Dynamic Thiol / Disulfide Homeostasis a Promising New Marker in the Diagnosis of Acute Appendicitis in Children

Year 2022, Volume: 12 Issue: 1, 82 - 86, 30.03.2022

Semih Mirapoğlu , Eray Metin Güler , Muhammed Yunus Bektay , Abdurrahim Koçyiğit , Fikret İzzettin

https://doi.org/10.33808/clinexphealthsci.814301

Abstract

Objectives: One of the most common emergency surgery in pediatric surgery is due to acute appendicitis (AA). The diagnosis of AA is usually
made using with the clinical score using clinical signs, symptoms, and laboratory tests. But symptoms and signs are not always typical, and
this situation put clinician in a compelling situation. The range of misdiagnosis of AA is between 28-57 % between 2-12 years old children.
Thiol/ Disulphide homeostasis is an important indicator of oxidative stress and inflammation. This study is aimed to evaluate and compare the
feasibility of thiol/disulphide levels in pediatric patients with AA and abdominal pain (AP).
Methods: In this case-control study three different group established with 25 healthy participants (NCG), 25 patients with abdominal pain
(PCG), and 25 with AA (AAG). Demographics, white blood cell count, neutrophil-lymphocyte counts, hemoglobin, platelet, mean platelet
volume, C-reactive protein, total thiol (TT), native thiol, (NT) and disulphide (DS) levels measure through blood samples.
Results: According to our result, the level of NT were significantly lower in AAG when compared with NCG and PCG (p<0.001). DS levels were
significantly higher in AAG than in NCG (p<0.001). CRP levels were significantly higher in both PCG and AAG than those of NCG p<0.001).
Conclusion: Thiol/disulphide homeostasis is a valuable method to examine acute appendicitis in the pediatric patients. Fluctuations of thiol/
disulphide homeostasis could be used as a marker in daily clinical practice for diagnosis of appendicitis.

Keywords

Thiol/disulfide homeostasis, appendicitis, pediatric population, pediatric

Thanks

The authors would like to thank to Bezmialem Vakif University, Istanbul, Turkey, for support and opportunities given. The authors declare that the study was carried out in accordance with the principles of the Helsinki World Medical Association Declaration “Ethical Principles in Medical Research Containing Human Subjects” (amended in October 2013). The authors have no competing interests to declare. This study has not been supported financially. All research done by the authors.

References

• 1. Bansal S, Banever GT, Karrer FM, Partrick DA. Appendicitis in children less than 5 years old: influence of age on presentation and outcome. Am J Surg. 2012 Dec;204(6):1031–5; discussion 1035.
• 2. Dinc B, Oskay A, Dinc SE, Bas B, Tekin S. New parameter in diagnosis of acute appendicitis: platelet distribution width. World J Gastroenterol. 2015 Feb;21(6):1821–6.
• 3. Almaramhy HH. Acute appendicitis in young children less than 5 years: review article. Ital J Pediatr. 2017 Jan;43(1):15.
• 4. Huckins DS, Simon HK, Copeland K, Spiro DM, Gogain J, Wandell M. A novel biomarker panel to rule out acute appendicitis in pediatric patients with abdominal pain. Am J Emerg Med. 2013 Sep;31(9):1368–75.
• 5. Andersen SB, Paerregaard A, Larsen K. Changes in the epidemiology of acute appendicitis and appendectomy in Danish children 1996-2004. Eur J Pediatr Surg Off J Austrian Assoc Pediatr Surg . [et al] = Zeitschrift fur Kinderchirurgie. 2009 Oct;19(5):286–9.
• 6. Marzuillo P. Appendicitis in children less than five years old: A challenge for the general practitioner. World J Clin Pediatr. 2015;4(2):19.
• 7. Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986 May;15(5):557–64.
• 8. Ozyazici S, Karateke F, Turan U, Kuvvetli A, Kilavuz H, Karakaya B, et al. A Novel Oxidative Stress Mediator in Acute Appendicitis: Thiol/Disulphide Homeostasis. 2016;
• 9. de Oliveira Machado SL, Bagatini MD, da Costa P, Baldissarelli J, Reichert KP, de Oliveira LS, et al. Evaluation of mediators of oxidative stress and inflammation in patients with acute appendicitis. Biomarkers. 2016;21(6):530–7.
• 10. Circu ML, Aw TY. Reactive oxygen species, cellular redox systems, and apoptosis. Free Radic Biol Med. 2010 Mar;48(6):749–62.
• 11. Matteucci E, Giampietro O, Matteucci E, Giampietro O. Thiol Signalling Network with an Eye to Diabetes. Molecules. 2010 Dec;15(12):8890–903.
• 12. Prabhu A, Sarcar B, Kahali S, Yuan Z, Johnson JJ, Adam K-P, et al. Cysteine catabolism: a novel metabolic pathway contributing to glioblastoma growth. Cancer Res. 2014 Feb;74(3):787–96.
• 13. Go Y-M, Jones DP. Cysteine/cystine redox signaling in cardiovascular disease. Free Radic Biol Med. 2011 Feb;50(4):495–509.
• 14. Tetik S, Ahmad S, Alturfan AA, Fresko I, Disbudak M, Sahin Y, et al. Determination of oxidant stress in plasma of rheumatoid arthritis and primary osteoarthritis patients. Indian J Biochem Biophys. 2010 Dec;47(6):353–8.
• 15. Rodrigues SD, Batista GB, Ingberman M, Pecoits-Filho R, Nakao LS. Plasma cysteine/cystine reduction potential correlates with plasma creatinine levels in chronic kidney disease. Blood Purif. 2012;34(3–4):231–7.
• 16. Sbrana E, Paladini A, Bramanti E, Spinetti MC, Raspi G. Quantitation of reduced glutathione and cysteine in human immunodeficiency virus-infected patients. Electrophoresis. 2004 Jun;25(10–11):1522–9.
• 17. Smeyne M, Smeyne RJ. Glutathione metabolism and Parkinson’s disease. Free Radic Biol Med. 2013 Sep;62:13–25.
• 18. Linam LE, Munden M. Sonography as the first line of evaluation in children with suspected acute appendicitis. J Ultrasound Med. 2012 Aug;31(8):1153–7.
• 19. Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem. 2014 Dec;47(18):326–32.
• 20. Schellekens DHSM, Hulsewe KWE, van Acker BAC, van Bijnen AA, de Jaegere TMH, Sastrowijoto SH, et al. Evaluation of the diagnostic accuracy of plasma markers for early diagnosis in patients suspected for acute appendicitis. Acad Emerg Med. 2013 Jul;20(7):703–10.
• 21. Choi JY, Ryoo E, Jo JH, Hann T, Kim SM. Risk factors of delayed diagnosis of acute appendicitis in children: for early detection of acute appendicitis. Korean J Pediatr. 2016 Sep;59(9):368–73.
• 22. Kharbanda AB, Taylor GA, Fishman SJ, Bachur RG. A clinical decision rule to identify children at low risk for appendicitis. Pediatrics. 2005 Sep;116(3):709–16. 23. Samuel M. Pediatric appendicitis score. J Pediatr Surg. 2002 Jun;37(6):877–81.
• 24. Yilmaz FM, Yilmaz G, Erol MF, Köklü S, Yücel D. Nitric oxide, lipid peroxidation and total thiol levels in acute appendicitis. J Clin Lab Anal. 2010;24(2):63–6.
• 25. Dumlu EG, Tokaç M, Bozkurt B, Yildirim MB, Ergin M, Yalçin A, et al. Correlation between the serum and tissue levels of oxidative stress markers and the extent of inflammation in acute appendicitis. Clinics (Sao Paulo). 2014 Dec;69(10):677–82.
• 26. Zhavoronok T V, Stepovaia EA, Riazantseva N V, Petina G V, Sokolovich EG, Starikov I V, et al. [Impaired oxidative metabolism in acute inflammatory diseases]. Klin Lab Diagn. 2006 Dec;(12):10–4.
• 27. Sen CK, Packer L. Thiol homeostasis and supplements in physical exercise. Am J Clin Nutr [Internet]. 2000 Aug 1;72(2):653S-669S. Available from: https://doi.org/10.1093/ajcn/72.2.653S
• 28. Baba SP, Bhatnagar A. ROLE OF THIOLS IN OXIDATIVE STRESS. Curr Opin Toxicol. 2018 Feb;7:133–9.
• 29. Comini MA. Measurement and meaning of cellular thiol:disufhide redox status. Free Radic Res. 2016;50(2):246–71.
• 30. Elmas B, Yildiz T, Yazar H, İlçe Z, Bal C, Özbek B, et al. New Oxidative Stress Markers Useful in the Diagnosis of Acute Appendicitis in Children. Pediatr Emerg Care. 2017;00(00):1.