S100 protein as a marker of central nerves injury

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To evaluate the severity of cerebral damage, this study investigated the immunohistochemical distribution of S100 protein in cerebral cortex in forensic autopsy cases (n=300) with regard to the cause of death and relationship to serum S100B protein levels.The serum S100B level was usually higher in the subclavian vein than in the right heart and external iliac vein, and lowest in the left, heart blood, showing no significant postmortem influence within 48 h postmortem. The serum level was markedly higher for acute deaths from head injury and asphyxiation due to neck compression (strangulation and hanging). For head injury cases, the serum level was dependent on the severity of the brain injury and survival ; it was significantly higher for the cases of peracute and acute deaths due to head injury than for longer survival cases.S100 immunopositivity was mainly observed in the gliacytes, in part, in the neurons and myelin. S100 positivity in the astrocytes was dependent on the cause of death, and was significantly lower in acute deaths due to strangulation/hanging and drowning, and mildly low in those due to injuries. S100 positivity in neurons and myelins was frequently observed in delayed head injury deaths and fire fatalities, showing an inverse relationship with the positivity in astrocytes in head injury cases. For cases of acute death, there was an inverse relationship between S100 positivity in the astrocytes and the serum S100B level.The above observations suggest that combined analyses of S100 positivity in the brain and serum S100B levels may be useful for investigation death due to head injury, hypoxic and/or ischemic cerebral damage.