The level of neuron-specific enolase and S-100 protein in the cerebrospinal fluid of patients with acute bacterial meningitis

Authors

  • A. V. Sokhan Kharkiv National Medical University,

DOI:

https://doi.org/10.14739/2310-1210.2016.4.79780

Keywords:

Bacterial Meningitis, Neuron-Specific Enolase, S-100 Protein, Cerebrospinal Fluid

Abstract

Aim. To evaluate the diagnostic and prognostic role of neuron-specific enolase (NSE) and S-100 protein levels in cerebrospinal fluid (CSF) of patients with acute bacterial meningitis in the course of the disease.

Materials and Methods. 54 cases of acute bacterial meningitis were analyzed, among them – 26 with pneumococcal and 28 with meningococcal etiology. Patients were divided into groups depending on the severity and etiology of disease. In addition to routine laboratory methods, we analyzed the CSF levels of S-100 protein and NSE at admission and after 10 – 12 days of treatment. 12 patients with acute respiratory infections and meningism were examined as a comparison group.

Results. In all patients with acute bacterial meningitis CSF NSE and protein S-100 levels were significantly higher than in the control group (P <0,05). CSF neuro specific proteins level was in direct dependence on severity of the disease, and in patients with severe disease was significantly higher than in patients with moderate severity and in the control group (P <0,01). After 10 – 12 days of treatment, the level of the NSE and S-100 protein decreased, but in severe cases was still higher than in the control group (P <0,05).

Conclusions. Increased cerebrospinal fluid NSE and S – 100 protein levels shows the presence and value of neurons and glial cells damage in patients with acute bacterial meningitis. CSF S-100 protein and neuron-specific enolase levels help to determine the severity of neurons destruction and glial cells in patients with acute bacterial meningitis. Level of neurospecific protein is in direct proportion to the severity of the disease and is the highest in patients with severe cases (P<0,05). It confirms the diagnostic and prognostic value of CSF neurospecific protein determination in patients with bacterial meningitis.

References

Brouwer, M. C., Tunkel, A. R., & van de Beek, D. (2010) Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis. Clinical Microbiology Reviews., 23, 467–492. doi: 10.1128/CMR.00070-09.

Giorgi, R., Mantovani, P. J., Ferroni, E., Forcina, A., Stanghellini, E., Curtale, F., & Borgia, P. (2009). Incidence of bacterial meningitis (2001–2005) in Lazio, Italy: the results of integrated surveillance system. BMC Infectious Diseases, 9, 13. doi: 10.1186/1471-2334-9-13.

Mishal, J., Embon, A., Darawshe, A., Kidon, M., & Magen, E. (2008). Community acquired acute bacterial meningitis in children and adults: an 11-year survey in a community hospital in Israel. European Journal of Internal Medicine, 19, 421–426. doi: 10.1016/j.ejim.2007.12.005.

van de Beek, D., de Gans, J., McIntyre, P., & Prasad, K. (2004). Steroids in adults with acute bacterial meningitis: a systematic review. The Lancet Infectious Diseases, 4, 139–143. doi: 10.1016/S1473-3099(04)00937-5.

Arda, B., Sipahi, O. R., Atalay, S., & Ulusoy, S. (2008) Pooled analysis of 2,408 cases of acute adult purulent meningitis from Turkey. Medical Principles and Practice, 17, 76–79. doi: 10.1159/000109595.

Thigpen, M. C., Rosenstein, N. E., Whitney, C. G., Lynfield, R. et al. (2005) Bacterial meningitis in the United States – 1998–2003 : 43-rd Annual Meeting Infectious Diseases Society of America. San Francisco.

Hsu, H. E., Shutt, K. A., Moore, M. R., Beall, B. W., Bennett, N. M., Craig, A. S., et al. (2009) Effect of pneumococcal conjugate vaccine on pneumococcal meningitis. New England Journal of Medicine, 360, 244–56. doi: 10.1056/NEJMoa0800836.

Nudelman, Y., & Tunkel, A. R. (2009) Bacterial meningitis: epidemiology, pathogenesis and management update. Drugs, 69(18), 2577–2596. doi: 10.2165/11530590-000000000-00000.

Takano, R., Misu, T., Takahashi, T., Sato, S, Fujihara, K., Itoyama, Y. (2010) Astrocytic damage is far more severe than demyelination in NMO: a clinical CSF biomarker study. Neurology, 75(3), 208–16. doi: 10.1212/WNL.0b013e3181e2414b.

Oh, S. H., Lee, J. G., Na, S. J., Park, J. H., Choi, Y. C., & Kim, W. J. (2003) Prediction of early clinical severity and extent of neuronal damage in anterior-circulation infarction using the initial serum neuron-specific enolase level. Arch. Neurol., 60(1), 37–41. doi: 10.1001/archneur.60.1.37.

Brunkhorst, R., Pfeilschifter, W., & Foerch, C. (2010) Astroglial Proteins as Diagnostic Markers of Acute Intracerebral Hemorrhage-Pathophysiological Background and Clinical Findings. Translational Stroke Research., 1(4), 246–51. doi: 10.1007/s12975-010-0040-6.

Dhandapani, M. K., Mahesh, V. B., & Brann, D. W. (2003) Astrocytes and brain function. Tmplications for reproduction. Experimental Biology and Medicine., 228, 253–260.

Gules, I., Satoh, M., Nanda, A., & Zhang, J. H. (2003) Apoptosis, blood-brain barrier, and subarachnoid hemorrhage. Acta Neurochirurgica Supplement, 86, 483–487. doi: 10.1007/978-3-7091-0651-8_99.

Rahati, M., Nozari, M., Eslami, H., Shabani, M., & Basiri, M. (2016) Effects of enriched environment on alterations in the prefrontal cortex GFAP- and S100B-immunopositive astrocytes and behavioral deficits in MK-801-treated rats. Neuroscience, 326, 105–16. doi: 10.1016/j.neuroscience.2016.03.065.

Lim, E. T., Sellebjerg, F., Jensen, C. V., Altmann, D. R., Grant, D., Keir, G., et al. (2005) Acute axonal damage predicts clinical outcome in patients with multiple sclerosis. Mult Scler., 11, 532–36. doi: 10.1191/1352458505ms1218oa.

Lim, E. T., Grant, D., Pashenkov, M., Keir, G., Thompson, E. J., Söderström, M, & Giovannoni G. (2004) Cerebrospinal fluid levels of brain specific proteins in optic neuritis. Mult Scler., 10, 261–5.

How to Cite

1.
Sokhan AV. The level of neuron-specific enolase and S-100 protein in the cerebrospinal fluid of patients with acute bacterial meningitis. Zaporozhye Medical Journal [Internet]. 2016Oct.13 [cited 2024Dec.23];18(4). Available from: http://zmj.zsmu.edu.ua/article/view/79780

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Section

Original research