Fototerapi Alfa Melanosit Uyarıcı Hormon Seviyelerini Etkiler mi?

Öz

Amaç: İlk kez bu araştırmayla indirekt hiperbilirubinemi (İHB) olan yenidoğanlarda fototerapinin plazma alfa-melanosit uyarıcı hormon (α-MSH) üzerine etkisinin araştırılması amaçlanmıştır. Materyal ve Metot: İHB nedeniyle yenidoğan yoğun bakım ünitesinde yatarak fototerapi tedavisi uygulanan 45 olgu, 1 Temmuz 2019-30 Eylül 2019 tarihleri arasında prospektif olarak çalışmaya dahil edildi. Fototerapi öncesi ve sonrası plazma α-MSH ve bilirubin düzeyleri ölçüldü. Bulgular: Çalışmaya 45 yenidoğan (19 kız, 26 erkek) dahil edildi. Ortalama doğum kilosu 3202 gr ve ortalama total bilirubin düzeyi 17,2 mg /dl idi. Fototerapi öncesi ve sonrası α-MSH seviyeleri sırasıyla 326,2 (4,0-2228,0) ng/L ve 373,9 (8,7-2283,0) ng/L olup benzerdi (p> 0,05). Sonuç: Bu çalışmayla İHB için yenidoğanlara uygulanan fototerapinin, plazma α-MSH üzerine etkisi olmadığı saptanmıştır.

Anahtar Kelimeler

• Alfa-melanosit uyarıcı hormon
• indirekt hiperbilirubinemi
• fototerapi
• yenidoğan

Does Phototherapy Influence Alpha Melanocyte Stimulating Hormone Levels?

Abstract

Objective: We aimed to investigate the effect of phototherapy on plasma alpha-melanocyte-stimulating hormone (α-MSH) levels of newborns with indirect hyperbilirubinemia (IHB) for the first time. Materials and Methods: A total of 45 cases, who were hospitalized in neonatal intensive care units between July 1, 2019, to September 30, 2019, and received phototherapy, were retrospectively included in the study. Plasma α-MSH and bilirubin levels were measured before and after the phototherapy. Results: A total of 45 newborns (19 girls and 26 boys) were included in to study. The average birth weight was 3202 grams and the mean total bilirubin level was 17.2 mg/dL. α-MSH levels before and after phototherapy were 326.2 (4.0-2228.0) ng/L and 373.9 (8.7-2283.0) ng/L, respectively and did not represent a significant difference (p>0.05). Conclusion: This study demonstrated that there was no effect between phototherapy applied for newborn IHB and plasma α-MSH levels.

Keywords

• Alpha-melanocyte stimulating hormone
• phototherapy
• newborn
• indirect hyperbilirubinemia

Kaynakça

1. Hansen TWR, Wong RJ, Stevenson DK. Molecular Physiology and Pathophysiology of Bilirubin Handling by the Blood, Liver, Intestine, and Brain in the Newborn. Physiol Rev. 2020;100:1291-1346.
2. Schwartz HP, Haberman BE, Ruddy RM. Hyperbilirubinemia. Pediatric Emergency Care. 2011;27:884-889.
3. Kaplan M, Muraca M, Hammerman C, et al. Imbalance Between Production and Conjugation of Bilirubin: A Fundamental Concept in the Mechanism of Neonatal Jaundice. PEDIATRICS. 2002;110:e47. doi:10.1542/peds.110.4.e47
4. Vreman HJ, Wong RJ, Stevenson DK. Phototherapy: current methods and future directions. Semin Perinatol. 2004;28:326-333.
5. Chakraborty AK, Funasaka Y, Slominski A, et al. Production and release of proopiomelanocortin (POMC) derived peptides by human melanocytes and keratinocytes in culture: regulation by ultraviolet B. Biochim Biophys Acta. 1996;1313:130-138.
6. Knigge U, Matzen S, Hannibal T, Jørgensen H, Warberg J. Involvement of Histamine in the Mediation of the Stress-Induced Release of Alpha-Melanocyte-Stimulating Hormone in Male Rats. Neuroendocrinology. 1991;54:646-52. doi:10.1159/000125974
7. Dong L, Wen J, Pier E, et al. Melanocyte-Stimulating Hormone Directly Enhances UV-Induced DNA Repair in Keratinocytes by a Xeroderma Pigmentosum Group A–Dependent Mechanism. Cancer Research. 2010;70:3547-3556. doi:10.1158/0008-5472.can-09-4596
8. Varga B, Gesztelyi R, Bombicz M, et al. Protective Effect of Alpha-Melanocyte-Stimulating Hormone (α-MSH) on the Recovery of Ischemia/Reperfusion (I/R)-Induced Retinal Damage in A Rat Model. Journal of Molecular Neuroscience. 2013;50:558-570. doi:10.1007/s12031-013-9998-3

9. Abdel-Malek ZA, Ruwe A, Kavanagh-Starner R, et al. α-MSH tripeptide analogs activate the melanocortin 1 receptor and reduce UV-induced DNA damage in human melanocytes. Pigment Cell & Melanoma Research. 2009;22:635-644. doi:10.1111/j.1755-148x.2009.00598.x
10. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2004;114:297-316.
11. Ayyappan S, Philip S, Bharathy N, et al. Antioxidant status in neonatal jaundice before and after phototherapy. J Pharm Bioallied Sci. 2015;7:S16-21.
12. Xiong T, Tang J, Mu D-Z. Side effects of phototherapy for neonatal hyperbilirubinemia. Zhongguo Dang Dai Er Ke Za Zhi. 2012;14:396-400.
13. Pichler R, Crespillo C, Maschek W, et al. Plasma levels of α-melanotropin and ACTH-like immunoreactivities do not vary by season or skin type in women from southern and central Europe. Neuropeptides. 2004;38:325-330. doi:10.1016/j.npep.2004.07.003
14. Spiro J, Parker S, Oliver I, Fraser C, Marks JM, Thody AJ. Effect of PUVA on plasma and skin immunoreactive alpha-melanocyte stimulating hormone concentrations. Br J Dermatol. 1987;117:703-707.
15. Videira IF dos S, Moura DFL, Magina S. Mechanisms regulating melanogenesis. An Bras Dermatol. 2013;88:76-83.