Impairment of Blood-Brain Barrier Integrity during Carotid Surgery as Assessed by Serum S-100B Protein Concentrations
| Autor: | Ildikó Gálfy, Mária Székely, László Gellér, Ilona Bobek, Zsuzsanna Járányi, László Selmeci |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
medicine.medical_treatment
Clinical Biochemistry S100 Calcium Binding Protein beta Subunit Carotid endarterectomy Blood–brain barrier Central nervous system disease medicine.artery medicine Humans Nerve Growth Factors Aged Endarterectomy Endarterectomy Carotid business.industry S100 Proteins Biochemistry (medical) General Medicine Perioperative Venous blood Middle Aged medicine.disease Peripheral medicine.anatomical_structure Blood-Brain Barrier Anesthesia Internal carotid artery business |
| Zdroj: | Clinical Chemistry and Laboratory Medicine. 41 |
| ISSN: | 1434-6621 |
| DOI: | 10.1515/cclm.2003.201 |
| Popis: | During carotid endarterectomy (CEA) the internal carotid artery is cross-clamped for a period of several minutes. This maneuver may cause cerebral hypoperfusion and/or impairment of the blood-brain barrier (BBB) even in cases where clinical signs are absent. The aim of the present study was to examine whether such alterations could be detected by monitoring the cerebral marker S-100B protein concentrations during and after CEA in the serum. Twenty-five consecutive patients (17 M/8 F, mean age: 64.2 years, range 47-79 years) undergoing elective CEA at our department were studied. All of these patients were without perioperative neurological deficit. Intraoperative samples were collected from internal jugular and peripheral venous blood: 1) before carotid cross-clamping; 2) immediately before declamping; 3) after clamp release. Postoperative samples were taken from peripheral blood at 6 and 24 h, respectively. S-100B was assayed in sera using an immunoluminometric technique. During carotid cross-clamping, S-100B protein concentrations in the ipsilateral jugular serum significantly (p < 0.02) increased to pre-clamp values. After declamping, however, S-100B returned to the baseline level. No differences were seen between the responses of hypertensive and normotensive patients. There was no correlation between carotid occlusion time and S-100B protein concentrations. In the peripheral venous serum no significant changes in S-100B concentrations were detected during or after CEA. We presume that the elevation of S-100B protein concentration during CEA in patients with no neurological deficits indicates the transient opening of the BBB elicited by carotid cross-clamping. |
| Databáze: | OpenAIRE |
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