ArticleCritical care (London, England)2025
Beyond blood-brain barrier disruption and molecular weight: compartmental kinetics of S100B and NSE for neurological prognostication after cardiac arrest.
Article in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Multimodal MR Imaging Reveals the Mechanisms of Post-Cardiac-Arrest Brain edema: Ferroptosis-Mediated BBB Disruption and AQP4 Dysfunction.Journal of magnetic resonance imaging : JMRI · 2026Article
- Latest in Resuscitation Research: Highlights from the 2025 American Heart Association's Resuscitation Science Symposium.Journal of the American Heart Association · 2026Article
- Extracorporeal Life Support in Severe Accidental Hypothermia: Mechanisms, Challenges and Clinical Horizons.Journal of clinical medicine · 2026Review
- Incremental Value of Adding S100B to NSE for High-Specificity Rule-in of Poor Neurological Outcome After Out-of-Hospital Cardiac Arrest.Journal of clinical medicine · 2026Article
- Etiology-specific prognostic value of ultra-early diffusion-weighted MRI after out-of-hospital cardiac arrest: a multicenter cohort study.Critical care (London, England) · 2026Article
- Prognostic Value of Serum S100B Protein for Neurological Outcomes After Cardiac Arrest: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
Corrections and comments
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Authors and funding
9 authors.
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Abstract
backgroundThe prognostic value of serum biomarkers after out-of-hospital cardiac arrest (OHCA) depends on timing, but the physiological basis remains unclear. We investigated whether blood-brain barrier (BBB) integrity and biomarker-specific properties explain the time-dependent differences in prognostic performance.
methodsThis retrospective study included comatose adult OHCA survivors who underwent paired serum and cerebrospinal fluid (CSF) measurements of neuron-specific enolase (NSE; 47 kDa) and S100 calcium-binding protein B (S100B; 21 kDa) at 0 (H0), 24 (H24), 48 (H48), and 72 (H72) h after return of spontaneous circulation. BBB disruption was assessed using the CSF/serum albumin quotient (Q
resultsAmong 111 patients (59% poor outcome), 646 serum and 620 CSF samples were analyzed. BBB disruption was more severe in the poor outcome group at all timepoints (all P < 0.001), peaking at H24 (Q
conclusionsSerum NSE levels closely reflect the degree of BBB disruption and CSF levels, while S100B exhibits a transient early-phase profile, with decreased serum detectability over time, even in the presence of sustained CSF elevation or severe BBB disruption. These findings highlight the importance of interpreting biomarker kinetics across compartments and timepoints rather than relying on molecular weight or BBB status alone.
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