Neuron-specific enolase (NSE)

Neuron-specific enolase (NSE) is a cytoplasmatic glycolytic enzyme expressed mainly in neurons and neuron-derived cells. It is found in smaller quantities in erythrocytes and platelets. NSE has been established in clinical routine as a tumor-marker for small cell lung cancer. A number of publications have investigated the usefulness of NSE as a marker of acute ischemic stroke. These efforts have recently been nicely reviewed by Anand, 2005. In summary, only one small study with 10 thrombembolic stroke patients showed significantly elevated NSE levels as early as 4h after stroke onset (Stevens 1999). Others could not detect differences at 4h, but reported an NSE increase from 8h to 72h (Fassbender, 1997). Three studies showed a significant NSE increase when blood was drawn within the first 24h after ischemic stroke onset (Oh, 2003; Hill, 2000; Missler, 1997). Differences between serum levels in ischemic and hemorrhagic stroke were found in one study at 48h and 72h after symptom onset, but not at hospital admission. Due to a considerable overlap of NSE levels between groups, the authors however advised against using serum NSE as a biomarker to distinguish between hemorrhagic and ischemic stroke (Cunningham, 1996).



Jauch EC, Lindsell C, Broderick J, Fagan SC, Tilley BC, Levine SR; NINDS rt-PA Stroke Study Group.
Association of serial biochemical markers with acute ischemic stroke: the National Institute of Neurological Disorders and Stroke recombinant tissue plasminogen activator Stroke Study.
Stroke. 2006 Oct;37(10):2508-13. Epub 2006 Sep 7.

Wunderlich MT, Lins H, Skalej M, Wallesch CW, Goertler M.
Neuron-specific enolase and tau protein as neurobiochemical markers of neuronal damage are related to early clinical course and long-term outcome in acute ischemic stroke.
Clin Neurol Neurosurg. 2006 Sep;108(6):558-63. Epub 2006 Feb 2.

Anand N, Stead LG.
Neuron-specific enolase as a marker for acute ischemic stroke: a systematic review.
Cerebrovasc Dis. 2005;20(4):213-9. Epub 2005 Aug 22. Review.

Wunderlich MT, Wallesch CW, Goertler M.
Release of neurobiochemical markers of brain damage is related to the neurovascular status on admission and the site of arterial occlusion in acute ischemic stroke.
J Neurol Sci. 2004 Dec 15;227(1):49-53.

Zimmermann-Ivol CG, Burkhard PR, Le Floch-Rohr J, Allard L, Hochstrasser DF, Sanchez JC.
Fatty acid binding protein as a serum marker for the early diagnosis of stroke: a pilot study.
Mol Cell Proteomics. 2004 Jan;3(1):66-72. Epub 2003 Oct 26.

Oh SH, Lee JG, Na SJ, Park JH, Choi YC, Kim WJ.
Prediction of early clinical severity and extent of neuronal damage in anterior-circulation infarction using the initial serum neuron-specific enolase level.
Arch Neurol. 2003 Jan;60(1):37-41.

Herrmann M, Ehrenreich H.
Brain derived proteins as markers of acute stroke: their relation to pathophysiology, outcome prediction and neuroprotective drug monitoring.
Restor Neurol Neurosci. 2003;21(3-4):177-90. Review.

Elting JW, Sulter GA, Kaste M, Lees KR, Diener HC, Hommel M, Versavel M, Teelken AW, De Keyser J.
AMPA antagonist ZK200775 in patients with acute ischemic stroke: possible glial cell toxicity detected by monitoring of S-100B serum levels.
Stroke. 2002 Dec;33(12):2813-8.

Oh SH, Lee JG, Na SJ, Park JH, Kim WJ.
The effect of initial serum neuron-specific enolase level on clinical outcome in acute carotid artery territory infarction.
Yonsei Med J. 2002 Jun;43(3):357-62.

Hill MD, Jackowski G, Bayer N, Lawrence M, Jaeschke R.
Biochemical markers in acute ischemic stroke.
CMAJ. 2000 Apr 18;162(8):1139-40. No abstract available.

Wunderlich MT, Ebert AD, Kratz T, Goertler M, Jost S, Herrmann M.
Early neurobehavioral outcome after stroke is related to release of neurobiochemical markers of brain damage.
Stroke. 1999 Jun;30(6):1190-5.

Stevens H, Jakobs C, de Jager AE, Cunningham RT, Korf J.
Neurone-specific enolase and N-acetyl-aspartate as potential peripheral markers of ischaemic stroke.
Eur J Clin Invest. 1999 Jan;29(1):6-11.

Sulter G, Elting JW, De Keyser J.
Increased serum neuron specific enolase concentrations in patients with hyperglycemic cortical ischemic stroke.
Neurosci Lett. 1998 Aug 28;253(1):71-3.

Missler U, Wiesmann M, Friedrich C, Kaps M.
S-100 protein and neuron-specific enolase concentrations in blood as indicators of infarction volume and prognosis in acute ischemic stroke.
Stroke. 1997 Oct;28(10):1956-60.

Fassbender K, Schmidt R, Schreiner A, Fatar M, Muhlhauser F, Daffertshofer M, Hennerici M.
Leakage of brain-originated proteins in peripheral blood: temporal profile and diagnostic value in early ischemic stroke.
J Neurol Sci. 1997 May 1;148(1):101-5.

Butterworth RJ, Wassif WS, Sherwood RA, Gerges A, Poyser KH, Garthwaite J, Peters TJ, Bath PM.
Serum neuron-specific enolase, carnosinase, and their ratio in acute stroke. An enzymatic test for predicting outcome?
Stroke. 1996 Nov;27(11):2064-8.

Cunningham RT, Watt M, Winder J, McKinstry S, Lawson JT, Johnston CF, Hawkins SA, Buchanan KD.
Serum neurone-specific enolase as an indicator of stroke volume.
Eur J Clin Invest. 1996 Apr;26(4):298-303.

Fang D, Li Y, Wang X, Yang Z.
[Neuro-specific enolase in acute ischemic stroke and related dementia patients]
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 1995 Dec;17(6):439-42. Chinese.

Niebroj-Dobosz I, Rafalowska J, Lukasiuk M, Pfeffer A, Mossakowski MJ.
Immunochemical analysis of some proteins in cerebrospinal fluid and serum of patients with ischemic strokes.
Folia Neuropathol. 1994;32(3):129-37.

Hatfield RH, McKernan RM.
CSF neuron-specific enolase as a quantitative marker of neuronal damage in a rat stroke model.
Brain Res. 1992 Apr 17;577(2):249-52.

Cunningham RT, Young IS, Winder J, O'Kane MJ, McKinstry S, Johnston CF, Dolan OM, Hawkins SA, Buchanan KD.
Serum neurone specific enolase (NSE) levels as an indicator of neuronal damage in patients with cerebral infarction.
Eur J Clin Invest. 1991 Oct;21(5):497-500.