Alsabri Mohammed, Elsnhory Ahmed B, Alattar Omar, Ahmed Noha, Ashraf Sarah, Alassri Riffa
Paediatrics, Brookdale University Hospital Medical Center, Brooklyn, USA.
General Practice, Al-Azhar University, Cairo, EGY.
Cureus. 2024 Sep 10;16(9):e69053. doi: 10.7759/cureus.69053. eCollection 2024 Sep.
Acute chest syndrome (ACS) is a severe and potentially life-threatening complication of sickle cell disease (SCD). Early identification of patients at risk for ACS is crucial for timely intervention. There is a potential association between ACS and elevated levels of secretory phospholipase A2 (sPLA2), an enzyme involved in the breakdown of phospholipids. sPLA2 has emerged as a promising biomarker for predicting ACS. This systematic review and meta-analysis aimed to assess the diagnostic value of PLA2 in predicting ACS among children with SCD. A comprehensive search was conducted across multiple databases, including MEDLINE, Embase, Cochrane Library, PubMed, and Web of Science. Studies assessing the relationship between sPLA2 levels and ACS in SCD patients were included. Pooled sensitivity, specificity, likelihood ratios, and the area under the receiver operating characteristic curve (AUC) were calculated to assess sPLA2's diagnostic accuracy. There is a potential association between significant association between elevated sPLA2 levels and increased ACS risk in SCD patients. The pooled sensitivity of sPLA2 for predicting ACS was 0.766 (95% CI: 0.620-0.877), with a pooled specificity of 0.736 (95% CI: 0.680-0.787). The AUC of the summary receiver operating characteristic (SROC) curve was 0.84, indicating good discriminatory ability. sPLA2 emerges as a promising biomarker for predicting ACS in SCD patients, potentially guiding risk stratification and early intervention strategies to enhance patient outcomes. Nonetheless, further prospective studies are warranted to validate its clinical utility and standardize sPLA2 assay protocols.
急性胸综合征（ACS）是镰状细胞病（SCD）的一种严重且可能危及生命的并发症。早期识别有ACS风险的患者对于及时干预至关重要。ACS与分泌型磷脂酶A2（sPLA2）水平升高之间可能存在关联，sPLA2是一种参与磷脂分解的酶。sPLA2已成为预测ACS的一种有前景的生物标志物。本系统评价和荟萃分析旨在评估PLA2在预测SCD儿童ACS中的诊断价值。对多个数据库进行了全面检索，包括MEDLINE、Embase、Cochrane图书馆、PubMed和Web of Science。纳入评估SCD患者sPLA2水平与ACS之间关系的研究。计算合并敏感性、特异性、似然比和受试者操作特征曲线下面积（AUC）以评估sPLA2的诊断准确性。SCD患者中sPLA2水平升高与ACS风险增加之间存在显著关联。sPLA2预测ACS的合并敏感性为0.766（95%CI：0.620 - 0.877），合并特异性为0.736（95%CI：0.680 - 0.787）。汇总受试者操作特征（SROC）曲线的AUC为0.84，表明具有良好的鉴别能力。sPLA2成为预测SCD患者ACS的一种有前景的生物标志物，可能指导风险分层和早期干预策略以改善患者预后。尽管如此，仍需要进一步的前瞻性研究来验证其临床实用性并规范sPLA2检测方案。
