Serum Ischemia‐modified Albumin Levels in an Experimental Acute Mesenteric Ischemia Model

Abstract

Objectives: This experimental study aimed to assess the changes in the levels of serum ischemiamodified albumin (IMA) and interleukin-6 (IL-6) by time in cases of acute mesenteric ischemia due to superior mesenteric artery occlusion.Methods: Twenty-one New Zealand rabbits were randomly divided into three groups. Blood samples were collected at hours 0, 1, 3, and 6 from animals in a control group; a sham group following a simple laparotomy; and in an ischemia group following superior mesenteric artery ligation. All blood samples were analyzed for serum IMA and IL-6 levels, and then the time-dependent changes of biomarkers were investigated. Results:The serum IMA levels of the ischemia group at hours 3 and 6 were significantly higher than those of the control and sham groups (hour 3, p = 0.017; hour 6, p = 0.001). The increase in serum IL-6 levels in the ischemia group at hours 1, 3, and 6 compared to the control and sham groups was also significant (hour 1, p = 0.002; hour 3, p = 0.003; hour 6, p = 0.003).Conclusions: IMA may be helpful as a marker in the diagnosis of acute mesenteric ischemia; however, its diagnostic value and use as a routine biochemical test should be assessed in further studies.ACADEMIC EMERGENCY MEDICINE 2010; 17:1233-1238 ª 2010 by the Society for Academic Emergency Medicine M esenteric ischemia is a sudden decrease in intestinal blood flow due to occlusion, vasospasm, or hypoperfusion.1,2 Currently, acute mesenteric ischemia accounts for approximately 0.1% of all hospital admissions, 2 and while it constitutes 1% to 2% of all gastrointestinal diseases, the incidence has recently increased with the increasing age of the population. 3The mortality rate of acute mesenteric ischemia due to all causes is approximately 71%, with a range of 59% to 93%.2-4 Early diagnosis, before the development of intestinal infarction and peritonitis, is essential for patient survival.2,4 In a case series of 21 patients with embolism of the superior mesenteric artery, intestinal viability was found to be 100% in patients who were diagnosed within the first 12 hours of the onset of symptoms, 56% in those diagnosed within 12-24 hours, and 18% in those diagnosed after 24 hours. 5In acute mesenteric ischemia, for which time is vital according to the consensus result of recent studies on biochemical markers, there is no adequately sensitive and specific marker with an early diagnostic power to increase survival. 6 The optimum biochemical marker to be used in the early diagnosis of acute mesenteric ischemia should be released from the intestinal mucosa, should escape from the first-pass effect of the liver, and should be detected in the peripheral blood. The new diagnostic markers, which have recently been developed with this thought, are more promising than older markers. [6][7][8] During ischemia or reperfusion after ischemia, the human serum albumin capacity for metal binding may decrease as a result of loss of a part of the N-terminal connection site of the albumin or significant molecular modification. Th...

The Diagnostic Value of Ischemia-modified Albumin in a Rat Model of Acute Mesenteric Ischemia

“…Dundar et al 18 reported a rabbit model of mesenteric ischemia and found that significantly higher serum IMA levels were present both in the control group and in the mesenteric ischemia group (means of 0.451 to 0.720 ABSU). Unluer et al 19 also reported high serum IMA levels for time variable different ischemia groups in another rabbit model (means of 0.60 to 0.65 ABSU).…”

Evaluation of matrix metalloproteinase, myeloperoxidase, and oxidative damage in mesenteric ischemia–reperfusion injury

“…35,[39][40][41] In this study, significant morphological changes were observed in both the IG and the I/RG groups. In the ischemic group, the degree of mucosal injury was minimal to moderate,…”

Can ischemia-modified albumin be used to differentiate between generalized seizures and pseudoseizures?

“…IMA increases in myocardial ischemia, cancers, infections, end-stage renal disease, liver disease, and cerebral ischemia (2)(3)(4)(5)(6)(7)(8)(9)(10)16). This study shows that serum IMA levels increase even in the absence of hypoxia markers in patients undergoing GTC seizures and that serum IMA values are directly proportional to length of seizure.…”

“…The ACB test is a quantitative assay that measures IMA in human serum (2). Experimental and clinical studies have shown an increase in IMA levels in blood in various organ ischemias or injuries, particularly myocardial ischemia, and systemic ischemias (2)(3)(4)(5)(6)(7)(8)(9). One study of patients with PCI reported that IMA is not only a marker of the occurrence of an ischemic event, but also an indicator of the severity of ischemia (10).…”