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'''[[S100 protein|S100]] calcium-binding protein B''' ('''S100B''') is a protein of the [[S-100 protein]] family.
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| update_protein_box = yes
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{{GNF_Protein_box
| image = PBB_Protein_S100B_image.jpg
| image_source = [[Protein_Data_Bank|PDB]] rendering based on 1b4c.
| PDB = {{PDB2|1b4c}}, {{PDB2|1cfp}}, {{PDB2|1dt7}}, {{PDB2|1mho}}, {{PDB2|1mq1}}, {{PDB2|1mwn}}, {{PDB2|1psb}}, {{PDB2|1qlk}}, {{PDB2|1sym}}, {{PDB2|1uwo}}, {{PDB2|1xyd}}, {{PDB2|2h61}}
| Name = S100 calcium binding protein B
| HGNCid = 10500
| Symbol = S100B
| AltSymbols =; S100; NEF; S100beta
| OMIM = 176990
| ECnumber = 
| Homologene = 4567
| MGIid = 98217
| GeneAtlas_image1 = PBB_GE_S100B_209686_at_tn.png
| Function = {{GNF_GO|id=GO:0005509 |text = calcium ion binding}} {{GNF_GO|id=GO:0008270 |text = zinc ion binding}} {{GNF_GO|id=GO:0019210 |text = kinase inhibitor activity}} {{GNF_GO|id=GO:0042803 |text = protein homodimerization activity}} {{GNF_GO|id=GO:0048154 |text = S100 beta binding}} {{GNF_GO|id=GO:0048156 |text = tau protein binding}} {{GNF_GO|id=GO:0048306 |text = calcium-dependent protein binding}}
| Component = {{GNF_GO|id=GO:0001726 |text = ruffle}} {{GNF_GO|id=GO:0005576 |text = extracellular region}} {{GNF_GO|id=GO:0005634 |text = nucleus}} {{GNF_GO|id=GO:0005737 |text = cytoplasm}} {{GNF_GO|id=GO:0043025 |text = cell soma}}
| Process = {{GNF_GO|id=GO:0006112 |text = energy reserve metabolic process}} {{GNF_GO|id=GO:0006874 |text = cellular calcium ion homeostasis}} {{GNF_GO|id=GO:0006917 |text = induction of apoptosis}} {{GNF_GO|id=GO:0007409 |text = axonogenesis}} {{GNF_GO|id=GO:0007417 |text = central nervous system development}} {{GNF_GO|id=GO:0007613 |text = memory}} {{GNF_GO|id=GO:0008283 |text = cell proliferation}} {{GNF_GO|id=GO:0042035 |text = regulation of cytokine biosynthetic process}} {{GNF_GO|id=GO:0045917 |text = positive regulation of complement activation}} {{GNF_GO|id=GO:0048143 |text = astrocyte activation}} {{GNF_GO|id=GO:0048151 |text = hyperphosphorylation}} {{GNF_GO|id=GO:0048169 |text = regulation of long-term neuronal synaptic plasticity}}
| Orthologs = {{GNF_Ortholog_box
    | Hs_EntrezGene = 6285
    | Hs_Ensembl = ENSG00000160307
    | Hs_RefseqProtein = NP_006263
    | Hs_RefseqmRNA = NM_006272
    | Hs_GenLoc_db = 
    | Hs_GenLoc_chr = 21
    | Hs_GenLoc_start = 46842968
    | Hs_GenLoc_end = 46849424
    | Hs_Uniprot = P04271
    | Mm_EntrezGene = 20203
    | Mm_Ensembl = ENSMUSG00000033208
    | Mm_RefseqmRNA = NM_009115
    | Mm_RefseqProtein = NP_033141
    | Mm_GenLoc_db = 
    | Mm_GenLoc_chr = 10
    | Mm_GenLoc_start = 75697569
    | Mm_GenLoc_end = 75703788
    | Mm_Uniprot = Q3UY00
  }}
}}


'''S100 calcium binding protein B''' or '''S100B''' is a protein of the [[S-100 protein]] family.
S100 proteins are localized in the cytoplasm and nucleus of a wide range of cells, and involved in the regulation of a number of cellular processes such as [[cell cycle]] progression and differentiation. S100 genes include at least 13 members which are located as a cluster on chromosome 1q21; however, this gene is located at 21q22.3.
 
== Function ==
S100B is [[glia]]l-specific and is expressed primarily by [[astrocyte]]s, but not all astrocytes express S100B. It has been shown that S100B is only expressed by a subtype of mature astrocytes that ensheath blood vessels and by NG2-expressing cells.<ref name="pmid18948166">{{cite journal | vauthors = Wang DD, Bordey A | title = The astrocyte odyssey | journal = Prog. Neurobiol. | volume = 86 | issue = 4 | pages = 342–67 | date = December 2008 | pmid = 18948166 | pmc = 2613184 | doi = 10.1016/j.pneurobio.2008.09.015 }}</ref>
 
This protein may function in [[neurite]] extension, proliferation of melanoma cells, stimulation of Ca<sup>2+</sup> fluxes, inhibition of [[Protein kinase C|PKC]]-mediated [[phosphorylation]], [[astrocytosis]] and axonal proliferation, and inhibition of microtubule assembly. In the developing [[central nervous system|CNS]] it acts as a [[neurotrophic factor]] and neuronal survival protein. In the adult organism it is usually elevated due to nervous system damage, which makes it a potential clinical marker.


S100 proteins are localized in the cytoplasm and nucleus of a wide range of cells, and involved in the regulation of a number of cellular processes such as [[cell cycle]] progression and differentiation. S100 genes include at least 13 members which are located as a cluster on chromosome 1q21; however, this gene is located at 21q22.3.
== Clinical significance ==
 
[[Chromosomal rearrangement]]s and altered expression of this gene have been implicated in several neurological, neoplastic, and other types of diseases, including [[Alzheimer's disease]], [[Down's syndrome]], [[epilepsy]], [[amyotrophic lateral sclerosis]], schwannoma, [[melanoma]], and [[type I diabetes]].<ref>{{cite web | title = Entrez Gene: S100B S100 calcium binding protein B| url = https://www.ncbi.nlm.nih.gov/sites/entrez?Db=gene&Cmd=ShowDetailView&TermToSearch=6285| accessdate = }}</ref>
 
It has been suggested that the regulation of S100B by [[melittin]] has potential for the treatment of [[epilepsy]].<ref name="Verma_2013">{{cite journal | vauthors = Verma N, Karmakar M, Singh KP, Smita S |date=February 2013 | title = Structural and Dynamic Insights into S100B Protein Activity Inhibition by Melittin for the Treatment of Epilepsy | journal = International journal of Computer Application | volume = NSAAILS | issue = 0975 – 8887 | pages = 55–60 | url = http://www.ijcaonline.org/proceedings/nsaails/number1/10386-1012 }}</ref>
 
== Diagnostic use ==
 
S100B is secreted by astrocytes or can spill from injured cells and enter the extracellular space or bloodstream. Serum levels of S100B increase in patients during the acute phase of brain damage.  Over the last decade, S100B has emerged as a candidate peripheral biomarker of blood–brain barrier  (BBB) permeability and CNS injury.  Elevated S100B levels accurately reflect the presence of neuropathological conditions including [[Traumatic brain injury|traumatic head injury]] or neurodegenerative diseases.  Normal S100B levels reliably exclude major CNS pathology.  Its potential clinical use in the therapeutic decision making process is substantiated by a vast body of literature validating variations in serum 100B levels with standard modalities for prognosticating the extent of CNS damage: alterations in neuroimaging, cerebrospinal pressure, and other brain molecular markers (neuron specific enolase and glial fibrillary acidic protein).  However, more importantly, S100B levels have been reported to rise prior to any detectable changes in intracerebral pressure, neuroimaging, and neurological examination findings.  Thus, the major advantage of using S100B is that elevations in serum or CSF levels provide a sensitive measure for determining CNS injury at the molecular level before gross changes develop, enabling timely delivery of crucial medical intervention before irreversible damage occurs. S100B serum levels are elevated before seizures suggesting that BBB leakage may be an early event in seizure development.
<ref>{{cite journal | vauthors = Marchi N, Angelov L, Masaryk T, Fazio V, Granata T, Hernandez N, Hallene K, Diglaw T, Franic L, Najm I, Janigro D | title = Seizure-promoting effect of blood–brain barrier disruption | journal = Epilepsia | volume = 48 | issue = 4 | pages = 732–42 | date = April 2007 | pmid = 17319915 | doi = 10.1111/j.1528-1167.2007.00988.x }}</ref>
An extremely important application of serum  S100B testing is in the selection of patients with minor head injury who do not need further neuroradiological evaluation, as studies comparing CT scans and S100B levels have demonstrated S100B values below 0.12&nbsp;ng/mL are associated with low risk of obvious neuroradiological changes (such as intracranial hemorrhage or brain swelling) or significant clinical sequelae.<ref>{{cite journal | vauthors = Zongo D, Ribéreau-Gayon R, Masson F, Laborey M, Contrand B, Salmi LR, Montaudon D, Beaudeux JL, Meurin A, Dousset V, Loiseau H, Lagarde E | title = S100-B protein as a screening tool for the early assessment of minor head injury | journal = Annals of Emergency Medicine | volume = 59 | issue = 1 | pages = 209–218 | year = 2012 | pmid = 21944878 | doi = 10.1016/j.annemergmed.2011.07.027 }}</ref> The excellent negative predictive value of S100B in several neurological conditions is due to the fact that serum S100B levels reflect blood–brain barrier permeability changes even in absence of neuronal injury.<ref>{{cite journal | vauthors = Czeisler BM, Janigro D | title = Reading and writing the blood–brain barrier: relevance to therapeutics | journal = Recent patents on CNS drug discovery | volume = 1 | issue = 2 | pages = 157–73 | date = June 2006 | pmid = 18221201 | doi = 10.2174/157488906777452712 }}</ref><ref>{{cite journal | vauthors = Marchi N, Cavaglia M, Fazio V, Bhudia S, Hallene K, Janigro D | title = Peripheral markers of blood–brain barrier damage | journal = Clinica Chimica Acta | volume = 342 | issue = 1–2 | pages = 1–12 | date = April 2004 | pmid = 15026262 | doi = 10.1016/j.cccn.2003.12.008 }}</ref>
In addition, S100B, which is also present in human melanocytes, is a reliable marker for melanoma malignancy both in bioptic tissue and in serum.<ref name="pmid22145907">{{cite journal | vauthors = Michetti F, Corvino V, Geloso MC, Lattanzi W, Bernardini C, Serpero L, Gazzolo D | title = The S100B protein in biological fluids: more than a lifelong biomarker of brain distress | journal = J. Neurochem. | volume = 120 | issue = 5 | pages = 644–59 | date = March 2012 | pmid = 22145907 | doi = 10.1111/j.1471-4159.2011.07612.x }}</ref><ref name="pmid7290214">{{cite journal | vauthors = Cocchia D, Michetti F, Donato R | title = Immunochemical and immuno-cytochemical localization of S-100 antigen in normal human skin | journal = Nature | volume = 294 | issue = 5836 | pages = 85–7 | date = November 1981 | pmid = 7290214 | doi = 10.1038/294085a0 }}</ref>
 
== Model organisms ==
 
{| class="wikitable sortable collapsible collapsed" border="1" cellpadding="2" style="float: right;" |
|+ ''S100b'' knockout mouse phenotype
|-
! Characteristic!! Phenotype
|-
| [[Homozygote]] viability || bgcolor="#488ED3"|Normal
|-
| Fertility || bgcolor="#488ED3"|Normal
|-
| Body weight || bgcolor="#488ED3"|Normal
|-
| [[Open Field (animal test)|Anxiety]] || bgcolor="#488ED3"|Normal
|-
| Neurological assessment || bgcolor="#488ED3"|Normal
|-
| Grip strength || bgcolor="#488ED3"|Normal
|-
| [[Hot plate test|Hot plate]] || bgcolor="#488ED3"|Normal
|-
| [[Dysmorphology]] || bgcolor="#488ED3"|Normal
|-
| [[Indirect calorimetry]] || bgcolor="#488ED3"|Normal
|-
| [[Glucose tolerance test]] || bgcolor="#488ED3"|Normal
|-
| [[Auditory brainstem response]] || bgcolor="#488ED3"|Normal
|-
| [[Dual-energy X-ray absorptiometry|DEXA]] || bgcolor="#488ED3"|Normal
|-
| [[Radiography]] || bgcolor="#488ED3"|Normal
|-
| Body temperature || bgcolor="#488ED3"|Normal
|-
| Eye morphology || bgcolor="#488ED3"|Normal
|-
| [[Clinical chemistry]] || bgcolor="#488ED3"|Normal
|-
| [[Haematology]] || bgcolor="#488ED3"|Normal
|-
| [[Peripheral blood lymphocyte]]s || bgcolor="#488ED3"|Normal
|-
| [[Micronucleus test]] || bgcolor="#488ED3"|Normal
|-
| Heart weight || bgcolor="#488ED3"|Normal
|-
| Brain histopathology || bgcolor="#488ED3"|Normal
|-
| ''[[Salmonella]]'' infection || bgcolor="#488ED3"|Normal<ref name="''Salmonella'' infection">{{cite web |url=http://www.sanger.ac.uk/mouseportal/phenotyping/MCFR/salmonella-challenge/ |title=''Salmonella'' infection data for S100b |publisher=Wellcome Trust Sanger Institute}}</ref>
|-
| ''[[Citrobacter]]'' infection || bgcolor="#488ED3"|Normal<ref name="''Citrobacter'' infection">{{cite web |url=http://www.sanger.ac.uk/mouseportal/phenotyping/MCFR/citrobacter-challenge/ |title=''Citrobacter'' infection data for S100b |publisher=Wellcome Trust Sanger Institute}}</ref>
|-
| colspan=2; style="text-align: center;" | All tests and analysis from<ref name="mgp_reference">{{cite journal| doi = 10.1111/j.1755-3768.2010.4142.x| title = The Sanger Mouse Genetics Programme: High throughput characterisation of knockout mice| year = 2010| author = Gerdin AK| journal = Acta Ophthalmologica| volume = 88| issue = S248 }}</ref><ref>[http://www.sanger.ac.uk/mouseportal/ Mouse Resources Portal], Wellcome Trust Sanger Institute.</ref>
|}
[[Model organism]]s have been used in the study of S100B function. A conditional [[knockout mouse]] line, called ''S100b<sup>tm1a(EUCOMM)Wtsi</sup>''<ref name="allele_ref">{{cite web |url=http://www.knockoutmouse.org/martsearch/search?query=S100b |title=International Knockout Mouse Consortium}}</ref><ref name="mgi_allele_ref">{{cite web |url=http://www.informatics.jax.org/searchtool/Search.do?query=MGI:4432844 |title=Mouse Genome Informatics}}</ref> was generated as part of the [[International Knockout Mouse Consortium]] program — a high-throughput mutagenesis project to generate and distribute animal models of disease to interested scientists — at the [[Wellcome Trust Sanger Institute]].<ref name="pmid21677750">{{cite journal | vauthors = Skarnes WC, Rosen B, West AP, Koutsourakis M, Bushell W, Iyer V, Mujica AO, Thomas M, Harrow J, Cox T, Jackson D, Severin J, Biggs P, Fu J, Nefedov M, de Jong PJ, Stewart AF, Bradley A | title = A conditional knockout resource for the genome-wide study of mouse gene function | journal = Nature | volume = 474 | issue = 7351 | pages = 337–42 | date = June 2011 | pmid = 21677750 | pmc = 3572410 | doi = 10.1038/nature10163 }}</ref><ref name="mouse_library">{{cite journal | vauthors = Dolgin E | title = Mouse library set to be knockout | journal = Nature | volume = 474 | issue = 7351 | pages = 262–3 | date = June 2011 | pmid = 21677718 | doi = 10.1038/474262a }}</ref><ref name="mouse_for_all_reasons">{{cite journal | vauthors = Collins FS, Rossant J, Wurst W | title = A mouse for all reasons | journal = Cell | volume = 128 | issue = 1 | pages = 9–13 | date = January 2007 | pmid = 17218247 | doi = 10.1016/j.cell.2006.12.018 }}</ref>
 
Male and female animals underwent a standardized [[phenotypic screen]] to determine the effects of deletion.<ref name="mgp_reference" /><ref name="pmid21722353">{{cite journal | vauthors = van der Weyden L, White JK, Adams DJ, Logan DW | title = The mouse genetics toolkit: revealing function and mechanism | journal = Genome Biol | volume = 12 | issue = 6 | pages = 224 | year = 2011 | pmid = 21722353 | pmc = 3218837 | doi = 10.1186/gb-2011-12-6-224 }}</ref> Twenty three tests were carried out on [[mutant]] mice, but no significant abnormalities have yet been observed.<ref name="mgp_reference" />


S100B is [[glia]]l-specific and is expressed primarily by [[astrocyte]]s. This protein may function in [[neurite]] extension, proliferation of melanoma cells, stimulation of Ca2+ fluxes, inhibition of [[Protein kinase C|PKC]]-mediated [[phosphorylation]], [[astrocytosis]] and axonal proliferation, and inhibition of microtubule assembly. In the developing [[central nervous system |CNS]] it acts as a [[neurotrophic factor]] and neuronal survival protein. In the adult organism it is usually elevated due to nervous system damage, which makes it a potential clinical marker.
== Interactions ==


[[Chromosomal rearrangement]]s and altered expression of this gene have been implicated in several neurological, neoplastic, and other types of diseases, including [[Alzheimer's disease]], [[Down's syndrome]], [[epilepsy]], [[amyotrophic lateral sclerosis]], [[melanoma]], and [[type I diabetes]].<ref>{{cite web | title = Entrez Gene: S100B S100 calcium binding protein B| url = http://www.ncbi.nlm.nih.gov/sites/entrez?Db=gene&Cmd=ShowDetailView&TermToSearch=6285| accessdate = }}</ref>  
S100B has been shown to [[Protein-protein interaction|interact]] with:
* [[AHNAK]],<ref name="pmid11312263">{{cite journal | vauthors = Gentil BJ, Delphin C, Mbele GO, Deloulme JC, Ferro M, Garin J, Baudier J | title = The giant protein AHNAK is a specific target for the calcium- and zinc-binding S100B protein: potential implications for Ca2+ homeostasis regulation by S100B | journal = J. Biol. Chem. | volume = 276 | issue = 26 | pages = 23253–61 | date = June 2001 | pmid = 11312263 | doi = 10.1074/jbc.M010655200 }}</ref>
* [[IMPA1]],<ref name="pmid19593677">{{cite journal | vauthors = Vig PJ, Shao Q, Subramony SH, Lopez ME, Safaya E | title = Bergmann glial S100B activates myo-inositol monophosphatase 1 and Co-localizes to purkinje cell vacuoles in SCA1 transgenic mice | journal = Cerebellum | volume = 8 | issue = 3 | pages = 231–44 | date = September 2009 | pmid = 19593677 | pmc = 3351107 | doi = 10.1007/s12311-009-0125-5 }}</ref>
* [[IQGAP1]],<ref name="pmid12377780">{{cite journal | vauthors = Mbele GO, Deloulme JC, Gentil BJ, Delphin C, Ferro M, Garin J, Takahashi M, Baudier J | title = The zinc- and calcium-binding S100B interacts and co-localizes with IQGAP1 during dynamic rearrangement of cell membranes | journal = J. Biol. Chem. | volume = 277 | issue = 51 | pages = 49998–50007 | date = December 2002 | pmid = 12377780 | doi = 10.1074/jbc.M205363200 }}</ref>
* [[Tau protein|MAPT]],<ref name="pmid11264299">{{cite journal | vauthors = Yu WH, Fraser PE | title = S100beta interaction with tau is promoted by zinc and inhibited by hyperphosphorylation in Alzheimer's disease | journal = J. Neurosci. | volume = 21 | issue = 7 | pages = 2240–6 | date = April 2001 | pmid = 11264299 | doi =  }}</ref><ref name="pmid2833519">{{cite journal | vauthors = Baudier J, Cole RD | title = Interactions between the microtubule-associated tau proteins and S100b regulate tau phosphorylation by the Ca2+/calmodulin-dependent protein kinase II | journal = J. Biol. Chem. | volume = 263 | issue = 12 | pages = 5876–83 | date = April 1988 | pmid = 2833519 | doi =  }}</ref> and
* [[P53]],<ref name="pmid15178678">{{cite journal | vauthors = Lin J, Yang Q, Yan Z, Markowitz J, Wilder PT, Carrier F, Weber DJ | title = Inhibiting S100B restores p53 levels in primary malignant melanoma cancer cells | journal = J. Biol. Chem. | volume = 279 | issue = 32 | pages = 34071–7 | date = August 2004 | pmid = 15178678 | doi = 10.1074/jbc.M405419200 }}</ref>
* [[PGM1]],<ref name="pmid8894274">{{cite journal | vauthors = Landar A, Caddell G, Chessher J, Zimmer DB | title = Identification of an S100A1/S100B target protein: phosphoglucomutase | journal = [[Cell Calcium]] | volume = 20 | issue = 3 | pages = 279–85 | date = September 1996 | pmid = 8894274 | doi = 10.1016/S0143-4160(96)90033-0 }}</ref>
* [[S100 calcium binding protein A1|S100A1]],<ref name="pmid16189514">{{cite journal | vauthors = Rual JF, Venkatesan K, Hao T, Hirozane-Kishikawa T, Dricot A, Li N, Berriz GF, Gibbons FD, Dreze M, Ayivi-Guedehoussou N, Klitgord N, Simon C, Boxem M, Milstein S, Rosenberg J, Goldberg DS, Zhang LV, Wong SL, Franklin G, Li S, Albala JS, Lim J, Fraughton C, Llamosas E, Cevik S, Bex C, Lamesch P, Sikorski RS, Vandenhaute J, Zoghbi HY, Smolyar A, Bosak S, Sequerra R, Doucette-Stamm L, Cusick ME, Hill DE, Roth FP, Vidal M | title = Towards a proteome-scale map of the human protein-protein interaction network | journal = Nature | volume = 437 | issue = 7062 | pages = 1173–8 | date = October 2005 | pmid = 16189514 | doi = 10.1038/nature04209 }}</ref><ref name="pmid9925766">{{cite journal | vauthors = Yang Q, O'Hanlon D, Heizmann CW, Marks A | title = Demonstration of heterodimer formation between S100B and S100A6 in the yeast two-hybrid system and human melanoma | journal = Exp. Cell Res. | volume = 246 | issue = 2 | pages = 501–9 | date = February 1999 | pmid = 9925766 | doi = 10.1006/excr.1998.4314 }}</ref>
* [[S100A6]],<ref name="pmid9925766"/><ref name="pmid10913138"/>
* [[S100A11]],<ref name="pmid10913138">{{cite journal | vauthors = Deloulme JC, Assard N, Mbele GO, Mangin C, Kuwano R, Baudier J | title = S100A6 and S100A11 are specific targets of the calcium- and zinc-binding S100B protein in vivo | journal = J. Biol. Chem. | volume = 275 | issue = 45 | pages = 35302–10 | date = November 2000 | pmid = 10913138 | doi = 10.1074/jbc.M003943200 }}</ref>
* [[VAV1]].<ref name="pmid10394361">{{cite journal | vauthors = Fackler OT, Luo W, Geyer M, Alberts AS, Peterlin BM | title = Activation of Vav by Nef induces cytoskeletal rearrangements and downstream effector functions | journal = Mol. Cell | volume = 3 | issue = 6 | pages = 729–39 | date = June 1999 | pmid = 10394361 | doi = 10.1016/S1097-2765(01)80005-8 }}</ref>


==References==
== References ==
{{reflist|2}}
{{reflist|2}}
==Further reading==
 
== Further reading ==
{{refbegin | 2}}
{{refbegin | 2}}
{{PBB_Further_reading
* {{cite journal | vauthors = Schäfer BW, Heizmann CW | title = The S100 family of EF-hand calcium-binding proteins: functions and pathology | journal = Trends Biochem. Sci. | volume = 21 | issue = 4 | pages = 134–40 | year = 1996 | pmid = 8701470 | doi = 10.1016/S0968-0004(96)80167-8 }}
| citations =
* {{cite journal | vauthors = Garbuglia M, Verzini M, Sorci G, Bianchi R, Giambanco I, Agneletti AL, Donato R | title = The calcium-modulated proteins, S100A1 and S100B, as potential regulators of the dynamics of type III intermediate filaments | journal = Braz. J. Med. Biol. Res. | volume = 32 | issue = 10 | pages = 1177–85 | year = 2000 | pmid = 10510252 | doi = 10.1590/s0100-879x1999001000001 }}
*{{cite journal | author=Schäfer BW, Heizmann CW |title=The S100 family of EF-hand calcium-binding proteins: functions and pathology. |journal=Trends Biochem. Sci. |volume=21 |issue= 4 |pages= 134-40 |year= 1996 |pmid= 8701470 |doi= }}
* {{cite journal | vauthors = Rothermundt M, Peters M, Prehn JH, Arolt V | title = S100B in brain damage and neurodegeneration | journal = Microsc. Res. Tech. | volume = 60 | issue = 6 | pages = 614–32 | year = 2003 | pmid = 12645009 | doi = 10.1002/jemt.10303 }}
*{{cite journal | author=Garbuglia M, Verzini M, Sorci G, ''et al.'' |title=The calcium-modulated proteins, S100A1 and S100B, as potential regulators of the dynamics of type III intermediate filaments. |journal=Braz. J. Med. Biol. Res. |volume=32 |issue= 10 |pages= 1177-85 |year= 2000 |pmid= 10510252 |doi= }}
* {{cite journal | vauthors = Michetti F, Gazzolo D | title = S100B testing in pregnancy | journal = Clin. Chim. Acta | volume = 335 | issue = 1–2 | pages = 1–7 | year = 2004 | pmid = 12927678 | doi = 10.1016/S0009-8981(03)00243-2 }}
*{{cite journal | author=Rothermundt M, Peters M, Prehn JH, Arolt V |title=S100B in brain damage and neurodegeneration. |journal=Microsc. Res. Tech. |volume=60 |issue= 6 |pages= 614-32 |year= 2003 |pmid= 12645009 |doi= 10.1002/jemt.10303 }}
* {{cite journal | vauthors = Raabe A, Kopetsch O, Woszczyk A, Lang J, Gerlach R, Zimmermann M, Seifert V | title = Serum S-100B protein as a molecular marker in severe traumatic brain injury | journal = Restor. Neurol. Neurosci. | volume = 21 | issue = 3–4 | pages = 159–69 | year = 2004 | pmid = 14530578 | doi =  }}
*{{cite journal | author=Michetti F, Gazzolo D |title=S100B testing in pregnancy. |journal=Clin. Chim. Acta |volume=335 |issue= 1-2 |pages= 1-7 |year= 2004 |pmid= 12927678 |doi= }}
* {{cite journal | vauthors = Sen J, Belli A | title = S100B in neuropathologic states: the CRP of the brain? | journal = J. Neurosci. Res. | volume = 85 | issue = 7 | pages = 1373–80 | year = 2007 | pmid = 17348038 | doi = 10.1002/jnr.21211 }}
*{{cite journal | author=Raabe A, Kopetsch O, Woszczyk A, ''et al.'' |title=Serum S-100B protein as a molecular marker in severe traumatic brain injury. |journal=Restor. Neurol. Neurosci. |volume=21 |issue= 3-4 |pages= 159-69 |year= 2004 |pmid= 14530578 |doi=  }}
* {{cite journal | vauthors = Morii K, Tanaka R, Takahashi Y, Minoshima S, Fukuyama R, Shimizu N, Kuwano R | title = Structure and chromosome assignment of human S100 alpha and beta subunit genes | journal = Biochem. Biophys. Res. Commun. | volume = 175 | issue = 1 | pages = 185–91 | year = 1991 | pmid = 1998503 | doi = 10.1016/S0006-291X(05)81218-5 }}
*{{cite journal | author=Sen J, Belli A |title=S100B in neuropathologic states: the CRP of the brain? |journal=J. Neurosci. Res. |volume=85 |issue= 7 |pages= 1373-80 |year= 2007 |pmid= 17348038 |doi= 10.1002/jnr.21211 }}
* {{cite journal | vauthors = Allore RJ, Friend WC, O'Hanlon D, Neilson KM, Baumal R, Dunn RJ, Marks A | title = Cloning and expression of the human S100 beta gene | journal = J. Biol. Chem. | volume = 265 | issue = 26 | pages = 15537–43 | year = 1990 | pmid = 2394738 | doi =  }}
*{{cite journal | author=Morii K, Tanaka R, Takahashi Y, ''et al.'' |title=Structure and chromosome assignment of human S100 alpha and beta subunit genes. |journal=Biochem. Biophys. Res. Commun. |volume=175 |issue= 1 |pages= 185-91 |year= 1991 |pmid= 1998503 |doi= }}
* {{cite journal | vauthors = Duncan AM, Higgins J, Dunn RJ, Allore R, Marks A | title = Refined sublocalization of the human gene encoding the beta subunit of the S100 protein (S100B) and confirmation of a subtle t(9;21) translocation using in situ hybridization | journal = Cytogenet. Cell Genet. | volume = 50 | issue = 4 | pages = 234–5 | year = 1989 | pmid = 2530061 | doi = 10.1159/000132767 }}
*{{cite journal | author=Allore RJ, Friend WC, O'Hanlon D, ''et al.'' |title=Cloning and expression of the human S100 beta gene. |journal=J. Biol. Chem. |volume=265 |issue= 26 |pages= 15537-43 |year= 1990 |pmid= 2394738 |doi=  }}
* {{cite journal | vauthors = Baudier J, Cole RD | title = Interactions between the microtubule-associated tau proteins and S100b regulate tau phosphorylation by the Ca2+/calmodulin-dependent protein kinase II | journal = J. Biol. Chem. | volume = 263 | issue = 12 | pages = 5876–83 | year = 1988 | pmid = 2833519 | doi =  }}
*{{cite journal | author=Duncan AM, Higgins J, Dunn RJ, ''et al.'' |title=Refined sublocalization of the human gene encoding the beta subunit of the S100 protein (S100B) and confirmation of a subtle t(9;21) translocation using in situ hybridization. |journal=Cytogenet. Cell Genet. |volume=50 |issue= 4 |pages= 234-5 |year= 1989 |pmid= 2530061 |doi= }}
* {{cite journal | vauthors = Allore R, O'Hanlon D, Price R, Neilson K, Willard HF, Cox DR, Marks A, Dunn RJ | title = Gene encoding the beta subunit of S100 protein is on chromosome 21: implications for Down syndrome | journal = Science | volume = 239 | issue = 4845 | pages = 1311–3 | year = 1988 | pmid = 2964086 | doi = 10.1126/science.2964086 }}
*{{cite journal | author=Baudier J, Cole RD |title=Interactions between the microtubule-associated tau proteins and S100b regulate tau phosphorylation by the Ca2+/calmodulin-dependent protein kinase II. |journal=J. Biol. Chem. |volume=263 |issue= 12 |pages= 5876-83 |year= 1988 |pmid= 2833519 |doi=  }}
* {{cite journal | vauthors = Jensen R, Marshak DR, Anderson C, Lukas TJ, Watterson DM | title = Characterization of human brain S100 protein fraction: amino acid sequence of S100 beta | journal = J. Neurochem. | volume = 45 | issue = 3 | pages = 700–5 | year = 1985 | pmid = 4031854 | doi = 10.1111/j.1471-4159.1985.tb04048.x }}
*{{cite journal | author=Allore R, O'Hanlon D, Price R, ''et al.'' |title=Gene encoding the beta subunit of S100 protein is on chromosome 21: implications for Down syndrome. |journal=Science |volume=239 |issue= 4845 |pages= 1311-3 |year= 1988 |pmid= 2964086 |doi= }}
* {{cite journal | vauthors = Baudier J, Glasser N, Haglid K, Gerard D | title = Purification, characterization and ion binding properties of human brain S100b protein | journal = Biochim. Biophys. Acta | volume = 790 | issue = 2 | pages = 164–73 | year = 1984 | pmid = 6487634 | doi = 10.1016/0167-4838(84)90220-6 }}
*{{cite journal | author=Jensen R, Marshak DR, Anderson C, ''et al.'' |title=Characterization of human brain S100 protein fraction: amino acid sequence of S100 beta. |journal=J. Neurochem. |volume=45 |issue= 3 |pages= 700-5 |year= 1985 |pmid= 4031854 |doi= }}
* {{cite journal | vauthors = Adams MD, Kerlavage AR, Fleischmann RD, Fuldner RA, Bult CJ, Lee NH, Kirkness EF, Weinstock KG, Gocayne JD, White O | title = Initial assessment of human gene diversity and expression patterns based upon 83 million nucleotides of cDNA sequence | journal = Nature | volume = 377 | issue = 6547 Suppl | pages = 3–174 | year = 1995 | pmid = 7566098 | doi = <!-- none available --> | url = http://www.columbia.edu/itc/biology/pollack/w4065/client_edit/readings/nature377_3.pdf | format = PDF }}
*{{cite journal | author=Baudier J, Glasser N, Haglid K, Gerard D |title=Purification, characterization and ion binding properties of human brain S100b protein. |journal=Biochim. Biophys. Acta |volume=790 |issue= 2 |pages= 164-73 |year= 1984 |pmid= 6487634 |doi= }}
* {{cite journal | vauthors = Schäfer BW, Wicki R, Engelkamp D, Mattei MG, Heizmann CW | title = Isolation of a YAC clone covering a cluster of nine S100 genes on human chromosome 1q21: rationale for a new nomenclature of the S100 calcium-binding protein family | journal = Genomics | volume = 25 | issue = 3 | pages = 638–43 | year = 1995 | pmid = 7759097 | doi = 10.1016/0888-7543(95)80005-7 }}
*{{cite journal | author=Adams MD, Kerlavage AR, Fleischmann RD, ''et al.'' |title=Initial assessment of human gene diversity and expression patterns based upon 83 million nucleotides of cDNA sequence. |journal=Nature |volume=377 |issue= 6547 Suppl |pages= 3-174 |year= 1995 |pmid= 7566098 |doi= }}
* {{cite journal | vauthors = Reeves RH, Yao J, Crowley MR, Buck S, Zhang X, Yarowsky P, Gearhart JD, Hilt DC | title = Astrocytosis and axonal proliferation in the hippocampus of S100b transgenic mice | journal = Proc. Natl. Acad. Sci. U.S.A. | volume = 91 | issue = 12 | pages = 5359–63 | year = 1994 | pmid = 8202493 | pmc = 43994 | doi = 10.1073/pnas.91.12.5359 }}
*{{cite journal  | author=Schäfer BW, Wicki R, Engelkamp D, ''et al.'' |title=Isolation of a YAC clone covering a cluster of nine S100 genes on human chromosome 1q21: rationale for a new nomenclature of the S100 calcium-binding protein family. |journal=Genomics |volume=25 |issue= 3 |pages= 638-43 |year= 1995 |pmid= 7759097 |doi= }}
* {{cite journal | vauthors = Engelkamp D, Schäfer BW, Mattei MG, Erne P, Heizmann CW | title = Six S100 genes are clustered on human chromosome 1q21: identification of two genes coding for the two previously unreported calcium-binding proteins S100D and S100E | journal = Proc. Natl. Acad. Sci. U.S.A. | volume = 90 | issue = 14 | pages = 6547–51 | year = 1993 | pmid = 8341667 | pmc = 46969 | doi = 10.1073/pnas.90.14.6547 }}
*{{cite journal | author=Reeves RH, Yao J, Crowley MR, ''et al.'' |title=Astrocytosis and axonal proliferation in the hippocampus of S100b transgenic mice. |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=91 |issue= 12 |pages= 5359-63 |year= 1994 |pmid= 8202493 |doi= }}
* {{cite journal | vauthors = Peña LA, Brecher CW, Marshak DR | title = beta-Amyloid regulates gene expression of glial trophic substance S100 beta in C6 glioma and primary astrocyte cultures | journal = Brain Res. Mol. Brain Res. | volume = 34 | issue = 1 | pages = 118–26 | year = 1997 | pmid = 8750867 | doi = 10.1016/0169-328X(95)00145-I }}
*{{cite journal | author=Engelkamp D, Schäfer BW, Mattei MG, ''et al.'' |title=Six S100 genes are clustered on human chromosome 1q21: identification of two genes coding for the two previously unreported calcium-binding proteins S100D and S100E. |journal=Proc. Natl. Acad. Sci. U.S.A. |volume=90 |issue= 14 |pages= 6547-51 |year= 1993 |pmid= 8341667 |doi= }}
* {{cite journal | vauthors = Argandoña EG, Bengoetxea H, Lafuente JV | title = Physical exercise is required for environmental enrichment to offset the quantitative effects of dark-rearing on the S-100β astrocytic density in the rat visual cortex | journal = [[Journal of Anatomy]] | volume = 215 | issue = 2 | pages = 132–40 | year = 2009 | pmid = 19500177 | pmc = 2740960 | doi = 10.1111/j.1469-7580.2009.01103.x }}
*{{cite journal | author=Peña LA, Brecher CW, Marshak DR |title=beta-Amyloid regulates gene expression of glial trophic substance S100 beta in C6 glioma and primary astrocyte cultures. |journal=Brain Res. Mol. Brain Res. |volume=34 |issue= 1 |pages= 118-26 |year= 1997 |pmid= 8750867 |doi= }}
* {{cite journal | vauthors = Landar A, Caddell G, Chessher J, Zimmer DB | title = Identification of an S100A1/S100B target protein: phosphoglucomutase | journal = Cell Calcium | volume = 20 | issue = 3 | pages = 279–85 | year = 1997 | pmid = 8894274 | doi = 10.1016/S0143-4160(96)90033-0 }}
*{{cite journal  | author=Landar A, Caddell G, Chessher J, Zimmer DB |title=Identification of an S100A1/S100B target protein: phosphoglucomutase. |journal=Cell Calcium |volume=20 |issue= 3 |pages= 279-85 |year= 1997 |pmid= 8894274 |doi= }}
}}
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S100 calcium-binding protein B (S100B) is a protein of the S-100 protein family.

S100 proteins are localized in the cytoplasm and nucleus of a wide range of cells, and involved in the regulation of a number of cellular processes such as cell cycle progression and differentiation. S100 genes include at least 13 members which are located as a cluster on chromosome 1q21; however, this gene is located at 21q22.3.

Function

S100B is glial-specific and is expressed primarily by astrocytes, but not all astrocytes express S100B. It has been shown that S100B is only expressed by a subtype of mature astrocytes that ensheath blood vessels and by NG2-expressing cells.[1]

This protein may function in neurite extension, proliferation of melanoma cells, stimulation of Ca2+ fluxes, inhibition of PKC-mediated phosphorylation, astrocytosis and axonal proliferation, and inhibition of microtubule assembly. In the developing CNS it acts as a neurotrophic factor and neuronal survival protein. In the adult organism it is usually elevated due to nervous system damage, which makes it a potential clinical marker.

Clinical significance

Chromosomal rearrangements and altered expression of this gene have been implicated in several neurological, neoplastic, and other types of diseases, including Alzheimer's disease, Down's syndrome, epilepsy, amyotrophic lateral sclerosis, schwannoma, melanoma, and type I diabetes.[2]

It has been suggested that the regulation of S100B by melittin has potential for the treatment of epilepsy.[3]

Diagnostic use

S100B is secreted by astrocytes or can spill from injured cells and enter the extracellular space or bloodstream. Serum levels of S100B increase in patients during the acute phase of brain damage. Over the last decade, S100B has emerged as a candidate peripheral biomarker of blood–brain barrier (BBB) permeability and CNS injury. Elevated S100B levels accurately reflect the presence of neuropathological conditions including traumatic head injury or neurodegenerative diseases. Normal S100B levels reliably exclude major CNS pathology. Its potential clinical use in the therapeutic decision making process is substantiated by a vast body of literature validating variations in serum 100B levels with standard modalities for prognosticating the extent of CNS damage: alterations in neuroimaging, cerebrospinal pressure, and other brain molecular markers (neuron specific enolase and glial fibrillary acidic protein). However, more importantly, S100B levels have been reported to rise prior to any detectable changes in intracerebral pressure, neuroimaging, and neurological examination findings. Thus, the major advantage of using S100B is that elevations in serum or CSF levels provide a sensitive measure for determining CNS injury at the molecular level before gross changes develop, enabling timely delivery of crucial medical intervention before irreversible damage occurs. S100B serum levels are elevated before seizures suggesting that BBB leakage may be an early event in seizure development. [4] An extremely important application of serum S100B testing is in the selection of patients with minor head injury who do not need further neuroradiological evaluation, as studies comparing CT scans and S100B levels have demonstrated S100B values below 0.12 ng/mL are associated with low risk of obvious neuroradiological changes (such as intracranial hemorrhage or brain swelling) or significant clinical sequelae.[5] The excellent negative predictive value of S100B in several neurological conditions is due to the fact that serum S100B levels reflect blood–brain barrier permeability changes even in absence of neuronal injury.[6][7] In addition, S100B, which is also present in human melanocytes, is a reliable marker for melanoma malignancy both in bioptic tissue and in serum.[8][9]

Model organisms

Model organisms have been used in the study of S100B function. A conditional knockout mouse line, called S100btm1a(EUCOMM)Wtsi[14][15] was generated as part of the International Knockout Mouse Consortium program — a high-throughput mutagenesis project to generate and distribute animal models of disease to interested scientists — at the Wellcome Trust Sanger Institute.[16][17][18]

Male and female animals underwent a standardized phenotypic screen to determine the effects of deletion.[12][19] Twenty three tests were carried out on mutant mice, but no significant abnormalities have yet been observed.[12]

Interactions

S100B has been shown to interact with:

References

  1. Wang DD, Bordey A (December 2008). "The astrocyte odyssey". Prog. Neurobiol. 86 (4): 342–67. doi:10.1016/j.pneurobio.2008.09.015. PMC 2613184. PMID 18948166.
  2. "Entrez Gene: S100B S100 calcium binding protein B".
  3. Verma N, Karmakar M, Singh KP, Smita S (February 2013). "Structural and Dynamic Insights into S100B Protein Activity Inhibition by Melittin for the Treatment of Epilepsy". International journal of Computer Application. NSAAILS (0975–8887): 55–60.
  4. Marchi N, Angelov L, Masaryk T, Fazio V, Granata T, Hernandez N, Hallene K, Diglaw T, Franic L, Najm I, Janigro D (April 2007). "Seizure-promoting effect of blood–brain barrier disruption". Epilepsia. 48 (4): 732–42. doi:10.1111/j.1528-1167.2007.00988.x. PMID 17319915.
  5. Zongo D, Ribéreau-Gayon R, Masson F, Laborey M, Contrand B, Salmi LR, Montaudon D, Beaudeux JL, Meurin A, Dousset V, Loiseau H, Lagarde E (2012). "S100-B protein as a screening tool for the early assessment of minor head injury". Annals of Emergency Medicine. 59 (1): 209–218. doi:10.1016/j.annemergmed.2011.07.027. PMID 21944878.
  6. Czeisler BM, Janigro D (June 2006). "Reading and writing the blood–brain barrier: relevance to therapeutics". Recent patents on CNS drug discovery. 1 (2): 157–73. doi:10.2174/157488906777452712. PMID 18221201.
  7. Marchi N, Cavaglia M, Fazio V, Bhudia S, Hallene K, Janigro D (April 2004). "Peripheral markers of blood–brain barrier damage". Clinica Chimica Acta. 342 (1–2): 1–12. doi:10.1016/j.cccn.2003.12.008. PMID 15026262.
  8. Michetti F, Corvino V, Geloso MC, Lattanzi W, Bernardini C, Serpero L, Gazzolo D (March 2012). "The S100B protein in biological fluids: more than a lifelong biomarker of brain distress". J. Neurochem. 120 (5): 644–59. doi:10.1111/j.1471-4159.2011.07612.x. PMID 22145907.
  9. Cocchia D, Michetti F, Donato R (November 1981). "Immunochemical and immuno-cytochemical localization of S-100 antigen in normal human skin". Nature. 294 (5836): 85–7. doi:10.1038/294085a0. PMID 7290214.
  10. "Salmonella infection data for S100b". Wellcome Trust Sanger Institute.
  11. "Citrobacter infection data for S100b". Wellcome Trust Sanger Institute.
  12. 12.0 12.1 12.2 Gerdin AK (2010). "The Sanger Mouse Genetics Programme: High throughput characterisation of knockout mice". Acta Ophthalmologica. 88 (S248). doi:10.1111/j.1755-3768.2010.4142.x.
  13. Mouse Resources Portal, Wellcome Trust Sanger Institute.
  14. "International Knockout Mouse Consortium".
  15. "Mouse Genome Informatics".
  16. Skarnes WC, Rosen B, West AP, Koutsourakis M, Bushell W, Iyer V, Mujica AO, Thomas M, Harrow J, Cox T, Jackson D, Severin J, Biggs P, Fu J, Nefedov M, de Jong PJ, Stewart AF, Bradley A (June 2011). "A conditional knockout resource for the genome-wide study of mouse gene function". Nature. 474 (7351): 337–42. doi:10.1038/nature10163. PMC 3572410. PMID 21677750.
  17. Dolgin E (June 2011). "Mouse library set to be knockout". Nature. 474 (7351): 262–3. doi:10.1038/474262a. PMID 21677718.
  18. Collins FS, Rossant J, Wurst W (January 2007). "A mouse for all reasons". Cell. 128 (1): 9–13. doi:10.1016/j.cell.2006.12.018. PMID 17218247.
  19. van der Weyden L, White JK, Adams DJ, Logan DW (2011). "The mouse genetics toolkit: revealing function and mechanism". Genome Biol. 12 (6): 224. doi:10.1186/gb-2011-12-6-224. PMC 3218837. PMID 21722353.
  20. Gentil BJ, Delphin C, Mbele GO, Deloulme JC, Ferro M, Garin J, Baudier J (June 2001). "The giant protein AHNAK is a specific target for the calcium- and zinc-binding S100B protein: potential implications for Ca2+ homeostasis regulation by S100B". J. Biol. Chem. 276 (26): 23253–61. doi:10.1074/jbc.M010655200. PMID 11312263.
  21. Vig PJ, Shao Q, Subramony SH, Lopez ME, Safaya E (September 2009). "Bergmann glial S100B activates myo-inositol monophosphatase 1 and Co-localizes to purkinje cell vacuoles in SCA1 transgenic mice". Cerebellum. 8 (3): 231–44. doi:10.1007/s12311-009-0125-5. PMC 3351107. PMID 19593677.
  22. Mbele GO, Deloulme JC, Gentil BJ, Delphin C, Ferro M, Garin J, Takahashi M, Baudier J (December 2002). "The zinc- and calcium-binding S100B interacts and co-localizes with IQGAP1 during dynamic rearrangement of cell membranes". J. Biol. Chem. 277 (51): 49998–50007. doi:10.1074/jbc.M205363200. PMID 12377780.
  23. Yu WH, Fraser PE (April 2001). "S100beta interaction with tau is promoted by zinc and inhibited by hyperphosphorylation in Alzheimer's disease". J. Neurosci. 21 (7): 2240–6. PMID 11264299.
  24. Baudier J, Cole RD (April 1988). "Interactions between the microtubule-associated tau proteins and S100b regulate tau phosphorylation by the Ca2+/calmodulin-dependent protein kinase II". J. Biol. Chem. 263 (12): 5876–83. PMID 2833519.
  25. Lin J, Yang Q, Yan Z, Markowitz J, Wilder PT, Carrier F, Weber DJ (August 2004). "Inhibiting S100B restores p53 levels in primary malignant melanoma cancer cells". J. Biol. Chem. 279 (32): 34071–7. doi:10.1074/jbc.M405419200. PMID 15178678.
  26. Landar A, Caddell G, Chessher J, Zimmer DB (September 1996). "Identification of an S100A1/S100B target protein: phosphoglucomutase". Cell Calcium. 20 (3): 279–85. doi:10.1016/S0143-4160(96)90033-0. PMID 8894274.
  27. Rual JF, Venkatesan K, Hao T, Hirozane-Kishikawa T, Dricot A, Li N, Berriz GF, Gibbons FD, Dreze M, Ayivi-Guedehoussou N, Klitgord N, Simon C, Boxem M, Milstein S, Rosenberg J, Goldberg DS, Zhang LV, Wong SL, Franklin G, Li S, Albala JS, Lim J, Fraughton C, Llamosas E, Cevik S, Bex C, Lamesch P, Sikorski RS, Vandenhaute J, Zoghbi HY, Smolyar A, Bosak S, Sequerra R, Doucette-Stamm L, Cusick ME, Hill DE, Roth FP, Vidal M (October 2005). "Towards a proteome-scale map of the human protein-protein interaction network". Nature. 437 (7062): 1173–8. doi:10.1038/nature04209. PMID 16189514.
  28. 28.0 28.1 Yang Q, O'Hanlon D, Heizmann CW, Marks A (February 1999). "Demonstration of heterodimer formation between S100B and S100A6 in the yeast two-hybrid system and human melanoma". Exp. Cell Res. 246 (2): 501–9. doi:10.1006/excr.1998.4314. PMID 9925766.
  29. 29.0 29.1 Deloulme JC, Assard N, Mbele GO, Mangin C, Kuwano R, Baudier J (November 2000). "S100A6 and S100A11 are specific targets of the calcium- and zinc-binding S100B protein in vivo". J. Biol. Chem. 275 (45): 35302–10. doi:10.1074/jbc.M003943200. PMID 10913138.
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Further reading

This article incorporates text from the United States National Library of Medicine, which is in the public domain.