Diagnostic Value of α-Glutathione S-transferase in Acute Mesenteric Ischemia

Abstract

Background: Acute mesenteric ischemia (AMI) is a life-threatening problem, and the early clinical manifestations of it are non-specific. Despite the advances in laboratory & radiological diagnostic procedures, the mortality rate of AMI is still high. Aim: The purpose of the study to evaluate the ability of α-glutathione S-transferase (α-GST) to predict AMI in patients with abdominal pain. Methods: This prospective study was conducted in Tanta University Hospitals between November 2014 and December 2017. Nighty patients were included after clinical suspicious of AMI. Serum levels of α-GST were measured in the collected stored samples, and other biochemical markers were performed (e.g. LDH, PH, and WBC). AMI was confirmed by CT angiography or laparotomy. Patients without ischemic bowel were considered to be controls. Results: A total of 90 patients in the study, the ischemic group included 52 patients, and the non-ischemic group included 38 patients. Patients with intestinal ischemia had significant higher serum values of D-dimer, LDH and α-GST. Where α-GST diagnosed AMI by accuracy of 84.4%. Conclusion: Measurement of plasma α-GST is a simple, early, easy, and effective procedure making it a useful serum biomarker for early diagnosis of AMI.

The Efficiency of Serum Biomarkers in Predicting the Clinical Outcome of Patients with Mesenteric Ischemia during Follow-Up: A Systematic Review

“…In addition to citrulline, alpha-GST is another important constituent of enterocytes. Physiologically, it is involved in cell detoxification, but high plasma levels of alpha-GST indicate intestinal injury and ischemia [56]. While single biomarkers have clinical utility, there are currently studies investigating the power of biomarker panels, where several biomarkers are being determined at the same time.…”

“…In a study including 26 patients with acute abdominal pain, 12 of whom had AMI, plasma alpha-GST was found to be significantly increased in patients with AMI [55]. Moreover, in a prospective study conducted by Elshoura et al, 90 patients were included after clinical suspicion of AMI, confirmed by CT angiography or laparotomy [56]. Patients with intestinal ischemia (n = 52) had significantly higher serum values of alpha-GST, with this marker diagnosing AMI with an accuracy of 84.4% [56].…”

“…Moreover, in a prospective study conducted by Elshoura et al, 90 patients were included after clinical suspicion of AMI, confirmed by CT angiography or laparotomy [56]. Patients with intestinal ischemia (n = 52) had significantly higher serum values of alpha-GST, with this marker diagnosing AMI with an accuracy of 84.4% [56]. Additionally, Block et al investigated a series of biomarkers, including alpha-GST, D-dimer, alkaline phosphatase, and lactate dehydrogenase.…”