Diagnostic accuracy of novel serological biomarkers to detect acute mesenteric ischemia: a systematic review and meta-analysis

Abstract

Laparotomy remains the gold standard for diagnosis of acute mesenteric ischemia (AMI), but is often unhelpful or too late due to non-specific clinical and radiological signs. This systematic review and meta-analysis aims to evaluate the diagnostic accuracy of the novel serological biomarkers intestinal fatty acid-binding protein (I-FABP), α-glutathione S-transferase (α-GST), D-lactate, ischemia modified albumin (IMA), and citrulline to detect AMI. A systematic search of electronic databases was performed to identify all published diagnostic accuracy studies on I-FABP, α-GST, D-lactate, IMA, and citrulline. Articles were selected based on pre-defined inclusion and exclusion criteria. Risk of bias and applicability were assessed. Two-by-two contingency tables were constructed to calculate accuracy standards. Summary estimates were computed using random-effects models. The search yielded 1925 papers, 21 were included in the final analysis. Pooled sensitivity and specificity for investigated biomarkers were: I-FABP (Uden); 79.0 (95% CI 66.5-88.5) and 91.3

Reliability of gastrointestinal barrier integrity and microbial translocation biomarkers at rest and following exertional heat stress

“…Despite growing popularity, the temporal reliability of circulating I‐FABP has never been previously assessed. In the present study, resting I‐FABP concentrations were consistently at the upper end of the general healthy reference range for studies utilizing a human ELISA kit (0.1–2.0 ng ml −1 ; Treskes, Persoon, & Zanten, ). These concentrations must be considered when evaluating the absolute reliability thresholds reported herein.…”

Diagnosis biomarkers in acute intestinal ischemic injury: so close, yet so far

“…Derikx et al [73] presented D-dimer, I-FABP and α-GST as the most promising biomarkers. Treskes et al [74] calculated combined AUC for IFABP, D-lactates and α-GST and α-GST appeared to be the more accurate, before IFABP and D-lactates, with only discrete differences between AUC (0.876, 0.84 and 0.814), respectively. Overall, on the basis of available studies, IFABP, α-GST, D-dimers and D-lactates appear to be useful in the diagnosis of acute i3, none of this marker being performant enough to be use solely.…”

New Biomarkers of Acute Mesenteric Ischemia

“…Сердечную изоформу этого белка используют для ранней диагностики инфаркта миокарда [17,18]. При ОИИ по результатам клинических и экспериментальных исследований [21,28,30,31,35,36,37, 38] он показал чувствительность 80%, специфичность -85%. Однако в экспери-ментальном исследовании Z.D.…”

“…В другом клиническом исследовании чув-ствительность и специфичность I-FABP была показана на уровне 95% и 91,3% соответствен-но, D-лактата -71,7% и 74,2%, α-глутатион-S-трансферазы -67,8% и 84,2%, ишемия-моди-фицированного альбумина -94,7% и 86,4% [21].…”