Plasma concentrations of glutathione S-transferase isoenzyme are raised inpatients with intestinal ischaemia

Background: The mortality rate associated with acute mesenteric ischaemia ( AMI) remains high. Diagnosis is frequently confounded by the non-specific h istory and physical signs, in conjunction with the absence of a reliable bi ological assay. Glutathione S-transferase (GST) is an enzyme with a crucial role in cellular homoeostasis, the a isoenzyme of which is highly specific to small bowel and liver, This study assessed alpha GST as a marker for AM I. Methods: Twenty-six patients with acute abdominal pain were enrolled. Each patient manifested a diagnostic dilemma, with a potential diagnosis of AMI. Plasma was reserved for alpha GST assay during routine blood testing and s tored at -20 degrees C for analysis. A final diagnosis was made by autopsy, laparotomy, a definitive other investigation or a return to full health. Results: Twelve patients had AMI. Plasma alpha GST was significantly increa sed in patients with AMI (P < 0.0001). Although pH differed and other bioch emical changes occurred, only alpha GST accurately predicted AMI. Conclusion: A threshold of 4 ng/ml for alpha GST was 100 per cent sensitive and 86 per cent specific for AMI. If these observations can be confirmed, evaluation of aGST may reliably predict the presence or absence of AMI.