S100B as a biomarker of blood–brain barrier disruption after thoracoabdominal aortic aneurysm repair: a secondary analysis from a prospective cohort study

Purpose The objective of this study was to determine whether the magnitude of the peripheral inflammatory response to cardiovascular surgery is associated with increases in blood–brain barrier (BBB) permeability as reflected by changes in cerebrospinal fluid (CSF)/plasma S100B concentrations. Methods We conducted a secondary analysis from a prospective cohort study of 35 patients undergoing elective thoracoabdominal aortic aneurysm repair with ( n = 17) or without ( n = 18) cardiopulmonary bypass (CPB). Plasma and CSF S100B, interleukin-6 (IL-6), and albumin concentrations were measured at baseline (C 0 ) and serially for up to five days. Results Following CPB, the median [interquartile range] plasma S100B concentration increased from 58 [32–88] pg·mL -1 at C 0 to a maximum concentration (C max ) of 1,131 [655–1,875] pg·mL -1 over a median time (t max ) of 6.3 [5.9–7.0] hr. In the non-CPB group, the median plasma S100B increased to a lesser extent. There was a delayed increase in CSF S100B to a median C max of 436 [406–922] pg·mL -1 in the CPB group at a t max of 23.7 [18.5–40.2] hr. In the non-CPB group, the CSF concentrations were similar at all time points. In the CPB group, we did not detect significant correlations between plasma and CSF S100B with plasma IL-6 [r = 0.52 (95% confidence interval [CI], -0.061 to 0.84)] and CSF IL-6 [r = 0.53 (95% CI, -0.073 to 0.85)] concentrations, respectively. Correlations of plasma or CSF S100B levels with BBB permeability were not significant. Conclusion The lack of parallel increases in plasma and CSF S100B following CPB indicates that S100B may not be a reliable biomarker for BBB disruption after thoracoabdominal aortic aneurysm repair employing CPB. Trial registration www.clinicaltrials.gov (NCT00878371); registered 7 April 2009.