Reference ranges for serum S100B protein during the first three years of life

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Abstract

Objective

Clinical and diagnostic management of traumatic brain injuries is problematic in young children. To facilitate this management, we describe blood reference ranges for the well established biomarker S100B in children younger than 3 years.

Design and methods

Serum S100B concentrations were determined by electro-chemiluminescence immunoassay in a population of 186 healthy children aged 0–3 years.

Results

Four age groups emerged, i.e. 0–3, 4–9, 10–24 and 25–36 months. We also found an interesting inverse correlation with head circumference.

Conclusion

This study provides useful serum S100B values from the largest cohort of healthy children aged 0–3 years old.

Introduction

The diagnosis of mild traumatic brain injury (mTBI) in babies and younger children (a very exposed population) is difficult. An alternative strategy to routine cranial computed tomography (CCT) based on biomarkers was developed [1], [2]. For this purpose, S100B protein appears to be the most sensitive and specific of the proposed biomarkers. Belonging to a multigenic family of calcium-binding proteins [3], S100B is predominantly expressed by cells of the central nervous system (mainly astroglial and also neuronal cells). Few recent works determined blood S100B values in children as a step towards validated ranges proposed for diagnosis and predicting the outcome of mTBI in this vulnerable population [4], [5]. Detailed (to month-group scale) reference ranges for children under 3 years of age have not yet been determined, mainly due to scattered data and limited patient numbers.

The aim of our study is to determine S100B serum levels in a large population of healthy children younger than 3 years old.

Section snippets

Material and methods

Two different centres recruited a pooled total of 236 healthy children seen during a routine consultation (males, n = 144; females, n = 92) whose ages ranged from 1 day to 16 years of age (mean = 2.7 years), with a majority (78%) younger than 3 years old. This study is in compliance with the Declaration of Helsinki ethical principles for medical research involving human subjects. The project was approved by the institutional ethics review boards of both hospitals. Written informed consent was obtained

Results

Serum S100B protein concentrations were measurable in all the children. S100B concentration in the global cohort of children aged 0–16 years old averaged 0.17 μg/L (SD 0.11; range 0.07–0.83) with no significant difference between males and females (p = 0.16), as previously described using the same technique [4]. S100B levels were moderately inversely correlated with age (r = − 0.66; p < 0.001). Mean S100B concentration in children aged over 36 months (0.11 μg/L) was similar to that previously described [4]

Discussion

This is the first study to report reference ranges for serum S100B protein in what, to date, is the largest published population of healthy paediatric patients aged under 3 years old — a population highly exposed to traumatic brain injury. Protein S100B, neuron-specific enolase, and glial fibrillary acidic protein are the most commonly studied biomarkers, while protein S100B has been studied the most in the field of paediatric mTBI [1]. This biological information provides clinicians with help

Acknowledgments

The authors thank A.T.T (Auvergne Traduction Technique®) for proofreading the manuscript.

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Copyright © 2011 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.