Diagnostic values of glial fibrillary acidic protein, neuron-specific enolase and protein S100β for sepsis-associated encephalopathy

Cao, Zhigang; Huang, Xiang; Chen, Feixiang

doi:10.2478/rrlm-2023-0009

Abstract

Background

To investigate the expressions of glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE) and protein S100β and their diagnostic values for sepsis-associated encephalopathy (SAE).

Methods

One hundred patients with sepsis treated from August 2021 to August 2022 were included. They were assigned to a sepsis group (n=65) and an SAE group (n=35), while 50 healthy volunteers physically examined in the same period were enrolled as a control group. The levels of GFAP and NSE were detected by enzyme-linked immunosorbent assay, and that of S100β was determined by transmitted immunoturbidimetric assay. The expressions of GFAP, NSE and S100β in patients with SAE were detected, and their correlations and diagnostic values were analyzed.

Results

Compared to patients with mild and moderate SAE, those with severe SAE had higher levels of GFAP, NSE and S100β (P<0.05). The levels of GFAP, NSE and S100β were higher in coma patients than those with consciousness disturbance, and they were higher in patients with a poor prognosis than those with a good prognosis (P<0.05). Positive correlations were identified between GFAP and NSE (r=0.573, P=0.001), GFAP and S100β (r=0.468, P=0.005), and NSE and S100β (r=0.540, P=0.001) expression in patients with SAE. Compared with GFAP, NSE and S100β alone, their combination had higher sensitivity and lower specificity for diagnosing SAE (P<0.05).

Conclusions

There are correlations among GFAP, NSE and S100β, and the combined detection of these three indicators is highly valuable for the diagnosis of SAE.

References

1. Chiu C, Legrand M. Epidemiology of sepsis and septic shock. Curr Opin Anaesthesiol. 2021;34(2):71-6. DOI: 10.1097/ACO.0000000000000958
Search in Google Scholar Back to article
2. Pierrakos C, Velissaris D, Bisdorff M, Marshall JC, Vincent JL. Biomarkers of sepsis: time for a reappraisal. Crit Care. 2020;24(1):287. DOI: 10.1186/s13054-020-02993-5
Search in Google Scholar Back to article
3. Tauber SC, Djukic M, Gossner J, Eiffert H, Brück W, Nau R. Sepsis-associated encephalopathy and septic encephalitis: an update. Expert Rev Anti Infect Ther. 2021;19(2):215-31. DOI: 10.1080/14787210.2020.1812384
Search in Google Scholar Back to article
4. Gao Q, Hernandes MS. Sepsis-Associated Encephalopathy and Blood-Brain Barrier Dysfunction. Inflammation. 2021;44(6):2143-50. DOI: 10.1007/s10753-021-01501-3
Search in Google Scholar Back to article
5. Chung HY, Wickel J, Brunkhorst FM, Geis C. Sepsis-Associated Encephalopathy: From Delirium to Dementia? J Clin Med. 2020;9(3):703. DOI: 10.3390/jcm9030703
Search in Google Scholar Back to article
6. Ren C, Yao RQ, Zhang H, Feng YW, Yao YM. Sepsis-associated encephalopathy: a vicious cycle of immunosuppression. J Neuroinflammation. 2020;17(1):14. DOI: 10.1186/s12974-020-1701-3
Search in Google Scholar Back to article
7. Ren C, Yao RQ, Zhang H, Feng YW, Yao YM. Pathogenesis of sepsis-associated encephalopathy: more than blood-brain barrier dysfunction. Mol Biol Rep. 2022;49(10):10091-9. DOI: 10.1007/s11033-022-07592-x
Search in Google Scholar Back to article
8. Society of Critical Care Medicine, Chinese Medical Association. Guidelines for the treatment of severe sepsis/septic shock in China (2014). Chin Crit Care Med. 2015;27:401-26. DOI: 10.3760/cma.j.issn.2095-4352.2015.06.001
Search in Google Scholar Back to article
9. Zhao L, Gao Y, Guo S, et al. Sepsis-Associated Encephalopathy: Insight into Injury and Pathogenesis. CNS Neurol Disord Drug Targets. 2021;20(2):112-24. DOI: 10.2174/18715273MTExrNTka3
Search in Google Scholar Back to article
10. Mazeraud A, Bozza FA, Sharshar T. Sepsis-associated Encephalopathy Is Septic. Am J Respir Crit Care Med. 2018;197(2):698-9. DOI: 10.1164/rccm.201712-2593ED
Search in Google Scholar Back to article
11. Wei XB, Jiang WQ, Zeng JH, Huang LQ, Ding HG, Jing YW, et al. Exosome-Derived lncRNA NEAT1 Exacerbates Sepsis-Associated Encephalopathy by Promoting Ferroptosis Through Regulating miR-9-5p/TFRC and GOT1 Axis. Mol Neurobiol. 2022;59(3):1954-69. DOI: 10.1007/s12035-022-02738-1
Search in Google Scholar Back to article
12. Kikuchi DS, Campos ACP, Qu H, Forrester SJ, Pagano RL, Lassègue B, et al. Poldip2 mediates blood-brain barrier disruption in a model of sepsis-associated encephalopathy. J Neuroinflammation. 2019;16(1):241. DOI: 10.1186/s12974-019-1575-4
Search in Google Scholar Back to article
13. Wu L, Ai ML, Feng Q, Deng S, Liu ZY, Zhang LN, et al. Serum glial fibrillary acidic protein and ubiquitin C-terminal hydrolase-L1 for diagnosis of sepsis-associated encephalopathy and outcome prognostication. J Crit Care. 2019,52:172-9. DOI: 10.1016/j.jcrc.2019.04.018
Search in Google Scholar Back to article
14. Liu X, Wen M, Han Y, Ding H, Chen S, Li Y, et al. Mechanism of resveratrol on ameliorating the cognitive dysfunction induced by sepsis associated encephalopathy in rats. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2020;32(10):1189-93. DOI: 10.3760/cma.j.cn121430-20200720-00531
Search in Google Scholar Back to article
15. Yan S, Gao M, Chen H, Jin X, Yang M. Expression level of glial fibrillary acidic protein and its clinical significance in patients with sepsis-associated encephalopathy. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2019;44(10):1137-42. DOI: 10.11817/j.issn.1672-7347.2019.190180
Search in Google Scholar Back to article
16. Li XL, Xie JF, Ye XY, Li Y, Li YG, Feng K, et al. Value of cerebral hypoxic-ischemic injury markers in the early diagnosis of sepsis associated encephalopathy in burn patients with sepsis. Zhonghua Shao Shang Za Zhi. 2022;38(1):21-8. DOI: 10.3760/cma.j.cn501120-20211006-00346
Search in Google Scholar Back to article
17. Zheng SM, Zhao FL, Luo YY, Lin XF, Wen MY. Clinical effect of electroacupuncture at Baihui and Shuigou points in treatment of brain injury in patients with sepsis-associated encephalopathy. Zhen Ci Yan Jiu. 2020;45(5):402-6. DOI: 10.13702/j.1000-0607.190781
Search in Google Scholar Back to article
18. Meng JF, Li YP, Tan DM, Chen MJ, Chen J. [Diagnosis value of combined detection of serum TNF-α, NSE and MCP-1 in early sepsis-related encephalopathy]. Hebei Medicine. 2020;26(10):1596-600.
Search in Google Scholar Back to article
19. Guo W, Li Y, Li Q. Relationship between miR-29a levels in the peripheral blood and sepsis-related encephalopathy. Am J Transl Res. 2021;13(7):7715-22.
Search in Google Scholar Back to article
20. Ehler J, Saller T, Wittstock M, Rommer PS, Chappell D, Zwissler B, et al. Diagnostic value of NT-proCNP compared to NSE and S100B in cerebrospinal fluid and plasma of patients with sepsis-associated encephalopathy. Neurosci Lett. 2019;692:167-73.. DOI: 10.1016/j.neulet.2018.11.014
Search in Google Scholar Back to article
21. Wu L, Feng Q, Ai ML, Deng SY, Liu ZY, Huang L, et al. The dynamic change of serum S100B levels from day 1 to day 3 is more associated with sepsis-associated encephalopathy. Sci Rep. 2020;10(1):7718. DOI: 10.1038/s41598-020-64200-3
Search in Google Scholar Back to article