GFAP and S100B Protein are Associated with Discharged NIHSS of Anterior Circulation Ischemic Stroke

Yenny Surjawan, Suryani As'ad, Teguh A S Ranakusuma, Andi Wijaya

Abstract


BACKGROUND: Patient with larger ischemic lesion will suffer more severe neurogical deficit. The utility of MRI for lesion size measurement is still limited, therefore additional approach was pursued through examination of markers released by damaged brain cell, GFAP and S100B protein. The aim of this study is to know whether both markers are associated with the neurological deficit of anterior circulation ischemic stroke. 

METHODS: This observational prospective study enrolled 74 patients with anterior circulation ischemic stroke diagnosis. GFAP and S100B protein were measured with ELISA using blood collected at 48 to 72 hours after onset. The neurological deficit was assessed with NIHSS ad discharged.

RESULTS: There was a significant association between GFAP level and discharged NIHSS (p=0.008) with 100% sensitivity and 100% negative predictive value. S100B protein also showed a significant correlation with discharged NIHSS (r=0.488; p=0.000) and this correlation could be described with an equation (OR=1.009; 95% CI=1.0003-1.0188; p=0.044). S100B protein at 78.3215 ng/L would give true prediction as 73.9% (95% CI=62.7%-85.2%, p=0.001).

CONCLUSIONS: GFAP and S100B protein that were measured at 48 to 72 hours after onset were significantly associated with NIHSS at discharge.

KEYWORDS: GFAP, S100B protein, discharged NIHSS, ischemic stroke


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References


Indonesian Ministry of Health. Indonesian Health Profile 2008. Jakarta: Indonesian Ministry of Health; 2010.

Parham S. New biomarkers could deliver a strike at stroke. CAP Today. 2004 Nov, Feature Story. Available from: http://www.captodayonline.com/.

Whiteley W, Tseng MC, Sandercock P. Blood biomarkers in the diagnosis of ischemic stroke: A systematic review. Stroke. 2008; 39: 2902-9, CrossRef.

Whiteley W, Chong WL, Sengupta A, Sandercock P. Blood markers for the prognosis of ischemic stroke: A systematic review. Stroke. 2009; 40: e380-9, CrossRef.

Buttner T, Weyers S, Postert T, Sprengelmeyer R, Kuhn W. S-100 protein: serum marker of focal brain damage after ischemic territorial MCA infarction. Stroke. 1997; 28: 1961-5, CrossRef.

Missler U, Wiesmann M, Wittmann G, Magerkurth O, Hagenström H. Measurement of glial fibrillary acidic protein in human blood: analytical method and preliminary clinical results. Clin Chem. 1999; 45: 138-41, PMID.

Wunderlich MT, Ebert AD, Kratz T, Goertler M, Jost S, Herrmann M. Early neurobehavioral outcome after stroke is related to release of neurobiochemical markers of brain damage. Stroke. 1999; 30:1190-5, CrossRef.

Caplan LR. Caplan’s Stroke: A Clinical Approach. 4th ed. Philadelphia: Saunders; 2009, NLMID.

Michetti F, Gazzolo D. S100B protein in biological fluids: a tool for perinatal medicine. Clin Chem. 2002; 48: 2097-104, PMID.

Herrmann M, Vos P, Wunderlich MT, de Bruijn CHMM, Lamers KJB. Release of glial tissue-specific proteins after acute stroke : A comparative analysis of serum concentrations of protein S-100B and glial fibrillary acidic protein. Stroke. 2000; 31: 2670-7, CrossRef.

Hill MD. Diagnostic biomarkers for stroke: a stroke neurologist's perspective. Clin Chem. 2005; 51: 2001-2, CrossRef.

Foerch C, Curdt I, Yan B, Dvorak F, Hermans M, Berkefeld J, et al. Serum glial fibrillary acidic protein as a biomarker for intracerebral haemorrhage in patients with acute stroke. J Neurol Neurosurg Psychiatry. 2006; 77: 181-4, CrossRef.

Maas MB, Furie KL. Molecular biomarkers in stroke diagnosis and prognosis. Biomark Med. 2009; 3: 363-83, CrossRef.




DOI: https://doi.org/10.18585/inabj.v4i2.170

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