Biochemical markers of acute intestinal ischemia: Possibilities and limitations
Open accessAbstract
Acute intestinal ischemia is a relative rare abdominal emergency, associated with considerably high morbidity and mortality rates. Although the conventional diagnostic approach to acute intestinal ischemia entails a preliminary evaluation of signs and symptoms, followed by radiological and laboratory investigations, a definitive diagnosis is can usually be made after laparotomy, which still remains the gold standard diagnostic (and therapeutic) procedure. Several potential laboratory biomarkers have been investigated over the past decades, but none of these seems to reach a suitable diagnostic accuracy for an early and reliable diagnosis of intestinal ischemia. The aim of this narrative review is to provide an overview on traditional laboratory tests for diagnosing acute intestinal ischemia (i.e., complete blood count, D-dimer, blood gas analysis, total lactic acid, C-reactive protein and procalcitonin), and summarize current evidence regarding some emerging and potentially useful biomarkers such as D-lactate, intestinal fatty acid-binding protein (I-FABP), ischemia modified albumin (IMA), α-glutathione S-transferase (α-GST), interleukin-6 (IL-6), citrulline and smooth muscle protein of 22 kDa (SM22). Among the various tests, D-lactate, IMA and I-FABP are perhaps the most promising, since they are characterized by optimal sensitivity and relatively good specificity, early kinetics, and can be measured with assays suited for a rapid diagnosis.
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Higher D-lactate levels could be more specific for mesenteric ischemia due to increased bacterial proliferation at the level of the ischemic bowel, but the results obtained in different studies are mostly inconsistent.
“Higher D-lactate levels could be more specific for mesenteric ischemia due to increased bacterial proliferation at the level of the ischemic bowel, but the results obtained in different studies are mostly inconsistent [53,54].”
From Acute mesenteric ischemia in COVID-19 patients (2021) · cites this paper as [54]
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References 78 · Cited by 108
Research works printed but not linked: 3
- Powell A, Armstrong P. Plasma biomarkers for early diagnosis of acuteintestinal ischemia. Semin Vasc Surg 2014;27:170-5.
- Nutz V, Sommer HJ. Hyperlactacidemia in intestinal ischemia. I. Theoretical considerations (in German). Langenbecks Arch Chir 1987;370:63-8.
- Tan WW, Zhang M. Clinical value of D-dimer for early diagnosis and severity of ischemic bowel disease. Lab Med Clin 2016;13:1497-9.
- Authors
- Montagnana, M., Danese, E., & Lippi, G.
- Affiliations
- University of Verona (IT)
- Corresponding author
- Montagnana, Martina
- Venue
- Annals of Translational Medicine
- Publisher
- AME Publishing Company
- Published
- 2018-09
- Volume
- 6
- Issue
- 17
- Pages
- 341-341
- ISSN
- 2305-5839 (ISSN-L)
- 2305-5847
- PMC
- PMC6174180
- OpenAlex
- W2885860559
- Cited by
- 108
- References
- 78
- Citations by year
- 2026: 7 · 2025: 17 · 2024: 10 · 2023: 23 · 2022: 16 · 2021: 18 · 2020: 11 · 2019: 6
- FWCI
- 1.95
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Annals of Translational Medicine (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
- Keywords
- acute mesenteric ischemia, biomarkers, laboratory diagnosis, D-lactate, intestinal fatty acid binding protein, ischemia-modified albumin, alpha-glutathione S-transferase, interleukin-6, citrulline, D-dimer, C-reactive protein, procalcitonin, blood gas analysis, diagnostic accuracy
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