The role of thiol-disulfide and ischemia-modified albumin levels in the diagnosis of childhood appendicitis

Year 2021, , 214 - 219, 14.07.2021

Ahmet Ertürk , Can Öztorun , Süleyman Arif Bostancı , Gökhan Demirtaş , Rabia Demir , Doğuş Güney , Emine Yurt , Özcan Erel , Cüneyt Karagöl , Müjdem Azılı , Emrah Şenel

https://doi.org/10.38053/acmj.916262

Abstract

Aim: The accurate diagnosis of acute appendicitis can be achieved by a combination of evaluation of clinical symptoms, physical examination findings and history taking, but is still challenging for the clinician. Some biochemical markers have been evaluated for the purpose of increasing the diagnostic accuracy rate for appendicitis. In this study, our aim is to evaluate the diagnostic value of thiol-disulfide levels and IMA, in pediatric patients with suspected acute appendicitis.
Materials And Methods:
The children (1-17 years age) who were admitted to our clinic for suspected acute appendicitis between March 2017 and September 2017 were evaluated. A total of 238 children are enrolled in the study; 119 were operated for suspected acute appendicitis and the 119 children who did not have appendicitis constituted the control group. Serum levels of native thiol (-SH), total thiol (SH + SS), dynamic disulfide (SS), dynamic disulfide (SS)/total thiol (SH + SS) ratio, albumin, ischemic modified albumin (IMA) and WBC levels were obtained and compared within groups.
Results:
The mean age of the patients was 10.9 years (±3.7, 3-17 years) and 9.1 years (±3.7, 1-17 years) in the operation and the control groups, respectively. The SH, SH+SS, SS and albumin levels and SS/SH+SS ratio were significantly lower and IMA levels were significantly higher in the operation group than the control group. Among the operated patients, IMA and dynamic disulfide levels were significantly higher and WBC levels were significantly lower in patients with non-perforated appendicitis than patients with perforated appendicitis. A significant decrease in serum levels of IMA was observed in the postoperative 1st day when compared with the preoperative values.
Conclusion:
Measuring the IMA levels with thiol/disulfide homeostasis may increase the diagnostic accuracy rate when evaluating the patients with suspected appendicitis. However, it appears that these evaluations fail to distinguish the patients with perforated and non-perforated appendicitis, thus further studies are necessary.

Keywords

Appendicitis, oxidative stress, children, thiol disulfide

References

• Vahdad M.R, Nissen M, Semaan A, et al. Experiences with LESS-appendectomy in Children. Arch Iran Med 2016; 19: 57.
• Park JS, Jeong JH, Lee JI, Lee JH, Park JK, Moon HJ. Accuracies of diagnostic methods for acute appendicitis. Am Surg 2013; 79: 101-6.
• Dumlu EG, Tokaç M, Bozkurt B, et al. Correlation between the serum and tissue levels of oxidative stress markers and the extent of inflammation in acute appendicitis. Clinics 2014; 69: 677-82
• Mohammed AA, Daghman NA, Aboud SM, Oshibi HO. The diagnostic value of C-reactive protein, white blood cell count and neutrophil percentage in childhood appendicitis. Saudi Med J 2004; 25: 1212-5.
• Yıldırım O, Solak C, Koçer B, et al. The role of serum inflammatory markers in acute appendicitis and their success in preventing negative laparotomy. J Invest Surg 2006; 19: 345-52.
• Paajanen H, Mansikka A, Laato M, Ristamäki R, Pulkki K, Kostiainen S. Novel serum inflammatory markers in acute appendicitis. Scand J Clin Lab Invest 2002; 62: 579-84.
• Saugstad OD. Mechanisms of tissue injury by oxygen radicals: implications for neonatal disease. Acta Paediatr 1996; 85: 1-4.
• Valko M, Leibfritz D, Moncol J, Cronin MT, Mazur M, Telser J. Free radicals and antioxidants in normal physiological functions and human disease. Int J Biochem Cell Biol 2007; 39: 44-84.
• Bolukbas C, Bolukbas FF, Horoz M, Aslan M, Celik H, Erel O. Increased oxidative stress associated with the severity of the liver disease in various forms of hepatitis B virus infection. BMC Infect Dis 2005; 5: 95.
• Ozdogan M, Devay AO, Gurer A, et al. Plasma total anti-oxidant capacity correlates inversely with the extent of acute appendicitis: a case control study. World J Emerg Surg 2006; 1: 6.
• Serefhanoglu K, Taskin A, Turan H, Timurkaynak FE, Arslan H, Erel O. Evaluation of oxidative status in patients with brucellosis. Braz J Infect Dis 2009; 13: 249-51.
• Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem 2014; 47: 326-32.
• Hu M.L. Measurement of protein thiol groups and glutathione in plasma. Methods Enzymol 1994; 233: 380-5.
• Abuja P.M, Albertini R. Methods for monitoring oxidative stress, lipid peroxidation and oxidation resistance of lipoproteins. Clin Chim Acta 2001; 306: 1-17.
• De Oliveira Machado SL, Bagatini MD, Da Costa P, et al. Evaluation of mediators of oxidative stress and inflammation in patients with acute appendicitis. Biomarkers 2016; 21: 530-7.
• Karadag-Oncel E, Erel O, Ozsurekci Y, et al. Plasma oxidative stress and total thiol levels in Crimean-Congo hemorrhagic fever. Jpn J Infect Dis 2014; 67: 22-6.
• Dinc ME, Ozdemir C, Ayan NN, et al. Thiol/disulfide homeostasis as a novel indicator of oxidative stress in obstructive sleep apnea patients. Laryngoscope 2017; 127: 244-50.
• Ozyazici S, Karateke F, Turan U, et al. A Novel oxidative stress mediator in acute appendicitis: thiol/disulphide homeostasis. Mediators Inflamm 2016:6761050.
• Elmas B, Erel Ö, Ersavaş D, Yürümez Y. Thiol/disulfide homeostasis as a novel indicator of oxidative stress in children with simple febrile seizures. Neurol Sci 2017; 38: 1969-75.
• Elmas B, Karacan M, Dervişoğlu P, Kösecik M, İşgüven ŞP, Bal C. Dynamic thiol/disulphide homeostasis as a novel indicator of oxidative stress in obese children and its relationship with inflammatory-cardiovascular markers. Anatol J Cardiol 2017; 18: 361-9.
• Wudkowska A, Goch J, Goch A. Ischemia-modified albumin in differential diagnosis of acute coronary syndrome without ST elevation and unstable anginapectoris. Kardiol Pol 2010; 68: 431-7.
• Aran T, Unsal MA, Güven S, Kart C, Cetin E, Alver A. Carbon dioxide pneumoperitoneum induces systemic oxidative stres: a clinical study. Eur J Obstet Gynecol Reprod Biol 2012; 161: 80-3.
• Ma SG, Wei CL, Hong B, Yu WN. Ischemia-modified albumin in type 2 diabetic patients with and without peripheral arterial disease. Clinics 2011; 66: 1677-80.
• Mastella AK, Moresco RN, da Silva DB, et al. Evaluation of ischemiamodified albumin in myocardial infarction and prostatic diseases. Biomed Pharmacother 2009; 63: 762-6.
• Lippi G, Montagnana M. Ischemia Modified Albumin in Ischemic Disorders. Ann Thorac Cardiovasc Surg 2009; 15: 137
• Bar-Or D, Lau E, Winkler JV. A novel assay for cobalt–albumin binding and its potential as a marker for myocardial ischemia a preliminary report. J Emerg Med 2000; 19: 311-5.
• Erel Ö, Erdoğan S. Thiol-disulfide homeostasis: an integrated approach with biochemical and clinical aspects. Turk J Med Sci 2020; 50.SI-2: 1728-38.
• Ulusoy E, Çitlenbik H, Akgül F, et al. Is ischemia-modified albumin a reliable marker in accurate diagnosis of appendicitis in children? World J Surg 2020; 44: 1309-15.
• Yeniocak S, Saraç F, Yazıcıoğlu M, et al. The diagnostic values of ischemia-modified albumin in patients with acute abdominal pain and its role in differentiating acute abdomen. Emerg Med Int 2020; 2020: 7925975.
• Demir S, Dere Günal Y, Özmen İ, Dindar Badem N, Neşelioğlu S, Erel Ö. Can thiol/disulphide homeostasis help in the differential diagnosis of appendicitis in children?. Türkiye Çocuk Hast Derg 2020; 14: 236-43.
• Kaya M, Boleken ME, Kanmaz T, Erel O, Yucesan S. Total antioxidant capacity in children with acute appendicitis. Eur J Pediatr Surg 2006; 16: 34-8.
• Nazik S, Avci V, Kiraz KZ. Ischemia-modified albumin and other inflammatory markers in the diagnosis of appendicitis in children. Ulus Travma Acil Cerrahi Derg 2017; 23: 317-21.
• Boshnak N, M Boshnaq, Elgohary H. Evaluation of platelet indices and red cell distribution width as new biomarkers for the diagnosis of acute appendicitis. J Invest Surg 2017; 31: 1-9.
• Koltuksuz U, Uz E, Özen S, Aydinç M, Karaman A, Akyol Ö. Plasma superoxide dismutase activity and malondialdehyde level correlate with the extent of acute appendicitis. Pediatr Surg Int 2000; 16: 559-61.
• Fan Z, Pan J, Zhang Y, et al. Mean platelet volume and platelet distribution width as markers in the diagnosis of acute gangrenous appendicitis. Dis Markers 2015: 542013.
• Reddy VS, Perugu B, Garg MK. Ischemia-modified albumin must be evaluated as an oxidative stress marker together with albumin and bilirubin in individuals with acute appendicitis. Clinics 2015; 70: 531-2.
• Reddy VS, Sethi S, Agrawal P, Gupta N, Garg R. Ischemia modified albumin (IMA) and albumin adjusted-IMA (AAIMA) as biomarkers for diabetic retinopathy. Nepal J Ophthalmol 2015; 7: 117-23.
• Kılıç MÖ, Güldoğan CE, Balamir İ, Tez M. Ischemia-modified albumin as a predictor of the severity of acute appendicitis. Am J Emerg Med 2017; 35: 92-5.
• Hakkoymaz H, Nazik S, Seyithanoğlu M, et al. The value of ischemia-modified albumin and oxidative stress markers in the diagnosis of acute appendicitis in adults. Am J Emerg Med 2019; 37: 2097-101.
• Ayengin K, Alp HH, Avci V, Huyut Z. The effect of laparoscopic and open surgery on oxidative DNA damage and IL-37 in children with acute appendicitis. Ir J Med Sci 2021; 190: 281-9.