Serological markers for human intestinal ischemia: A systematic review

Area of Science:

• Gastroenterology
• Biomarker Discovery
• Diagnostic Medicine

Background:

• Early diagnosis of intestinal ischemia is critical for timely treatment and improved patient outcomes.
• Clinical presentation of intestinal ischemia is often non-specific, necessitating reliable diagnostic tools.
• Plasma biomarkers offer a potential avenue for accurate and early detection of acute mesenteric ischemia.

Purpose of the Study:

• To systematically review human plasma biomarkers for acute mesenteric ischemia reported in the last ten years.
• To evaluate the diagnostic accuracy of various biomarkers for intestinal ischemia.
• To identify promising novel biomarkers for future research and clinical application.

Main Methods:

• Systematic literature review of studies published within the last decade.
• Analysis of diagnostic accuracy data for identified plasma biomarkers.
• Comparison of classic markers with emerging biomarkers for intestinal ischemia.

Main Results:

• Classic markers (lactate, white cell count, base excess) demonstrate poor diagnostic accuracy.
• Ischemia-modified albumin and procalcitonin show promising preliminary results.
• D-dimer, alpha-Glutathione S-transferase (a-GST), and Intestinal fatty acid binding protein (I-FABP) exhibit the best diagnostic accuracy, reflecting coagulation and mucosal damage.

Conclusions:

• D-dimer, a-GST, and I-FABP are the most accurate plasma biomarkers for diagnosing intestinal ischemia currently.
• Further research, including Phase IV trials, is needed to confirm the clinical utility and impact of these biomarkers.
• Identification of novel biomarkers for different types and stages of intestinal ischemia is essential.