Neuron specific enolase as a possible indicator of neuron damage in children with acute meningitis

Authors

  • L. V. Pypa National Pirogov Memorial Medical University, Vinnytsya, Ukraine,
  • R. V. Svistilnik National Pirogov Memorial Medical University, Vinnytsya, Ukraine,
  • G.S. Moskovko National Pirogov Memorial Medical University, Vinnytsya, Ukraine,
  • Yu. M. Lysytsia National Pirogov Memorial Medical University, Vinnytsya, Ukraine,
  • M. M. Murhina National Pirogov Memorial Medical University, Vinnytsya, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2018.3.130466

Keywords:

acute meningitis, neuron-specific enolase, children

Abstract

Acute meningitis in children is a common cause of complications and leads to developmental disabilities. That is the reason why it is important to look for possible markers that indicate nerve tissue damage for early diagnosis, their prevention and prognosis of CNS complications.

Objective. To examine Neuron Specific Enolase (NSE) and its diagnostic significance as an indicator of neuronal damage in children with acute meningitis.

Materials and methods. Blood samples of 40 children with acute meningitis and 30 of healthy children between the ages of 1 month to 18 years old were studied. The measurement of NSE was made from a blood serum during the first 24 hours after hospitalization by the enzyme-linked immunosorbent assay test performing. The degree of impaired consciousness was determined by the Glasgow Coma Scale. The results were processed with the Student’s t-test, correlation and regression analysis methods with constructing confidence intervals.

Results. NSE levels in children with acute meningitis was 7.6 times higher than the results of healthy children, which was 22.56 ± 1.14 and 2.95 ± 0.16 ng/ml, respectively, (P < 0.0001) (95 % CI; 19.19 to 20.03). CNS complications of the disease in patients were detected in 22 (55 %). Patients with complications had significantly higher level of NSE than patients without complications and it was 25.35 ± 1.61 and 18.60 ± 1.49 ng/ml, respectively, (P < 0.01) (95 % CI; 5.74 to 7.75). Impaired consciousness was observed in 21 (52.5 %) patients. The content of NSE in patients with impaired consciousness was within 20.72 ± 7.33 ng/ml and it was higher than NSE content in patients with normal consciousness that was within 16.56 ± 4.69 ng/ml (P < 0.05) (95 % CI; 0.17 to 8.14). Reliable inverse and strong correlation was detected between the NSE level and the level of consciousness by the Glasgow Coma Scale, where the coefficient of determination R2 = 0.624 and coefficient of correlation r -0.785 (P < 0.001) (95 % CI; -1.08 to -0.48).

Conclusions. Thus, the data indicates that acute meningitis occurs with the brain matter damage. The blood NSE content in acute meningitis can be used as a biochemical marker for the neuronal damage severity and as a prognostic marker for the CNS complications development.

References

Wang, S., Peng, L., Gai, Z., Zhang, L., Jong, A., Cao, H., & Huang S-H. (2016) Pathogenic Triad in Bacterial Meningitis: Pathogen Invasion, NF- κ B Activation, and Leukocyte Transmigration that Occur at the Blood-Brain Barrier. Front. Microbiol., 7, 148. doi: 10.3389/fmicb.2016.00148.

Chaudhuri A., Martinez-Martin, P., Kennedy, P. G., Andrew Seaton, R., Portegies, P., Bojar, M., & Steiner, I. (2008) EFNS guideline on the management of community-acquired bacterial meningitis: report of an EFNS Task Force on acute bacterial meningitis in older children and adults. Eur J Neurol., 15(7), 649–59. doi: 10.1111/j.1468-1331.2008.02193.x.

Streitbürger, D. P., Arelin, K., Kratzsch, J., Thiery, J., Steiner, J., Villringer, A., Mueller, K., & Schroeter, M. L. (2012) Validating Serum S100B and Neuron-Specific Enolase as Biomarkers for the Human Brain–A Combined Serum, Gene Expression and MRI Study. PLoS ONE, 7(8), 43284. doi: 10.1371/journal.pone.0043284.

Rohlwink, U. K. & Figaji, A. A. (2014) Biomarkers of Brain Injury in Cerebral Infections. Clinical Chemistry, 60(6), 823–834. doi: 10.1373/clinchem.2013.212472.

El-Maraghi, S., Yehia, H., Hossam, H., Yehia, A., & Mowafy, H. (2013) The prognostic value of neuron specific enolase in head injury. The Egyptian Journal of Critical Care Medicine, 1, 25–32. doi: 10.1016/j.jemermed.2007.11.032.

Cheng, F., Yuan, Q., Yang, J., Wang, W., & Liu, H. (2014) The Prognostic Value of Serum Neuron-Specific Enolase in Traumatic Brain Injury: Systematic Review and Meta-Analysis. PLoS ONE, PLoS ONE. doi: 10.1371/journal.pone.0106680.

Zaheer, S., Beg, M., Rizvi, I., Islam, N., Ullah, E., & Akhtar, N. (2013) Correlation between serum neuron specific enolase and functional neurological outcome in patients of acute ischemic stroke. Ann Indian Acad Neurol., 16(4), 504–8. doi: 10.4103/0972-2327.120442.

Bartek, J. J., Thelin, E. P., Ghatan, P. H., Glimaker, M., & Bellander, B-M. (2016) Neuron-Specific Enolase Is Correlated to Compromised Cerebral Metabolism in Patients Suffering from Acute Bacterial Meningitis; An Observational Cohort Study. PLoS One, 11(3), 0152268. doi: 10.1371/journal.pone.0152268.

Peng, Y. & Jiang, L. (2015) Analysis of Prognostic Factors of Children with Intracranial Infection Coma. World Journal of Neuroscience, 5, 131–136.

Sokhan, A. V. (2016) Riven neiron-spetsyfichnoi enolazy ta bilka S-100 u tserebrospinalnii ridyni khvorykh na hostri bakterialni meninhity [The level of neuron-specific enolase and S-100 protein in the cerebrospinal fluid of patients with acute bacterial meningitis]. Zaporozhye medical journal, 4(97), 73–76. doi: 10.14739/2310-1210.2016.4.79780. [in Ukrainian].

Molochniy, V. P., Makarova, T. E., Golovkova, N. F., & Obukhova, G. G. (2012) Nejrospecificheskaya enolaza i gliofibrilyarnyj kislyj protein krovi i cerebrospinal'noj zhidkosti kak marker povrezhdeniya tkani mozga pri bakterial'nykh gnojnykh meningitakh u detej [Neurospecific enolase and gliofiblar acid protein of blood and cerebrospinal fluid as a marker of cerebral tissue damage in bacteial purulent meningitis in children]. Dal'nevostochnyj medicinskij zhurnal, 2, 48–51. [in Russian].

Downloads

How to Cite

1.
Pypa LV, Svistilnik RV, Moskovko G, Lysytsia YM, Murhina MM. Neuron specific enolase as a possible indicator of neuron damage in children with acute meningitis. Zaporozhye medical journal [Internet]. 2018May30 [cited 2024Apr.26];(3). Available from: http://zmj.zsmu.edu.ua/article/view/130466

Issue

Section

Original research