or mixed in origin. Moreover, from the serial determination of these substances, they would be better markers than cell counts and total protein in CSF for the active injury for the nervous tissues.     

14-3-3 protein, neuron-specific enolase, and S-100 protein in cerebrospinal fluid of patients with Creutzfeldt-Jakob disease

We explored simultaneously 14-3-3 protein, neuron-specific enolase (NSE), and one astroglial protein, S-100, recently proposed as Creutzfeld-Jakob disease (CJD) markers, in the cerebrospinal fluid (CSF) of 129 patients with suspected CJD. Cutoff values for NSE and S-100 were established at 25 and 2.5 ng/ml, respectively. The highest sensitivity was observed for S-100 (94.2%) followed by 14-3-3 (89.8%) and NSE (79.7%), while the highest specificity in CJD diagnosis was obtained with 14-3-3 protein (100%) as compared with NSE (91.5%) and S-100 (85.4%). No influence of sex, genotype at codon 129 of the prion protein gene, time between sampling, and death or disease duration has been found. Based on 90 cases initially referred as 'probable' or 'possible' CJD, with 14-3-3, NSE, or S-100 we could correctly discriminate between 'CJD' or 'non-CJD' categories in 94.4, 86.5, and 90% of the cases, respectively. When limited to 'possible CJD' cases, diagnosis based on one of the three CSF proteins was accurate in 98, 90.7 and 87.3%, respectively. In view of the fact that the CSF 14-3-3 protein test alone has the highest specificity and good sensitivity, it appears that there is no additional advantage at the moment to include NSE and/or S-100 protein in the exploration of clinically suspected CJD cases.     

Prognostic value of cerebrospinal fluid neuron-specific enolase and S-100b protein in Guillain-Barré syndrome

We measured the cerebrospinal fluid (CSF) concentrations of neuron-specific enolase (NSE) and S-100b protein (S-100b) using enzyme immunoassay methods, in 24 patients with Guillain-Barré syndrome and 46 controls, and examined their prognostic values. Sixteen of 24 patients showed elevated levels (> the mean + 2SD levels of controls) of NSE, S-100b, or both, and in those with higher NSE or S-100b levels there was a rather longer duration of disease, whereas 8 patients with the normal levels showed an early recovery. Further, NSE or S-100b levels were significantly correlated with months to recovery. Thus, NSE and S-100b in CSF may be useful markers for predicting the outcome of Guillain-Barré syndrome.     

神经元特异性烯醇化酶及S-100蛋白对Creutzfeldt-Jakob病诊断价值的研究

目的　探讨早期诊断Creutzfeldt Jakob病 (CJD)的一种简便易行的检测方法。方法　采用ELISA及双抗体夹心方法检测 10例CJD、10例非CJD痴呆患者及 10名健康对照者的血清及CSF中神经元特异性烯醇化酶 (NSE)、S 10 0蛋白水平。同时对CJD患者血清中朊蛋白 (PrP)基因进行检测。结果　CJD组血清及CSF中NSE、S 10 0蛋白均较非CJD痴呆组升高 (均P <0 .0 5 ) ,血清中S 10 0蛋白明显升高 (P <0 .0 1)。CJD组血清中NSE及CSF中NSE、S 10 0蛋白较健康对照组明显升高 (均P <0 .0 1) ,血清中S 10 0蛋白较健康对照组升高(P <0 .0 5 ) ;非CJD痴呆组血清及CSF中NSE、S 10 0蛋白较健康对照组升高 (P <0 .0 5 )。 10例CJD中 8例为12 9密码子甲硫氨酸纯合子型 ,2例 12 9密码子甲硫氨酸和缬氨酸杂合型 ,无 12 9密码子缬氨酸纯合子型。结论　早期CSF中NSE及血清、CSF中S 10 0蛋白检测对CJD可以进行病情的判断及预后的评估。血清中S 10 0蛋白检测可用于CJD与非CJD痴呆的鉴别诊断。散发型CJD大部分为 12 9密码子甲硫氨酸纯合型 ,12 9密码子甲硫氨酸及缬氨酸杂合型CJD其临床表现与纯合型不同。     

Elevation of neuron-specific enolase and S-100beta protein level in experimental acute spinal cord injury.

We evaluated the protein levels of neuron-specific enolase (NSE) and S-100beta in serum and cerebrospinal fluid (CSF) in an animal model of acute spinal cord injury and ascertained their relevance. Spinal cord injury was induced at the T8 level in rats. Enzyme-linked immunosorbent assay was used to measure the protein levels of NSE and S-100beta in both serum and CSF at different time points (30 min, 2 h, 6 h, 12 h and 24 h after induction of spinal cord injury). There existed a significant correlation between neurological deficits and the severity of spinal cord injury (p<0.05). Compared with the control group, the protein levels of NSE and S-100beta in serum and CSF significantly increased from 2 h after injury (p<0.05) and reached a maximum at 6 h. Within a certain time window, the protein levels of NSE and S-100beta in serum and CSF were closely related to the severity of injury level (p<0.05). The protein levels of NSE and S-100beta in serum and CSF significantly increased after experimental spinal cord injury in a time-dependent manner and thus may be considered specific biomarkers for acute spinal cord injury.     

S-100B and neuron-specific enolase in serum of mild traumatic brain injury patients. A comparison with health controls

OBJECTIVES: The aim of the study was to determine whether serum concentrations of neuron-specific enolase (NSE) and S100-B in mild traumatic brain injury (MTBI) patients are higher than in serum of healthy controls. MATERIAL AND METHODS: Blood samples from 104 MTBI patients were taken shortly after the trauma for measurement of S-100B and NSE in serum. In 92 healthy persons these markers were also measured. Marker concentrations in serum of patients and controls were compared. In the patient group the relation between serum-marker concentrations and clinical symptoms and signs, that occurred shortly after the traumatic event, were evaluated. RESULTS: Median NSE concentration was only slightly higher in patients (9.8 microg/l; 10 to 90 percentile range 6.9 to 14.3 microg/ l) than in controls (9.4 microg/l; 6.3 to 13.3 microg/l). Median S-100B concentration was significantly higher in patients (0.25 microg/l; 0.00 to 0.68 microg/l) than in controls (0.02 microg/l; 0.00 to 0.13 microg/l). An association was found between S-100B concentrations and vomiting in patients. CONCLUSIONS: S-100B is a useful marker for brain damage in MTBI patients and seems to be associated with the presence of vomiting after the trauma.     

Neuron-specific enolase and S-100 protein levels in cerebrospinal fluid of patients with cervical spondylosis and ossification of posterior longitudinal ligaments

We examined the levels of neuron-specific enolase (NSE) and S-100 protein in the cerebrospinal fluid (CSF) in 39 cases of cervical spondylosis (CS), in 16 cases of ossification of posterior longitudinal ligaments (OPLL), and in 29 control subjects by means of highly sensitive enzyme immunoassay methods. The levels (mean +/- SD) of NSE and S-100 protein in the control subjects, CS cases, and OPLL cases were shown as follows: NSE = 4.7 +/- 2.1, 8.0 +/- 3.4, 6.0 +/- 3.1 ng/ml, S-100b = 0.42 +/- 0.22, 0.72 +/- 0.40, 0.67 +/- 0.27 ng/ml, respectively. CS patients with a muscle atrophy of upper limbs showed a rise in NSE levels and this was especially seen in cases of cervical spondylotic amyotrophy (CSA). There were positive correlations between the distance of the A-P diameters of the spinal canal and the amount of NSE in OPLL cases (r = -0.6915, p less than 0.01). CS patients with severe spinal cord compressions demonstrated by myelo CT showed higher levels of NSE and S-100b. These results suggest that NSE, S-100 protein can be used as reliable markers to evaluate the damage of the spinal cord in CS and OPLL.     

Cerebrospinal fluid neuron-specific enolase (NSE) and S-100b protein in Guillain-Barré syndrome--their relations to prognosis]

We measured the cerebrospinal fluid (CSF) levels of neuron-specific enolase (NSE) and S-100b protein (S-100b) using enzyme immunoassay methods in 12 patients with Guillain-Barré syndrome (GBS), and 46 control subjects, and evaluated their clinical values in relation to prognosis. The 4 patients with the remarkably elevated level of NSE or S-100b in the acute stage recovered slowly over 1 year after onset, while the 2 patients showed the normal NSE and S-100b levels and recovered within 4 months. In 6 patients, the NSE and/or S-100b were slightly or moderately increased in the acute stage. They recovered from 1.5 to 11 months after onset, and the two patients showing very early recovery have the remarkably increase of S-100b in the recovery stage. These results suggest that CSF NSE and S-100b may be useful biochemical markers for estimation of prognosis in GBS patients.     

S-100 protein and neuron-specific enolase in cerebrospinal fluid and serum: markers of cell damage in human central nervous system

The development of a radioimmunoassay for S-100 protein is described. This method was used in combination with a recently developed radioimmunoassay for neuron-specific enolase in cerebrospinal fluid and serum from 47 patients with cerebral infarction, transient ischemic attack, intracerebral hemorrhage, subarachnoid hemorrhage, and head injury. In cerebrospinal fluid, increased concentrations of both S-100 and neuron-specific enolase were found after large infarcts, whereas after small infarcts and transient ischemic attacks, only neuron-specific enolase increased. The increased concentrations of S-100 and/or neuron-specific enolase were noted 18 hours to 4 days after cerebral infarction and transient ischemic attacks. Cerebrospinal fluid concentrations of these proteins also reflected the severity of the disease in patients with intracerebral hematoma, subarachnoid hemorrhage, or head injury. Temporal changes in serum S-100 and neuron-specific enolase concentrations reflected the clinical course in 4 patients. In stroke patients, the S-100 and neuron-specific enolase concentrations may reflect the extent of brain damage and could be useful in selecting patients with major stroke for more aggressive treatment during the acute phase.     

Cerebrospinal fluid level of aldolase C in patients with various neurological disorders: comparison with neuron-specific enolase, S-100b protein and creatine kinase BB isoenzyme

By employing a highly sensitive immunoassay method, concentration of aldolase C (Ald C) was determined in cerebrospinal fluid (CSF) of 180 patients with various neurological disorders and 46 age-and-sex matched control subjects. The results were compared with CSF levels of neuron-specific enolase (NSE), S-100b proteins (S-100b) and creatine kinase BB isoenzyme (CK-BB) in the same samples. Normal level of Ald C was 7.95 +/- 2.52 (mean +/- SD) ng/ml. CSF level of Ald C was elevated not only in patients with acute disorders, but also those of degenerative diseases. It increased significantly in purulent meningitis, encephalitis, cerebral infarction, and cervical spondylosis as compared with control subjects. The levels of Ald C were reached the peak levels later than those of NSE, S-100b and CK-BB. Concentration of Ald C in CSF correlated well with that of NSE but poorly with that of S-100b or CK-BB. These results suggested that Ald C in CSF was one of the useful marker in neurological disorders. Since these proteins have different distributions in the central nervous system and have different molecular weights, simultaneous determination of Ald C, NSE, S-100b and CK-BB levels in CSF might provide valuable information about pathologic nature of the underlying neurological disorders.     

Protein S-100B,neuron-specific enolase (NSE), myelin basic protein (MBP) and glial fibrillary acidic protein (GFAP) in cerebrospinal fluid (CSF) and blood of neurological patients

In this study, data about protein S-100B, neuron-specific enolase, myelin basic protein and glial fibrillary acidic protein in cerebrospinal fluid and blood of patients with an acute or chronic progressive neurological disorder with brain damage are reviewed. Especially in disorders with acute brain damage, determination of these proteins in CSF and blood can be helpful to establish structural and/or functional brain damage to determine severity and prognosis of the disease process and to monitor treatment effects.     

S100B蛋白及NSE在婴儿痉挛症患儿脑脊液中的水平研究

目的探讨婴儿痉挛症(infantile spasm,IS)发病初期S100B蛋白、神经元特异性烯醇化酶(neuron specific enolase,NSE)在脑脊液中的浓度及与IS脑损伤的关系。方法采集23例婴儿痉挛症发病早期患儿脑脊液,应用ELISA方法定量检测S100B蛋白、NSE浓度;20名同年龄组非神经系统疾病患儿设为对照组。结果实验显示婴儿痉挛症患儿脑脊液中S100B蛋白水平高于对照组,差异有统计学意义(P<0.01);观察组神经元特异性烯醇化酶浓度显著高于对照组(P<0.01)。结论IS患儿发病初期脑脊液中S100B蛋白、NSE水平表达增高,提示痉挛发作可导致神经胶质细胞和神经元等多个部位的脑损伤,S100B蛋白和NSE可作为IS患儿脑损伤的生化标记。     

癫痫患者与假性发作患者血清S100B蛋白、超敏C反应蛋白和神经元特异性烯醇化酶水平的改变及其意义

目的研究癫痫患者与假性发作患者血清S100B蛋白、超敏C反应蛋白(hs-CRP)和神经元特异性烯醇化酶(NSE)水平的改变及其意义。方法在癫痫(32例)及假性发作(30例)患者发作后第1 d、3 d、8 d、15 d时,分别采用酶联免疫吸附法(ELISA)、免疫比浊法和时间免疫荧光法检测其血清S100B蛋白、hs-CRP和NSE含量。并与正常对照者进行比较。结果癫痫组患者发作后第1 d、第3 d时血清S100B蛋白、hs-CRP和NSE含量均明显高于假性发作组和正常对照组(均P<0.01);发作后第8 d、第15 d时与正常对照组比较差异无统计学意义。假性发作组发作后各时间点的血清S100B蛋白、hs-CRP和NSE水平与正常对照组比较,差异均无统计学意义。结论癫痫患者发作后3 d内血清S100B蛋白、hs-CRP和NSE水平均明显升高,而假性发作患者无明显改变。血清S100B蛋白、hs-CRP和NSE水平可作为鉴别癫痫与假性发作的生物学指标。