ORIGINAL RESEARCH article
Front. Toxicol.
Sec. Clinical Toxicology
Volume 7 - 2025 | doi: 10.3389/ftox.2025.1697677
Diagnostic Value of GPX4, IL-13, Periostin, and Thiol/Disulfide Balance in Adult Patients With Scorpion Envenomation: A Prospective Observational Study
Provisionally accepted
- 1Associate Professor, Department of Emergency Medicine, Faculty of Medicine, Harran University,, Şanlıurfa, Türkiye
- 2Assistant Professor, Department of Family Medicine, Faculty of Medicine, Harran University,, ŞANLIURFA, Türkiye
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Background and ObjectivesScorpion envenomation presents with a wide spectrum of clinical manifestations, ranging from mild local symptoms to severe systemic complications. This study aimed to evaluate the diagnostic and prognostic utility of GPX4, IL-13, periostin, SDF-4, and thiol/disulfide homeostasis parameters in adult patients with confirmed scorpion envenomation. Materials and Methods: This prospective observational study included 60 adult patients with confirmed scorpion stings and 33 healthy controls. Serum levels of GPX4, IL-13, periostin, and SDF-4 were measured using ELISA. Thiol/disulfide balance was evaluated by spectrophotometric assay. Clinical severity was graded using a four-level scale (Grade I–IV) based on local and systemic findings. Receiver operating characteristic (ROC) analysis and logistic regression were performed to assess the diagnostic performance and independent predictive value of biomarkers. Results: Patients exhibited significantly lower GPX4, native thiol, and total thiol levels, and higher disulfide, IL-13, periostin, and SDF-4 levels compared to controls (p < 0.001). The disulfide/native thiol and disulfide/total thiol ratios were also elevated. GPX4 (AUC = 0.984), SDF-4 (AUC = 0.900), and periostin (AUC = 0.850) demonstrated excellent diagnostic accuracy. GPX4 and disulfide levels were identified as independent predictors of envenomation. Biomarker levels significantly correlated with clinical severity grades. This is a provisional file, not the final typeset article Conclusions: Oxidative and inflammatory biomarkers, particularly GPX4, disulfide/native thiol ratio, IL-13, and periostin, provide diagnostic and prognostic value in scorpion envenomation. Incorporating these parameters into clinical assessment may enhance early risk stratification and guide management in the emergency setting.
Keywords: biomarkers, Emergency Medicine, GPx4, IL-13, Oxidative Stress, periostin, Scorpionsting, thiol/disulfide balance
Received: 02 Sep 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Büyükaslan and Koçakoğlu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hasan Büyükaslan, hasanbuyukaslan@hotmail.com
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