{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:34:17Z","timestamp":1789778057021,"version":"4.0.1"},"reference-count":34,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Appendicitis is primarily diagnosed based on intraoperative or histopathological findings, and few studies have explored pre-operative markers of a perforated appendix. This study aimed to identify systemic biomarkers to predict pediatric appendicitis at various time points. The study group comprised pediatric patients with clinically suspected appendicitis between 2016 and 2019. Pre-surgical serum interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-\u03b1), intercellular cell-adhesion molecule-1 (ICAM-1), and endothelial selectin (E-selectin) levels were tested from day 1 to day 3 of the disease course. The biomarker values were analyzed and compared between children with normal appendices and appendicitis and those with perforated appendicitis (PA) and non-perforated appendicitis. Among 226 pediatric patients, 106 had non-perforated appendicitis, 102 had PA, and 18 had normal appendices. The levels of all serum proinflammatory biomarkers were elevated in children with acute appendicitis compared with those in children with normal appendices. In addition, the serum IL-6 and TNF-\u03b1 levels in children with PA were significantly higher, with an elevation in TNF-\u03b1 levels from days 1 and 2. In addition, serum IL-6 levels increased significantly from days 2 and 3 (both p &lt; 0.05). Serum ICAM-1 and E-selectin levels were elevated in the PA group, with consistently elevated levels within the first three days of admission (all p &lt; 0.05). These results indicate that increased serum levels of proinflammatory biomarkers including IL-6, TNF-\u03b1, ICAM-1, and E-selectin could be used as parameters in the prediction and early diagnosis of acute appendicitis, especially in children with PA.<\/jats:p>","DOI":"10.3390\/ijms25116076","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T06:35:32Z","timestamp":1717137332000},"page":"6076","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Changes in Levels of Serum Cytokines and Chemokines in Perforated Appendicitis in Children"],"prefix":"10.3390","volume":"25","author":[{"given":"Wen-Ya","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Taichung Veterans General Hospital, Taichung 40705, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4114-5877","authenticated-orcid":false,"given":"En-Pei","family":"Lee","sequence":"additional","affiliation":[{"name":"Pediatric Sepsis Study Group, Division of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Kweishan, Taoyuan 33305, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Tungs\u2019 Taichung Metro Harbor Hospital, Taichung 43503, Taiwan"},{"name":"Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli 356006, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1391-6264","authenticated-orcid":false,"given":"Bei-Cyuan","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 356006, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mao-Jen","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Taichung Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Taichung 427213, Taiwan"},{"name":"Department of Medicine, College of Medicine, Tzu Chi University, Hualien 970374, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0069-4183","authenticated-orcid":false,"given":"Han-Ping","family":"Wu","sequence":"additional","affiliation":[{"name":"College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"},{"name":"Department of Pediatrics, Chiayi Chang Gung Memorial Hospital, Chiayi 61363, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e20163003","DOI":"10.1542\/peds.2016-3003","article-title":"Efficacy and Safety of Nonoperative Treatment for Acute Appendicitis: A Meta-analysis","volume":"139","author":"Georgiou","year":"2017","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13017-020-00306-3","article-title":"Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines","volume":"15","author":"Podda","year":"2020","journal-title":"World J. 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