Effects of Phototherapy on Oxidant / Antioxidant Status Markers in Neonatal Jaundice

Öz

Background: Phototherapy is a non-invasive, well-tolerated, low-cost method that is easilyapplied to neonates with hyperbilirubinemia; however, phototherapy has been reported tocause variations in the levels of oxidative stress markers. Although many studies have beenconducted to assess the relationship between oxidative stress and phototherapy, we could notfind any published study that simultaneously determined paraoxonase (PON) and arylesteraseactivities, lipid hydroperoxide (LOOH) levels, and calculations of total antioxidant capacity(TAC), total oxidant status (TOS) and oxidative stress index (OSI) in newborns withhyperbilirubinemia. This study aimed to evaluate the effects of phototherapy on the oxidativestress panel by determining all of these biomarkers in neonates with hyperbilirubinemia. Materials-Methods: Forty-seven full-term and normal-weight newborns withhyperbilirubinemia requiring phototherapy were enrolled the study. Serum PON andarylesterase activities and TAC, TOS, OSI and LOOH levels were measuredspectrophotometrically. Results: Serum PON and arylesterase activities were increased after phototherapy (p<0,05);whereas, serum TAC, TOS, OSI and LOOH levels were decreased (p<0,05). Serumtriglyceride and uric acid levels were decreased with therapy, while serum LDL-C andalbumin levels were increased (p<0,05). Conclusions: This is the first study to evaluate PON, arylesterase, TAC, TOS and OSI levelsand lipid profile together in neonates receiving phototherapy due to neonatalhiperbilirubinemia. Decrease in TAC, TOS, OSI, LOOH levels and increase in PON and1arylesterase activities after phototherapy can indicate decreasing oxidative stress in neonataljaundice after management with phototherapy.

Anahtar Kelimeler

• Hyperbilirubinemia
• Paraoxonase
• arylesterase
• oxidative stress
• Phototherapy

Yenidoğan Sarılığında Fototerapinin Oksidan / Antioksidan Durum Belirteçleri Üzerine Etkileri

Öz

Giriş: Fototerapi, hiperbilirubinemili yenidoğanlara kolayca uygulanabilen, invaziv olmayan,iyi tolere edilen, düşük maliyetli bir yöntemdir; bununla birlikte, fototerapinin oksidatif stresbelirteçlerinin seviyelerinde değişikliklere neden olduğu bildirilmiştir. Oksidatif stres vefototerapi arasındaki ilişkiyi değerlendirmek için birçok çalışma yapılsa da,hiperbilirubinemili yenidoğanlarda paraoksonaz (PON) ve arilesteraz aktivitelerini, lipithidroperoksit (LOOH) seviyelerini total oksidan durum (TOS) ve oksidatif stres indeksi (OSI)toplam antioksidan kapasite (TAC) hesaplarını aynı anda belirleyen yayınlanmış bir çalışmabulamadık. Bu çalışma, hiperbilirubinemili yenidoğanlarda bu biyobelirteçlerin tümünübelirleyerek fototerapinin oksidatif stres paneli üzerindeki etkilerini değerlendirmeyiamaçlamıştır. Gereç-Yöntem: Fototerapi gerektiren hiperbilirubinemili kırk yedi term ve normal kiloluyenidoğan çalışmaya alındı. Serum PON ve arilesteraz aktiviteleri ile TAC, TOS, OSI veLOOH düzeyleri spektrofotometrik olarak ölçüldü. Bulgular: Fototerapi sonrası serum PON ve arilesteraz aktiviteleri arttı (p <0,05); oysa serumTAC, TOS, OSI ve LOOH düzeyleri düştü (p <0,05). Serum trigliserit ve ürik asit düzeyleritedavi ile azalırken, serum LDL-C ve albümin düzeyleri arttı (p <0,05). Sonuç: Neonatal hiperbilirubinemiye bağlı fototerapi alan yenidoğanlarda PON, arilesteraz,TAC, TOS ve OSI düzeyleri ile lipit profilini birlikte değerlendiren ilk çalışmadır. Fototerapisonrası TAC, TOS, OSI, LOOH düzeylerinde azalma ve PON ve arilesteraz aktivitelerindekiartış, fototerapi ile tedavi sonrası yenidoğan sarılığında oksidatif stresin azaldığını gösterebilir.

Anahtar Kelimeler

• Hiperbilirubinemi
• Paraoksonaz
• arilesteraz
• oksidatif stres
• Fototerapi

Kaynakça

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