Diagnostic performance of type I hypersensitivity-specific markers combined with CRP and IL-6 in complicated acute appendicitis in pediatric patients

Zhang, Tao; Cheng, Yuan; Zhou, Yuliang; Zhang, Zhenqiang; Qi, Shiqin; Pan, Zhubin

doi:10.1016/j.intimp.2023.110977

Cited by 5 publications

(27 citation statements)

References 24 publications

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“…Several recent studies have reinforced the hypothesis that there is a Th2 immune reaction in AA [19,45,47,[49][50][51][52][53][54][55][56][57][58][59] (Table 1).…”

Section: Appendicitismentioning

confidence: 88%

“…Recent investigations were focused on identifying a hypersensitivity type I reaction in AA, due to epidemiologic, experimental and clinical data supporting the notion that a Th2 immune reaction can happen in AA [19,45,47,[49][50][51][52][53][54][55][57][58][59] (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…The authors concluded that IgE, IL-6, and IL-13 levels can be risk factors for CAA. The combination of these markers can thus be used to diagnose CAA [52].…”

Section: T-lymphocytes: Il-4 Il-5 Il-9 and Il-13mentioning

confidence: 99%

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Compilation of Evidence Supporting the Role of a T Helper 2 Reaction in the Pathogenesis of Acute Appendicitis

Carvalho,

Barreira,

Henriques

et al. 2024

IJMS

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Despite being the most common abdominal surgical emergency, the cause of acute appendicitis (AA) remains unclear, since in recent decades little progress has been made regarding its etiology. Obstruction of the appendicular lumen has been traditionally presented as the initial event of AA; however, this is often the exception rather than the rule, as experimental data suggest that obstruction is not an important causal factor in AA, despite possibly occurring as a consequence of the inflammatory process. Type I hypersensitivity reaction has been extensively studied, involving Th2 lymphocytes, and cytokines such as IL-4, IL-5, IL-9 and IL-13, which have well-defined functions, such as a positive-feedback effect on Th0 for differentiating into Th2 cells, recruitment of eosinophils and the release of eosinophilic proteins and the production of IgE with the activation of mast cells, with the release of proteins from their granules. Cytotoxic activity and tissue damage will be responsible for the clinical manifestation of the allergy. AA histological features are similar to those found in allergic reactions like asthma. The intestine has all the components for an allergic immune response. It has contact with hundreds of antigens daily, most of them harmless, but some can potentially induce an allergic response. In recent years, researchers have been trying to assess if allergy is a component of AA, with their latest advances in the understanding of AA as a Th2 reaction shown by the authors of this article.

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“…Several recent studies have reinforced the hypothesis that there is a Th2 immune reaction in AA [19,45,47,[49][50][51][52][53][54][55][56][57][58][59] (Table 1).…”

Section: Appendicitismentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Compilation of Evidence Supporting the Role of a T Helper 2 Reaction in the Pathogenesis of Acute Appendicitis

Carvalho,

Barreira,

Henriques

et al. 2024

IJMS

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show abstract

“…The results disclosed significantly elevated IL-6 levels in children with complicated appendicitis [ 27 ]. This was echoed by a retrospective study of children with acute appendicitis, where IL-6 and other biomarkers such as CRP, immunoglobulin E (IgE), and interleukin-13 (IL-13) were found to be independent risk factors for complicated appendicitis ( p < 0.05) [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Changes in Levels of Serum Cytokines and Chemokines in Perforated Appendicitis in Children

Lin,

Lee,

Chen

et al. 2024

IJMS

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Appendicitis is primarily diagnosed based on intraoperative or histopathological findings, and few studies have explored pre-operative markers of a perforated appendix. This study aimed to identify systemic biomarkers to predict pediatric appendicitis at various time points. The study group comprised pediatric patients with clinically suspected appendicitis between 2016 and 2019. Pre-surgical serum interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), intercellular cell-adhesion molecule-1 (ICAM-1), and endothelial selectin (E-selectin) levels were tested from day 1 to day 3 of the disease course. The biomarker values were analyzed and compared between children with normal appendices and appendicitis and those with perforated appendicitis (PA) and non-perforated appendicitis. Among 226 pediatric patients, 106 had non-perforated appendicitis, 102 had PA, and 18 had normal appendices. The levels of all serum proinflammatory biomarkers were elevated in children with acute appendicitis compared with those in children with normal appendices. In addition, the serum IL-6 and TNF-α levels in children with PA were significantly higher, with an elevation in TNF-α levels from days 1 and 2. In addition, serum IL-6 levels increased significantly from days 2 and 3 (both p < 0.05). Serum ICAM-1 and E-selectin levels were elevated in the PA group, with consistently elevated levels within the first three days of admission (all p < 0.05). These results indicate that increased serum levels of proinflammatory biomarkers including IL-6, TNF-α, ICAM-1, and E-selectin could be used as parameters in the prediction and early diagnosis of acute appendicitis, especially in children with PA.

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“…Within the spectrum of AA, distinct patient subgroups exist, each presenting with marked clinical, therapeutic, and prognostic differences. For example, the pediatric population, which comprises a distinct and separate subgroup of patients with AA, has been extensively investigated in the last decade, leading to significant advancements in understanding etiopathogenesis, diagnosis, and treatment [8,9]. Currently, the adult population, especially the elderly subset, remains comparatively understudied, with a lack of sufficient data.…”

Section: Introductionmentioning

confidence: 99%

Acute Appendicitis in the Elderly: A Nationwide Retrospective Analysis

Gal,

Maya,

Ofer

et al. 2024

JCM

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Background: Acute appendicitis (AA) in older individuals remains understudied. We aimed to assess AA characteristics in patients older than 60 years and evaluate the impact of comorbidities. Methods: This retrospective study analyzed data from the American National Inpatient Sample between 2016 and 2019 to compare AA characteristics in patients younger and older than 60 years. Results: Of the 538,400 patients included, 27.5% were older than 60 years. Younger patients had a higher appendectomy rate (p < 0.01), while the complicated appendicitis rate was higher in older patients. Superficial wound infection, systemic infection, and mortality rates were higher in older patients (p < 0.01). Risk factors for superficial wound infection in patients younger than 60 years included cerebrovascular disease, chronic kidney disease, hypertension, heart failure, and obesity, whereas only heart failure was a risk factor in older patients. Risk factors for systemic infection in young patients included hypertension, heart failure, obesity, and diabetes mellitus, while in older patients they included hypertension, heart failure, and obesity. Complicated appendicitis was not a risk factor for infections in either group. Conclusions: This study highlights a higher incidence of AA in older individuals than previously reported, with comorbidities posing differing risks for infections between age groups.

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Diagnostic performance of type I hypersensitivity-specific markers combined with CRP and IL-6 in complicated acute appendicitis in pediatric patients

Cited by 5 publications

References 24 publications

Compilation of Evidence Supporting the Role of a T Helper 2 Reaction in the Pathogenesis of Acute Appendicitis

Compilation of Evidence Supporting the Role of a T Helper 2 Reaction in the Pathogenesis of Acute Appendicitis

Changes in Levels of Serum Cytokines and Chemokines in Perforated Appendicitis in Children

Acute Appendicitis in the Elderly: A Nationwide Retrospective Analysis

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