Research of neuron specific enolase (NSE) and S-100 β markers in patients with sepsis

Object and Aim: Sepsis is a systemic inflammatory response generated secondary to the infection by immune system. It provides convenience to fight against microorganisms in the early stages of systemic inflammatory response but, immune system response begins to damage the host body in the late period. Sepsis is a major cause of mortality in the world. Sepsis is the second most common cause of mortality in non-coronary intensive care units according to the US National Center for Health Statics Sepsis is in the 10th place among the causes of death in all societies. (1). Neuron Specific Enolase and S-100 β are popular biomarkers researched for availability in identifying central nervous system injury. NSE which is localized on neurons in the brain has an important role in glycolysis. (2). S-100 β is an intracellular calcium-binding protein dimer (3). It's known that NSE and S-100 β serum levels rise in neuronal injury. A biomarker which is useful in diagnosis central nervous system injury and determining the prognosis has been needed. The aim of our research is to investigate NSE and S-100 β biomarkers if they are useful in diagnosis central nervous system injury and helpful for clinicians in determining the prognosis in patients with sepsis. Materials and Methods: 70 patients who admitted to Duzce University Research and Training Hospital Emergency Department between 01.01.2014 to 31.12.2014 enrolled to the research. The patients diagnosed as sepsis according to universal sepsis and organ failure criteria adopted at 1992 The ACCP (American College of Chest Physicians) and SCCM (Society of Critical Care Medicine) Consensus Conference. It is designed as a prospective, case-control study. NSE, S-100 β levels and basic biochemical tests were examined on venous blood samples taken from patients. The data were compared with a control group and the significance of data was evaluated with various statistical tests. Results: NSE level was found as 0,1210 μg/L (min:0,001; max:1,781 μg/L) and S-100 β level was found as 0,4735 μg/L (min:0,158; max:2,372 μg/L). In patients died at six month follow-up, NSE level was found as 0,1100 μg/L (min:0,00; max:0,66 μg/L) and S-100 β level was found as 0,5800 μg/L (min:0,16; max:1,11). NSE and S-100 β levels in patients with sepsis were found statistically significant lower than the control group. At six month follow-up there was no statistically significant difference between patients who died due to sepsis and survivors in terms of NSE and S-100 β levels. In patients with sepsis there was a statistically borderline significant between albumin and S-100 β levels but there was no statistically significant between the other laboratory tests. At six month follow-up there was no statistically significant difference between GCS and NSE-S-100 β levels in patients with sepsis who died. Conclusion: This research may be helpful for scientists to explore a biomarker to diagnosis possible central nervous system injury and useful for determining the prognosis in sepsis clinical syndrome which the mortality rate is extremely high. It's needed further research to identify correlation between NSE and S-100 β without limitations as ours. So that, it can obtained more significant results. Keywords: Sepsis, Neuron Specific Enolase, S-100 β