Utility of thiol/disulphide homeostasis as a biomarker for acute appendicitis: a systematic review and meta-analysis
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In brief
In brief
This systematic review and meta-analysis of 11 studies (926 subjects) evaluates thiol/disulfide homeostasis as a potential biomarker for acute appendicitis. Results show significantly elevated oxidative stress markers in appendicitis patients versus controls, with lower total thiol levels distinguishing complicated from uncomplicated cases, though methodological limitations warrant further validation studies.
- Thiol/disulfide homeostasis parameters show significantly increased oxidative stress in acute appendicitis versus healthy controls.
- Complicated appendicitis demonstrates lower total thiol levels compared to uncomplicated cases, suggesting potential prognostic utility.
- Meta-analysis of 926 subjects validates TDH as a measurable biomarker reflecting oxidative stress burden in acute appendicitis.
- Methodological limitations in 5/11 studies indicate need for larger prospective trials before clinical implementation of TDH testing.
- TDH parameters (native/total thiol, disulfide ratios) may complement traditional diagnostics but require validation in powered studies.
Written by the GCMD Library team from the article.
Abstract
The aim of this study was to analyze the role of thiol/disulfide homeostasis (TDH) parameters as an indicator of oxidative stress in acute appendicitis (AA). PubMed, EMBASE, Web of Science, and Scopus databases were systematically searched. Studies reporting on TDH in AA (both complicated and uncomplicated cases) were included. The comparator group were healthy controls. The TDH domain was compared between the groups using anti-oxidant parameters, namely native thiol and total thiol levels, and native thiol/total thiol ratio; and oxidant parameters, namely disulfide level, disulfide/native thiol ratio, and disulfide/total thiol ratio. The statistical analysis was performed using a random-effects model. The methodological quality of the studies was assessed utilizing the Newcastle–Ottawa scale. Eleven studies with a total of 926 subjects, comprising 457 patients with uncomplicated appendicitis, 147 with complicated appendicitis, and 322 healthy controls were included. Our study demonstrated significantly increased oxidative stress in AA as compared to healthy controls in all TDH parameters and significantly lower total thiol levels in complicated AA as compared to uncomplicated AA. Due to a poor methodological quality in five out of eleven studies, future prospective studies with adequate power are essential to validate these observations and refine the diagnostic approaches to AA.