Author/Editor     Avberšek-Lužnik, Ivica; Zupančič, Meta
Title     Molekularno ozadje in diagnostična uporabnost Proteina S100B pri poškodbah glave
Type     članek
Source     In: Medpoklicno povezovanje na različnih ravneh zdravstvenega varstva: trendi, potrebe in izzivi : zbornik predavanj z recenzijo : = proceedings of lectures with peer review Jesenice : Fakulteta za zdravstvo Angele Boškin
Publication year     2018
Volume     str. Str. 149-156
Language     slv
Abstract     Teoretična izhodišča: Protein S100B spada med homologne kisle proteine, ki se sproščajo v krvni obtok ob poškodbah možganov, tromboembolični kapi, cerebralni ishemiji ter pri nevrodegenerativnih in psihiatričnih motnjah. Molekula S100B sestoji iz dveh podenot, S100A1B in S100BB. Raziskave so pokazale, da plazemske koncentracije S100B dobro korelirajo z intenziteto poškodbe možganov, zato je uporaben neinvaziven biomarker za odkrivanje in spremljanje poškodb glave. Namen naše raziskave je predstaviti fiziološko in patološko ozadje S100B pri skupini pacientov, ki so bili obavnavani v Urgentnem centru Splošne bolnišnice Jesenice. Metoda: Uporabili smo retrospektivno metodo pregleda rezultatov S100B za čas od novembra 2017 do februarja 2018. Koncentracije S100B so bile določene pri skupini 76 pacientov (41 moških,35 žensk; 29 mladostnikov, 47 odraslih), ki so bili zaradi nezgodnih poškodb glave v obravnavi v urgentni ambulanti. Meritve smo izvajali na Cobas e411 Roche avtomatizaciji z imunokemiluminiscentno metodo. Rezultati: Mediana koncentracij S100B pri celi skupini pacientov znaša 0,246 micro g/L, normalne vrednosti S100B je imelo 33 pacientov (0,028 - 0,097 micro g/L), zvišane pa 43 pacientov (0,103 - 4,420 micro g/L). Mladostniki so imeli vrednosti v območju od 0,051 do 1,36 micro g/L. Starejši od 65 let so imeli značilno višje vrednosti S100B od mlajših (p=0,008). Razprava: Rezultati meritev S100B kažejo, da je ta diagnostično uporaben biomarker, ki služi kot dodatno orodje za sprejem kliničnih odločitev. Trenutno predstavlja zlati standard za ugotavljanje poškodb možganov slikanje glave z računalniško tomografijo, ki je draga in zamudna metoda, meritve S100B v plazmi pa hitre in neinvazivne. Zdravniki morajo interpretirati rezultate S100B v tesni povezavi s kliničnim stanjem in starostjo pacienta.Theoretical background: Protein S100B is one of the homologous acidic proteins released in the blood stream upon brain injury, thromboembolic stroke, and cerebral ischaemia, as well as in neurodegenerative and psychiatric disorders. The S100B molecule is composed of two subunits: S100A1B and S100BB. Research has shown that plasma concentrations of S100B correlate well with the extent of brain injury, making it a useful non-invasive biomarker for the detection and monitoring of head injury. The purpose of our study was to elucidate the physiological and pathological background of S100B in 76 patients treated at the Emergency Unit of General Hospital Jesenice. Methods: A retrospective review of S100B results in the period from November 2017 to February 2018 was performed. During this period, the S100B concentration was assessed in 76 patients (41 males, 35 females; 29 adolescents, 47 adults) evaluated at the Emergency for traumatic head injury. All measurements were performed using the immunochemiluminiscent method on Cobas e411 Roche automatisation. Results: The median concentration of S100B in all patients was 0,246 micro g/L. Normal values (0,028 - 0,097 micro g/L) were observed in 33 patients, whereas the remaining 43 patients had abnormal values (0,103 - 4,420 micro g/L). The adolescents had values in the range of 0,051 do 1,36 micro g/L. Patients aged over 65 years had significantly higher S100B values compared with the younger population (p=0.008). Discussion: The results of the present work indicate that S100B is a diagnostically valuable biomarker, useful as a complementary tool to guide clinical decisions. The current gold standard to diagnose brain injury is computed tomography, which is relatively expensive and time-consuming, whereas S100B levels can be determined rapidly in a minimally invasive way. S100B results should be interpreted in the context of the clni ical presentation and age of the patient.
Keywords     neinvazivni biomarkerji
S100B
poškodbe možganov
CT glave
proteini
non-invasive biomarkers
S100B
brain injury
computed tomography
proteins