title: Current status on plasma biomarkers for acute mesenteric ischemia.
abstract: Clinical diagnosis of acute mesenteric ischemia is difficult. The aim of this review is to provide current status on the search for an accurate plasma biomarker for acute mesenteric ischemia. A search using the medical subject heading terms marker and mesenteric ischemia or intestinal ischemia or superior mesenteric artery                         occlusion or mesenteric venous thrombosis in the Medline and Embase databases from 1980 to 2011. Studies without a control group or a control group consisted of healthy individuals (human studies), or studies on intestinal reperfusion were excluded. Twenty animal and twelve human studies were identified. In human studies, the studied series of patients had a control group that had a need of laparotomy (n = 2), suspected acute mesenteric ischemia (n = 7), acute abdomen (n = 2) or systemic inflammatory response syndrome (n = 1). D: -dimer has been found to be the most consistent highly sensitive early marker, but specificity was low. The follow-up study on α-glutathione S-transferase yielded inferior sensitivity and accuracy than the preliminary study, clearly questioning the value of this marker. Intestinal fatty acid binding globulin (I-FABP) and D: -lactate are both interesting markers, but the results were conflicting. Different cut-off levels have been used in the studies on I-FABP. The encouraging preliminary result of cobalt-albumin and urinary FABP as an accurate marker needs to be addressed in other study populations. The early clinical and laboratory diagnosis of intestinal ischemia remains a challenge. None of the proposed plasma-derived tests for acute mesenteric ischemia has as yet entered routine clinical practice. The proposed biomarkers need to be evaluated in a prospective clinical research project in patients with acute abdomen.
authors.affiliation: Vascular Center, Skåne University Hospital, Malmö, Sweden. Stefan.acosta@telia.com
authors.forename: Stefan
authors.initials: S
authors.lastname: Acosta
authors.forename: Torbjörn
authors.initials: T
authors.lastname: Nilsson
mesh_terms: D000208:Acute Disease; D000818:Animals; D015415:Biomarkers / Q000097:blood*; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000097:blood* / Q000175:diagnosis / Q000628:therapy; D065666:Mesenteric Ischemia; D014652:Vascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000628:therapy
chemical_list: D015415:Biomarkers
references.citation: Heart. 2011 Mar;97(6):447-52
references.pmid: 21193685
references.citation: Thromb Haemost. 2001 Apr;85(4):671-8
references.pmid: 11341504
references.citation: Am Surg. 2003 Apr;69(4):324-9; discussion 329
references.pmid: 12716091
references.citation: Am Surg. 1998 Jul;64(7):611-6
references.pmid: 9655269
references.citation: Am Heart J. 2011 Aug;162(2):276-282.e1
references.pmid: 21835288
references.citation: Clin Biochem. 2008 Sep;41(13):1099-103
references.pmid: 18638467
references.citation: J Pediatr Surg. 1983 Aug;18(4):449-52
references.pmid: 6620088
references.citation: Surgery. 1999 Feb;125(2):202-10
references.pmid: 10026755
references.citation: J Emerg Med. 2012 Jun;42(6):635-41
references.pmid: 22137151
references.citation: Radiology. 2010 Jul;256(1):93-101
references.pmid: 20574087
references.citation: Cardiovasc Intervent Radiol. 2009 Sep;32(5):896-905
references.pmid: 19365685
references.citation: World J Gastroenterol. 2008 Apr 28;14(16):2540-3
references.pmid: 18442202
references.citation: Clin Biochem. 2006 Feb;39(2):137-42
references.pmid: 16297903
references.citation: Shock. 2000 Aug;14(2):123-7
references.pmid: 10947154
references.citation: Am J Surg. 1994 Jun;167(6):575-8
references.pmid: 8209931
references.citation: Acad Emerg Med. 2010 Nov;17(11):1233-8
references.pmid: 21175522
references.citation: J Pediatr Surg. 2002 Nov;37(11):1543-8
references.pmid: 12407536
references.citation: Eur J Vasc Endovasc Surg. 2011 Feb;41(2):281-7
references.pmid: 21095140
references.citation: World J Surg. 2009 Jul;33(7):1374-83
references.pmid: 19424744
references.citation: J Trauma. 2008 Jan;64(1):42-5
references.pmid: 18188097
references.citation: Thromb Res. 2006;117(4):463-7
references.pmid: 15922412
references.citation: Mol Med Rep. 2011 Nov-Dec;4(6):1095-9
references.pmid: 21842126
references.citation: J Invest Surg. 2006 May-Jun;19(3):155-61
references.pmid: 16809225
references.citation: J Emerg Med. 2012 Jun;42(6):741-7
references.pmid: 21871766
references.citation: Ann Surg. 1990 Mar;211(3):369-73
references.pmid: 2106844
references.citation: Pediatr Res. 2003 Oct;54(4):462-5
references.pmid: 12867598
references.citation: Br J Surg. 2004 Aug;91(8):991-4
references.pmid: 15286959
references.citation: J Clin Invest. 1974 Aug;54(2):326-38
references.pmid: 4211161
references.citation: J Surg Res. 1993 May;54(5):507-9
references.pmid: 8361176
references.citation: Clin Chem. 1994 Jul;40(7 Pt 1):1327-30
references.pmid: 8013108
references.citation: Surgery. 1997 Mar;121(3):335-42
references.pmid: 9068676
references.citation: Br J Surg. 1999 Oct;86(10):1349-53
references.pmid: 10540149
references.citation: Gastroenterology. 1996 Feb;110(2):339-43
references.pmid: 8566578
references.citation: Semin Vasc Surg. 2010 Mar;23(1):4-8
references.pmid: 20298944
references.citation: World J Gastroenterol. 2005 Feb 14;11(6):912-6
references.pmid: 15682493
references.citation: Scand J Clin Lab Invest. 2008;68(3):242-8
references.pmid: 17934974
references.citation: Asian J Surg. 2005 Apr;28(2):131-5
references.pmid: 15851368
references.citation: J Vasc Surg. 2011 Dec;54(6):1734-42
references.pmid: 21889287
references.citation: J Vasc Surg. 2011 Mar;53(3):698-704; discussion 704-5
references.pmid: 21236616
references.citation: Acad Emerg Med. 2011 Apr;18(4):355-9
references.pmid: 21496137
references.citation: Am J Emerg Med. 2009 Oct;27(8):975-9
references.pmid: 19857417
references.citation: Scand J Gastroenterol. 1990 Feb;25(2):149-54
references.pmid: 2305212
references.citation: Br J Surg. 2008 Oct;95(10):1245-51
references.pmid: 18720461
references.citation: Dig Dis Sci. 1992 Sep;37(9):1362-7
references.pmid: 1505286
references.citation: Ann Surg. 2011 Feb;253(2):303-8
references.pmid: 21245670
references.citation: Pancreas. 2010 Jan;39(1):26-30
references.pmid: 19752771
references.citation: Ann Surg. 2005 Mar;241(3):516-22
references.pmid: 15729076
references.citation: Int J Surg. 2011;9(5):428-32
references.pmid: 21530695
references.citation: J Surg Res. 2007 Dec;143(2):320-8
references.pmid: 17659304
references.citation: Res Vet Sci. 2004 Aug;77(1):89-91
references.pmid: 15120958
references.citation: Blood Coagul Fibrinolysis. 2004 Jan;15(1):69-76
references.pmid: 15166946
references.citation: J Vasc Surg. 2010 Oct;52(4):959-66
references.pmid: 20620006
references.citation: Ann Vasc Surg. 2005 May;19(3):328-34
references.pmid: 15818455
references.citation: ANZ J Surg. 2005 Jun;75(6):399-404
references.pmid: 15943725
references.citation: J Surg Res. 1984 Jul;37(1):25-32
references.pmid: 6738045
references.citation: Ann R Coll Surg Engl. 2009 Jul;91(5):381-4
references.pmid: 19409152
references.citation: Clin Chem. 2006 Sep;52(9):1635-7
references.pmid: 16940460
references.citation: Br J Surg. 2001 Mar;88(3):385-8
references.pmid: 11260104
references.citation: Scand J Clin Lab Invest. 2011 Oct;71(6):507-14
references.pmid: 21861600
references.citation: Eur J Surg. 1994 Jun-Jul;160(6-7):381-4
references.pmid: 7948358