Serum levels of neurofilament light chain, neuron-specific enolase and S100 calcium-binding protein B during acute bacterial meningitis: a prospective cohort study

Abstract

Purpose

Acute bacterial meningitis (ABM) is a severe disease with an overall poor outcome. Neurofilament (NFL) has shown to be a promising biomarker of neuroaxonal injury in various neurological disorders but has not been investigated in ABM. The aims of this study were (i) to obtain a temporal profile of NFL, neuron-specific enolase (NSE) and S100B in serum during ABM, and (ii) to evaluate their use as biomarkers of severity (Glasgow coma score) and prognosis (Glasgow Outcome Score, GOS and death) in severe ABM.

Methods

Fifteen adults with severe community-acquired ABM who were admitted to the intensive care unit (ICU) and fulfilled the inclusion criteria were included. Lumbar puncture and blood tests were performed on admission, and blood tests were performed three times daily during the ICU stay. GOS was obtained day 30.

Results

Serum NFL was significantly elevated in ABM patients compared to healthy controls, both at admission and throughout the observation period (p < .01). NFL increased significantly from day 1 up to day 3–6 (p < .0001), peaking day 6. NSE increased significantly from admission up to day 3 (p < .01). At day 5–6, the serum values were not significantly different from values at admission. The highest median serum value of S100B was observed at admission (0.10 µg/L, IQR 0.06–0.14), significantly decreasing day 4–6 (p < .05). None of the investigated biomarkers revealed significant correlation with severity and prognosis.

Conclusion

This study represents a first clinical observation of the temporal profile of NFL in serum, in severe ABM. No correlation with severity or prognosis.

Keywords:

• Neurofilament light chain
• neuron-specific enolase
• serum protein S100 calcium-binding protein B
• bacterial meningitis

Acknowledgements

We thank Ulla Damgaard Munk for technical assistance and the staff at the Department of Intensive Care. The assistance from Claire Gudex, BRIDGE, in proofreading the manuscript is greatly appreciated. Biological material was stored in OPEN, Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark: www.sdu.dk/ki/open.

Disclosure statement

The authors report no conflict of interest.

Author contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by MHG, TS, RWH, LL, MD and FRP. The first draft of the manuscript was written by MHG, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Additional information

Funding

This research received financial support from Research Funds of Odense University Hospital; the A.P. Moeller Foundation (Fonden til Laegevidenskabens Fremme); the Foundation for Danish-Swedish Co-operation; and the Højmosegård grant.