Michetti Fabrizio, Gazzolo Diego
Institute of Anatomy, Catholic University, Largo Francesco Vito 1, I-00168 Rome, Italy.
Clin Chem. 2002 Dec;48(12):2097-104.
The diagnosis of perinatal insults currently relies on adequate documentation of general medical and obstetric factors and on radiologic and laboratory assessments. The measurement of brain constituents such as S100B protein may offer an alternative and direct indicator of cell damage in the nervous system when clinical and radiologic assessments are still silent and has the additional advantage of providing a quantitative indicator of the extent of brain lesions. S100B protein has been measured by several immunoassays in biological fluids (i.e., cerebrospinal fluid, blood, amniotic fluid, and urine) from fetuses and newborns at high risk of perinatal brain damage. S100B protein in biological fluids increased at an early stage when standard monitoring procedures were still silent in the study populations that later developed brain damage. S100B concentration was also significantly correlated with the extent of brain lesions. S100B protein appears to satisfy the criteria for a marker for brain injuries in perinatal medicine: (a) simple to perform measurements with good reproducibility; (b) detection in a variety of biological fluids, possibly reducing perinatal stress related to testing; (c) possible use in longitudinal monitoring because of its 1-h half-life; and (d) well-established use as an early and quantitative marker of brain lesions/damage. Finally, because of the neurotrophic role putatively played by S100B, its measurement in biological fluids at pre-/perinatal ages makes it a candidate for the laboratory evaluation of brain maturation.
目前，围产期损伤的诊断依赖于对一般医学和产科因素的充分记录以及放射学和实验室评估。当临床和放射学评估尚无异常时，对诸如S100B蛋白等脑成分的测量可能提供神经系统细胞损伤的另一种直接指标，并且具有提供脑损伤程度定量指标的额外优势。已经通过几种免疫测定法对有围产期脑损伤高风险的胎儿和新生儿的生物体液（即脑脊液、血液、羊水和尿液）中的S100B蛋白进行了测量。在后来发生脑损伤的研究人群中，当标准监测程序尚无异常时，生物体液中的S100B蛋白在早期就升高了。S100B浓度也与脑损伤程度显著相关。S100B蛋白似乎符合围产医学中脑损伤标志物的标准：（a）测量方法简单且重复性好；（b）可在多种生物体液中检测，可能减少与检测相关的围产期应激；（c）由于其半衰期为1小时，可能用于纵向监测；（d）作为脑损伤/损害的早期定量标志物的应用已得到充分确立。最后，由于S100B可能发挥神经营养作用，在产前/围产期对生物体液进行测量使其成为脑成熟实验室评估的一个候选指标。
