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Ann Thorac Surg 2004;78:46-52
© 2004 The Society of Thoracic Surgeons

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Original article: cardiovascular

Peripheral detection of S100ß during cardiothoracic surgery: what are we really measuring?

^a Cerebrovascular Research Center, Cleveland, Ohio, USA
^b Neurological Surgery, Cleveland, Ohio, USA
^c Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA

Accepted for publication November 25, 2003.

^* Address reprint requests to Dr Janigro, Cerebrovascular Research Center, Department of Neurological Surgery, NB20, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195, USA
e-mail: janigrd{at}ccf.org

BACKGROUND: S100ß has been used in cardiac surgery to identify patients with postoperative neurologic complications. However, extracranial proteins may falsely elevate measurements of serum S100ß;. Objectives of this study were (1) to quantify S100ß levels in serum and pericardial cavity during coronary artery bypass grafting (CABG), and (2) to identify proteins recognized by standard immunodetection as S100ß.

METHODS: Systemic and pericardial cavity blood from 5 patients undergoing CABG were sampled before, during, and after cardiopulmonary bypass (CPB). A commercially available enzyme-linked immunosorbent assay (ELISA) kit was used to quantify S100ß. Two-dimensional gel electrophoresis, Western blot, and mass spectroscopy were also performed to identify S100â and other proteins.

RESULTS: Mean S100ß levels measured by ELISA, systemic and pericardial cavity blood were (in ng · mL^–1) 1.0 ± 0.46 and 111 ± 71 before CPB, 0.6 ± 0.11 and 113 ± 54 during CPB, and 1.7 ± 0.64 and 101 ± 42 after CPB, respectively. However, gel electrophoresis and Western blot analysis revealed proteins other than S100ß to be present in the pericardial cavity giving a falsely elevated serum S100â levels measured by immunoassay. Mass spectroscopy of identified potential candidates revealed contaminants including haptoglobin I precursor, apolipoprotein A-1 precursor, complement factor B precursor, and complement C3 precursor.

CONCLUSIONS: S100ß immunoassays are not specific for S100â and give a falsely elevated reading due to contaminants from the surgical field that cross react with the assay's antibody. This does not appear to be an issue in nonsurgical patients. Caution must be exerted when evaluating immunodetection results for low-abundance proteins under conditions where contamination of the sample is likely.

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