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Bortolussi G, Muro AF. Advances in understanding disease mechanisms and potential treatments for Crigler–Najjar syndrome. Expert Opin Orphan Drugs 2018. [DOI: 10.1080/21678707.2018.1495558] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Giulia Bortolussi
- Mouse Molecular Genetics Group, International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Andrés Fernando Muro
- Mouse Molecular Genetics Group, International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
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Farouk ZL, Muhammed A, Gambo S, Mukhtar-Yola M, Umar Abdullahi S, Slusher TM. Follow-up of Children with Kernicterus in Kano, Nigeria. J Trop Pediatr 2018; 64:176-182. [PMID: 28605485 DOI: 10.1093/tropej/fmx041] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Acute bilirubin encephalopathy (ABE) is associated with long-term sequelae (kernicterus). It continues to be a significant issue in our region of Nigeria, accounting for much morbidity and mortality. Herein we report the outcome of neonates with ABE seen at our centre. METHODOLOGY We established a surveillance of children who had ABE and returned to follow-up from prospective cases of ABE (2012-2014). ABE was diagnosed based on a bilirubin-induced neurologic dysfunction score of ≥ 1. Kernicterus was subsequently established based on a history of developmental delays, hearing impairments and abnormal physical and neurologic examinations at follow-up age ≥3 months. RESULT Five hundred fifty-one neonates had hyperbilirubinaemia of whom 104 (18.8%) had ABE. Mean transcutaneous bilirubin using the Ingram icterometer was 18.3 mg/dl ± SD 1.9 [(12.5-19.1), total serum bilirubin of 18.1 ± 10.9] (range: 10.3-64 mg/dl). Sixty-five infants returned for follow-up (41 males and 24 females); mean age 9 months (22 days to 17 months). Most (58 of 65; 89.2%) had abnormal neurological findings and 15 (25.9%) had probable kernicterus. CONCLUSION There is a critical need for a National Kernicterus Registry to document all cases of kernicterus and formulate an effective treatment and prevention policy.
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Affiliation(s)
| | | | - Safiya Gambo
- Department of Paediatrics Murtala Muhamed Specialist Hospital, Kano 7002 31, Nigeria
| | | | | | - Tina M Slusher
- Department of Pediatrics, Division of Global Pediatrics University of Minnesota, Minneapolis, MN 55415, USA
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Yang FC, Draper J, Smith PG, Vivian JL, Shapiro SM, Stanford JA. Short Term Development and Fate of MGE-Like Neural Progenitor Cells in Jaundiced and Non-Jaundiced Rat Brain. Cell Transplant 2018; 27:654-665. [PMID: 29845869 PMCID: PMC6041884 DOI: 10.1177/0963689718766327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Neonatal hyperbilirubinemia targets specific brain regions and can lead to kernicterus.
One of the most debilitating symptoms of kernicterus is dystonia, which results from
bilirubin toxicity to the globus pallidus (GP). Stem cell transplantation into the GP to
replace lost neurons and restore basal ganglia circuits function is a potential
therapeutic strategy to treat dystonia in kernicterus. In this study we transplanted human
medial ganglionic eminence (MGE)-like neural progenitor cells (NPCs) that we
differentiated into a primarily gamma-aminobutyric acid (GABA)ergic phenotype, into the GP
of non-immunosuppressed jaundiced (jj) and non-jaundiced (Nj) rats. We assessed the
survival and development of graft cells at three time-points post-transplantation. While
grafted MGE-like NPCs survived and generated abundant fibers in both jj and Nj brains, NPC
survival was greater in the jj brain. These results were consistent with our previous
finding that excitatory spinal interneuron-like NPCs exhibited a higher survival rate in
the jj brain than in the Nj brain. Our findings further support our hypothesis that
slightly elevated bilirubin levels in the jj brain served as an antioxidant and
immunosuppressant to protect the transplanted cells. We also identified graft fibers
growing toward brain regions that receive projections from the GP, as well as host fibers
extending toward the graft. These promising findings suggest that MGE-like NPCs may have
the capacity to restore the circuits connecting GP and other nuclei.
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Affiliation(s)
- Fu-Chen Yang
- 1 Department of Molecular & Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Julia Draper
- 2 Transgenic and Gene Targeting Institutional Facility, University of Kansas Medical Center, Kansas City, KS, USA
| | - Peter G Smith
- 1 Department of Molecular & Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA.,3 Kansas Intellectual & Developmental Disabilities Research Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jay L Vivian
- 4 Department of Pathology & Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Steven M Shapiro
- 5 Division of Child Neurology, Department of Pediatrics, Children's Mercy Hospital & Clinics, Kansas City, MO, USA
| | - John A Stanford
- 1 Department of Molecular & Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA.,3 Kansas Intellectual & Developmental Disabilities Research Center, University of Kansas Medical Center, Kansas City, KS, USA
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Maternal Administration of Cichorium intybus L. Extract Decreases the Plasma Total and Conjugated Bilirubin Level in Rat Neonates. Jundishapur J Nat Pharm Prod 2018. [DOI: 10.5812/jjnpp.14043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Pavlova LA, Pastukhov AV, Kopitsyna MN, Morozov AS, Bessonov IV, Smirnova SE, Bagnyukova DA, Davankov VA. Increasing selective bilirubin removal by hypercross-linked polystyrene hemosorbents. Russ Chem Bull 2018. [DOI: 10.1007/s11172-017-1963-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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56
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Preparation of nano-CaCO3/polystyrene nanocomposite beads for efficient bilirubin removal. Colloids Surf B Biointerfaces 2018; 161:480-487. [DOI: 10.1016/j.colsurfb.2017.11.017] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 10/17/2017] [Accepted: 11/07/2017] [Indexed: 11/18/2022]
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Wang Q, Wang Y, Li Y, Wen B, Dai Z, Ma S, Zhang Y. Identification and characterization of the structure-activity relationships involved in UGT1A1 inhibition by anthraquinone and dianthrone constituents of Polygonum multiflorum. Sci Rep 2017; 7:17952. [PMID: 29263357 PMCID: PMC5738440 DOI: 10.1038/s41598-017-18231-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 12/07/2017] [Indexed: 12/29/2022] Open
Abstract
The adverse effects of Polygonum (P.) multiflorum, including abnormal bilirubin metabolism, are a serious public health issue. As uridine diphosphate (UDP)-glucuronosyltransferase 1A1 (UGT1A1) is the only enzyme responsible for bilirubin metabolism, we investigated the inhibitory effect of a P. multiflorum extract and 10 anthraquinone and dianthrone compounds on UGT1A1 in rat liver microsomes in vitro. The P. multiflorum extract exhibited the strongest inhibitory effect on UGT1A1 activity (inhibition constant [Ki] = 0.3257 μM, 1422 μg of material/mL), followed by cis-emodin dianthrones (Ki = 0.8630 μM), trans-emodin dianthrones (Ki = 1.083 μM), emodin-8-O-glc (Ki = 3.425 μM), and polygonumnolide C2 (Ki = 4.291 μM). Analysis of the structure–activity relationships of these compounds suggested that the spatial orientation of the molecules and the presence of particular functional groups affect UGT1A1 inhibition. A mechanistic analysis showed that all the tested compounds docked into two of the nine active sites of UGT1A1 and suggested that hydrophobic interactions and hydrogen bonds are important for the affinity of the tested compounds for UGT1A1; moreover, their interaction energies were generally in agreement with the Ki values. These findings provide insight into adverse reactions to P. multiflorum and identify the pharmacophores involved in inhibition of UGT1A1.
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Affiliation(s)
- Qi Wang
- Beijing University of Chinese Medicine, Beijing, 100029, China.,National Institutes for Food and Drug Control, Beijing, 100050, China
| | - Yadan Wang
- National Institutes for Food and Drug Control, Beijing, 100050, China
| | - Yong Li
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Binyu Wen
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, 100078, China
| | - Zhong Dai
- National Institutes for Food and Drug Control, Beijing, 100050, China
| | - Shuangcheng Ma
- Beijing University of Chinese Medicine, Beijing, 100029, China. .,National Institutes for Food and Drug Control, Beijing, 100050, China.
| | - Yujie Zhang
- Beijing University of Chinese Medicine, Beijing, 100029, China.
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Slusher TM, Zamora TG, Appiah D, Stanke JU, Strand MA, Lee BW, Richardson SB, Keating EM, Siddappa AM, Olusanya BO. Burden of severe neonatal jaundice: a systematic review and meta-analysis. BMJ Paediatr Open 2017; 1:e000105. [PMID: 29637134 PMCID: PMC5862199 DOI: 10.1136/bmjpo-2017-000105] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 09/25/2017] [Accepted: 10/01/2017] [Indexed: 11/04/2022] Open
Abstract
CONTEXT To assess the global burden of late and/or poor management of severe neonatal jaundice (SNJ), a common problem worldwide, which may result in death or irreversible brain damage with disabilities in survivors. Population-based data establishing the global burden of SNJ has not been previously reported. OBJECTIVE Determine the burden of SNJ in all WHO regions, as defined by clinical jaundice associated with clinical outcomes including acute bilirubin encephalopathy/kernicterus and/or exchange transfusion (ET) and/or jaundice-related death. DATA SOURCES PubMed, Scopus and other health databases were searched, without language restrictions, from 1990 to 2017 for studies reporting the incidence of SNJ. STUDY SELECTION/DATA EXTRACTION Stratification was performed for WHO regions and results were pooled using random effects model and meta-regression. RESULTS Of 416 articles including at least one marker of SNJ, only 21 reported estimates from population-based studies, with 76% (16/21) of them conducted in high-income countries. The African region has the highest incidence of SNJ per 10 000 live births at 667.8 (95% CI 603.4 to 738.5), followed by Southeast Asian, Eastern Mediterranean, Western Pacific, Americas and European regions at 251.3 (132.0 to 473.2), 165.7 (114.6 to 238.9), 9.4 (0.1 to 755.9), 4.4 (1.8 to 10.5) and 3.7 (1.7 to 8.0), respectively. The incidence of ET per 10 000 live births was significantly higher for Africa and Southeast Asian regions at 186.5 (153.2 to 226.8) and 107.1 (102.0 to 112.5) and lower in Eastern Mediterranean (17.8 (5.7 to 54.9)), Americas (0.38 (0.21 to 0.67)), European (0.35 (0.20 to 0.60)) and Western Pacific regions (0.19 (0.12 to 0.31). Only 2 studies provided estimates of clear jaundice-related deaths in infants with significant jaundice [UK (2.8%) and India (30.8%). CONCLUSIONS Limited but compelling evidence demonstrates that SNJ is associated with a significant health burden especially in low-income and middle-income countries.
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Affiliation(s)
- Tina M Slusher
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
- Hennepin County Medical Center, Minneapolis, Minnesota, USA
| | - Tara G Zamora
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Duke Appiah
- Texas Tech University Health Science Center, Abilene, Texas, USA
| | - Judith U Stanke
- Biomedical Library, University of Minnesota, Minneapolis, Minnesota, USA
| | - Mark A Strand
- Department of Pharmacy, North Dakota State University, Fargo, North Dakota, USA
| | - Burton W Lee
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Shane B Richardson
- Department of Family Medicine, University of Arizona, Tucson, Arizona, USA
| | | | - Ashajoythi M Siddappa
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
- Hennepin County Medical Center, Minneapolis, Minnesota, USA
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Affiliation(s)
- Debra H Pan
- Division of Pediatric Gastroenterology and Nutrition, The Children's Hospital at Montefiore, Bronx, NY
| | - Yolanda Rivas
- Division of Pediatric Gastroenterology and Nutrition, The Children's Hospital at Montefiore, Bronx, NY
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Jiang X, Zhou D, Huang X, Zhao W, Zhao C. Hexanediamine functionalized poly (glycidyl methacrylate-co-N-vinylpyrrolidone) particles for bilirubin removal. J Colloid Interface Sci 2017; 504:214-222. [DOI: 10.1016/j.jcis.2017.05.039] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/12/2017] [Accepted: 05/13/2017] [Indexed: 11/27/2022]
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61
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Amini N, Vousooghi N, Soleimani M, Samadikuchaksaraei A, Akbari M, Safakheil H, Atafimanesh P, Shahbazi A, Brouki Milan P, Ramezani S, Mozafari M, Joghataei MT. A new rat model of neonatal bilirubin encephalopathy (kernicterus). J Pharmacol Toxicol Methods 2017; 84:44-50. [DOI: 10.1016/j.vascn.2016.10.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 10/03/2016] [Accepted: 10/09/2016] [Indexed: 11/17/2022]
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Memisoglu A, Kolgazi M, Yaman A, Bahadir E, Sirvanci S, Yeğen BÇ, Ozek E. Neuroprotective Effect of Erythropoietin on Phenylhydrazine-Induced Hemolytic Hyperbilirubinemia in Neonatal Rats. Neurochem Res 2016; 42:1026-1037. [PMID: 27995496 DOI: 10.1007/s11064-016-2135-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 11/28/2016] [Accepted: 12/03/2016] [Indexed: 01/04/2023]
Abstract
Neonatal unconjugated hyperbilirubinemia might cause severe bilirubin neurotoxicity in especially hemolytic conditions. The study aimed to elucidate the potential neuroprotective effects of erythropoietin (EPO) in hemolysis-induced hyperbilirubinemia. In newborn rats, hyperbilirubinemia secondary to hemolysis was induced by injecting with phenylhydrazine hydrochloride (PHZ) and rats were injected with either vehicle or EPO. At 54th hour of the PHZ injection, rats were decapitated. Serum levels of TNF-α, IL-1β, IL-10, brain-derived neurotrophic factor (BDNF) and S100-B and brain malondialdehyde, glutathione levels and myeloperoxidase activities were measured. TUNEL staining and NF-κB expression were evaluated. As compared to control pups, in vehicle-treated PHZ group, TNF-α and IL-1β levels, malondialdehyde level and myeloperoxidase activity were increased with concomitant decreases in IL-10 and glutathione. All EPO regimens reversed PHZ-induced alterations in IL-10, TNF-α, malondialdehyde and glutathione levels. Three-day-treatment abolished increases in myeloperoxidase activity and IL-1β levels, while BDNF and S100-B were elevated. Increased TUNEL (+) cells and NF-κB expressions in the brain of PHZ group were reduced in the 3-day-treated group. EPO exerted anti-inflammatory effects on PHZ-induced neural damage in newborn rats, while the neuroprotection was more obvious when the treatments were repeated successively. The results suggest that EPO treatment may have a therapeutic potential in supporting neuroplasticity in the hyperbilirubinemic neonates.
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Affiliation(s)
- Asli Memisoglu
- Department of Paediatrics, Division of Neonatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Meltem Kolgazi
- Department of Physiology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Akan Yaman
- Department of Paediatrics, Division of Neonatology, Marmara University School of Medicine, Istanbul, Turkey
| | - Elif Bahadir
- Department of Physiology, Marmara University School of Medicine, Basibüyük Mah. Maltepe Basibüyük Yolu No. 9/1, Maltepe, 34854, Istanbul, Turkey
| | - Serap Sirvanci
- Department of Histology and Embryology, Marmara University School of Medicine, Istanbul, Turkey
| | - Berrak Ç Yeğen
- Department of Physiology, Marmara University School of Medicine, Basibüyük Mah. Maltepe Basibüyük Yolu No. 9/1, Maltepe, 34854, Istanbul, Turkey.
| | - Eren Ozek
- Department of Paediatrics, Division of Neonatology, Marmara University School of Medicine, Istanbul, Turkey
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Choi JY, Choi YS, Rha DW, Park ES. The clinical outcomes of deep gray matter injury in children with cerebral palsy in relation with brain magnetic resonance imaging. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 55:218-225. [PMID: 27214680 DOI: 10.1016/j.ridd.2016.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 02/17/2016] [Accepted: 04/18/2016] [Indexed: 06/05/2023]
Abstract
UNLABELLED In the present study we investigated the nature and extent of clinical outcomes using various classifications and analyzed the relationship between brain magnetic resonance imaging (MRI) findings and the extent of clinical outcomes in children with cerebral palsy (CP) with deep gray matter injury. The deep gray matter injuries of 69 children were classified into hypoxic ischemic encephalopathy (HIE) and kernicterus patterns. HIE patterns were divided into four groups (I-IV) based on severity. Functional classification was investigated using the gross motor function classification system-expanded and revised, manual ability classification system, communication function classification system, and tests of cognitive function, and other associated problems. The severity of HIE pattern on brain MRI was strongly correlated with the severity of clinical outcomes in these various domains. Children with a kernicterus pattern showed a wide range of clinical outcomes in these areas. Children with severe HIE are at high risk of intellectual disability (ID) or epilepsy and children with a kernicterus pattern are at risk of hearing impairment and/or ID. Grading severity of HIE pattern on brain MRI is useful for predicting overall outcomes. The clinical outcomes of children with a kernicterus pattern range widely from mild to severe. WHAT THIS PAPER ADDS Delineation of the clinical outcomes of children with deep gray matter injury, which are a common abnormal brain MRI finding in children with CP, is necessary. The present study provides clinical outcomes for various domains in children with deep gray matter injury on brain MRI. The deep gray matter injuries were divided into two major groups; HIE and kernicterus patterns. Our study showed that severity of HIE pattern on brain MRI was strongly associated with the severity of impairments in gross motor function, manual ability, communication function, and cognition. These findings suggest that severity of HIE pattern can be useful for predicting the severity of impairments. Conversely, children with a kernicterus pattern showed a wide range of clinical outcomes in various domains. Children with severe HIE pattern are at high risk of ID or epilepsy and children with kernicterus pattern are at risk of hearing impairment or ID. The strength of our study was the assessment of clinical outcomes after 3 years of age using standardized classification systems in various domains in children with deep gray matter injury.
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Affiliation(s)
- Ja Young Choi
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul 03722, Republic of Korea.
| | - Yoon Seong Choi
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu, Seoul 03722, Republic of Korea.
| | - Dong-Wook Rha
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul 03722, Republic of Korea.
| | - Eun Sook Park
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seodaemun-gu, Seoul 03722, Republic of Korea.
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Abstract
A 5-day-old Thoroughbred foal was submitted to the necropsy service at the University of Kentucky Livestock Disease Diagnostic Center. The foal had a clinical history of seizure activity and severe icterus. A complete blood count and serum chemistry analysis indicated that the foal was anemic (hematocrit, 16%), hyperbilirubinemic (45 mg/dl), and hypoglycemic. At necropsy, all tissues were discolored various shades of yellow. Microscopically, there was degeneration and necrosis of cerebral neurons and cerebellar Purkinje cells; severe hepatocellular degeneration and necrosis; and deposition of amorphous golden-yellow material in the cerebellar granular cell layer, pulmonary alveoli, renal tubular epithelium, splenic trabecula, and the lamina propria of the small and large intestine. The golden-yellow material in the brain, lung, spleen, and small intestine was identified as bilirubin by histochemistry. Based on the macroscopic and microscopic findings, a diagnosis of kernicterus (bilirubin encephalopathy) was made. This report describes a rare case of equine neonatal kernicterus.
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Affiliation(s)
- Alan T Loynachan
- Livestock Disease Diagnostic Center, University of Kentucky, College of Agriculture, Lexington, KY 40511-4125, USA.
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Fluorescent protein-based detection of unconjugated bilirubin in newborn serum. Sci Rep 2016; 6:28489. [PMID: 27324682 PMCID: PMC4914990 DOI: 10.1038/srep28489] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 06/03/2016] [Indexed: 12/01/2022] Open
Abstract
Increased serum levels of unconjugated bilirubin are associated with the development of brain damage in newborns. In current clinical settings, there are no methods for directly determining serum levels of unconjugated bilirubin. UnaG, a fluorescent protein from Japanese eel muscle that specifically binds to unconjugated bilirubin was used in this study. Linear regression analysis was carried out to compare unconjugated bilirubin levels measured by UnaG and conventional bilirubin oxidase methods. Unconjugated bilirubin levels in the serum of newborns who were untreated or treated with phototherapy were compared. Effects of interfering factors in the serum (conjugated bilirubin, hemoglobin, and lipid) on unconjugated bilirubin concentration measured by the UnaG method were also evaluated. Unconjugated bilirubin levels measured by the UnaG method were highly correlated with those determined by the bilirubin oxidase assay. Unconjugated bilirubin levels determined by bilirubin oxidase and UnaG assays were similar in serum samples containing conjugated bilirubin. The performance of the UnaG assay was unaffected by phototherapy and the presence of serum hemoglobin and lipid emulsion. These results demonstrate the clinical applicability of the UnaG method for direct measurement of unconjugated bilirubin levels in newborn serum.
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66
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Maimburg RD, Olsen J, Sun Y. Neonatal hyperbilirubinemia and the risk of febrile seizures and childhood epilepsy. Epilepsy Res 2016; 124:67-72. [PMID: 27259071 DOI: 10.1016/j.eplepsyres.2016.05.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 02/05/2016] [Accepted: 05/17/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of the study was to estimate the association between newborn children treated with phototerapy for hyperbilirubinemia and the subsequent risk of febrile seizures or epilepsy in early childhood. METHODS We conducted a follow-up study of singleton children (N=70 230) born between February 1998 and May 2003 from the Danish National Birth Cohort (DNBC). Information on exposure to phototherapy for hyperbilirubinemia was obtained from a questionnaire in the DNBC. Information on epilepsy and febrile seizures were obtained from the Danish National Hospital Registry (DNHR). Cox proportional hazard regression model was used to calculate hazard ratios (HRs) with 95% confidence intervals (CI). RESULTS Newborns treated with phototherapy for hyperbilirubinemia had a higher risk of developing epilepsy in early childhood (HR: 1.66, 95% CI: 1.23-2.24) but not febrile seizures (HR: 1.04, 95% CI: 0.86-1.27). The increases risk of epilepsy were only present for boys (HR: 1.98, 95% CI: 1.40-2.78) not for girls (HR: 1.14, 95% CI: 0.64-2.02) CONCLUSION: Phototherapy for hyperbilirubinemia in newborns was associated with an increased risk of epilepsy for males in early childhood. No excess risk was seen with febrile seizures.
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Affiliation(s)
- Rikke Damkjær Maimburg
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Gynaecology and Obstetrics, Aarhus University Hospital, Skejby, Denmark; Centre of Research in Rehabilitation (CORIR), Aarhus University Hospital, Aarhus, Denmark.
| | - Jørn Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; Section of Epidemiology, School of Public Health, University of California at Los Angeles, CA, USA.
| | - Yuelian Sun
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
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Lv X, Wang XX, Hou J, Fang ZZ, Wu JJ, Cao YF, Liu SW, Ge GB, Yang L. Comparison of the inhibitory effects of tolcapone and entacapone against human UDP-glucuronosyltransferases. Toxicol Appl Pharmacol 2016; 301:42-9. [PMID: 27089846 DOI: 10.1016/j.taap.2016.04.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 04/12/2016] [Accepted: 04/14/2016] [Indexed: 01/15/2023]
Abstract
Tolcapone and entacapone are two potent catechol-O-methyltransferase (COMT) inhibitors with a similar skeleton and displaying similar pharmacological activities. However, entacapone is a very safe drug used widely in the treatment of Parkinson's disease, while tolcapone is only in limited use for Parkinson's patients and needs careful monitoring of hepatic functions due to hepatotoxicity. This study aims to investigate and compare the inhibitory effects of entacapone and tolcapone on human UDP-glucosyltransferases (UGTs), as well as to evaluate the potential risks from the view of drug-drug interactions (DDI). The results demonstrated that both tolcapone and entacapone exhibited inhibitory effects on UGT1A1, UGT1A7, UGT1A9 and UGT1A10. In contrast to entacapone, tolcapone exhibited more potent inhibitory effects on UGT1A1, UGT1A7, and UGT1A10, while their inhibitory potentials against UGT1A9 were comparable. It is noteworthy that the inhibition constants (Ki) of tolcapone and entacapone against bilirubin-O-glucuronidation in human liver microsomes (HLM) are determined as 0.68μM and 30.82μM, respectively, which means that the inhibition potency of tolcapone on UGT1A1 mediated bilirubin-O-glucuronidation in HLM is much higher than that of entacapone. Furthermore, the potential risks of tolcapone or entacapone via inhibition of human UGT1A1 were quantitatively predicted by the ratio of the areas under the plasma drug concentration-time curve (AUC). The results indicate that tolcapone may result in significant increase in AUC of bilirubin or the drugs primarily metabolized by UGT1A1, while entacapone is unlikely to cause a significant DDI through inhibition of UGT1A1.
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Affiliation(s)
- Xia Lv
- Laboratory of Pharmaceutical Resource Discovery, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China; State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Southern Medical University, Guangzhou 510515, China
| | | | - Jie Hou
- Dalian Medical University, Dalian 116044, China
| | | | - Jing-Jing Wu
- Laboratory of Pharmaceutical Resource Discovery, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China; State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Southern Medical University, Guangzhou 510515, China
| | | | - Shu-Wen Liu
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Southern Medical University, Guangzhou 510515, China
| | - Guang-Bo Ge
- Laboratory of Pharmaceutical Resource Discovery, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China; State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Southern Medical University, Guangzhou 510515, China.
| | - Ling Yang
- Laboratory of Pharmaceutical Resource Discovery, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian 116023, China; Jiangxi University of Traditional Chinese Medicine, Nanchang 330006, China.
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Liu M, Chen S, Yueh MF, Fujiwara R, Konopnicki C, Hao H, Tukey RH. Cadmium and arsenic override NF-κB developmental regulation of the intestinal UGT1A1 gene and control of hyperbilirubinemia. Biochem Pharmacol 2016; 110-111:37-46. [PMID: 27060662 DOI: 10.1016/j.bcp.2016.04.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 04/05/2016] [Indexed: 10/22/2022]
Abstract
Humanized UDP-glucuronosyltransferase (UGT)-1 (hUGT1) mice encode the UGT1 locus including the UGT1A1 gene. During neonatal development, delayed expression of the UGT1A1 gene leads to hyperbilirubinemia as determined by elevated levels of total serum bilirubin (TSB). We show in this report that the redox-sensitive NF-κB pathway is crucial for intestinal expression of the UGT1A1 gene and control of TSB levels. Targeted deletion of IKKβ in intestinal epithelial cells (hUGT1/Ikkβ(ΔIEC) mice) leads to greater neonatal accumulation of TSB than observed in control hUGT1/Ikkβ(F/F) mice. The elevation in TSB levels in hUGT1/Ikkβ(ΔIEC) mice correlates with a reduction in intestinal UGT1A1 expression. As TSB levels accumulate in hUGT1/Ikkβ(ΔIEC) mice during the neonatal period, the increase over that observed in hUGT1/Ikkβ(F/F) mice leads to weight loss, seizures and eventually death. Bilirubin accumulates in brain tissue from hUGT1/Ikkβ(ΔIEC) mice inducing an inflammatory state as shown by elevated TNFα, IL-1β and IL-6, all of which can be prevented by neonatal induction of hepatic or intestinal UGT1A1 and lowering of TSB levels. Altering the redox state of the intestines by oral administration of cadmium or arsenic to neonatal hUGT1/Ikkβ(F/F) and hUGT1/Ikkβ(ΔIEC) mice leads to induction of UGT1A1 and a dramatic reduction in TSB levels. Microarray analysis following arsenic treatment confirms upregulation of oxidation-reduction processes and lipid metabolism, indicative of membrane repair or synthesis. Our findings indicate that the redox state in intestinal epithelial cells during development is important in maintaining UGT1A1 gene expression and control of TSB levels.
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Affiliation(s)
- Miao Liu
- Laboratory of Environmental Toxicology, Departments of Chemistry & Biochemistry and Pharmacology, University of California, San Diego, La Jolla, CA 92023, United States; State Key Laboratory of Natural Medicine, Key Laboratory of Drug Metabolism and Pharmacokinetics, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Shujuan Chen
- Laboratory of Environmental Toxicology, Departments of Chemistry & Biochemistry and Pharmacology, University of California, San Diego, La Jolla, CA 92023, United States
| | - Mei-Fei Yueh
- Laboratory of Environmental Toxicology, Departments of Chemistry & Biochemistry and Pharmacology, University of California, San Diego, La Jolla, CA 92023, United States
| | - Ryoichi Fujiwara
- Laboratory of Environmental Toxicology, Departments of Chemistry & Biochemistry and Pharmacology, University of California, San Diego, La Jolla, CA 92023, United States
| | - Camille Konopnicki
- Laboratory of Environmental Toxicology, Departments of Chemistry & Biochemistry and Pharmacology, University of California, San Diego, La Jolla, CA 92023, United States
| | - Haiping Hao
- State Key Laboratory of Natural Medicine, Key Laboratory of Drug Metabolism and Pharmacokinetics, China Pharmaceutical University, Nanjing, People's Republic of China
| | - Robert H Tukey
- Laboratory of Environmental Toxicology, Departments of Chemistry & Biochemistry and Pharmacology, University of California, San Diego, La Jolla, CA 92023, United States.
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Mosayebi Z, Rahmani M, Behjati Ardakani S, Sheikh M, Shariat M, Rezaeizadeh G. Evaluation of Serum Zinc Levels in Hyperbilirubinemic Neonates Before and After Phototherapy. IRANIAN JOURNAL OF PEDIATRICS 2016; 26:e4146. [PMID: 27617068 PMCID: PMC4992089 DOI: 10.5812/ijp.4146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 02/08/2016] [Accepted: 02/18/2016] [Indexed: 12/04/2022]
Abstract
Background The existing therapeutic methods for neonatal jaundice are costly, time-consuming and potentially risky. Zinc salts can reduce phototherapy duration by precipitating unconjugated bilirubin in the intestine (bilirubin and zinc can form a complex in physiologic pH); however, zinc toxicity is an issue that must be considered since theoretically bilirubin reduction by phototherapy may increase serum zinc levels, making additional zinc supplementation the potential cause of zinc toxicity. Objectives So, our purpose was evaluating the serum zinc level alterations before and after phototherapy, in hyperbilirubinemic newborns. Materials and Methods A prospective cohort study was performed at the children’s medical center of Tehran University of Medical Sciences from 2012 to 2014. Healthy, full-term exclusively breast fed newborns with non-hemolytic jaundice were enrolled in the study. Participants were divided into two groups based on serum bilirubin levels (TSB < 18 mg/dL and TSB ≥ 18 mg/dL) at admission. Pre- and post-phototherapy total serum zinc level was measured before and 12 - 24 hours after termination of phototherapy. Results Phototherapy was associated with a significant increase in the serum zinc level in neonates with severe hyperbilirubinemia (TSB ≥ 18 mg/dL) but not in those with mild-moderate hyperbilirubinemia (TSB < 18 mg/dL). In addition, phototherapy caused a significant increase in the rate of zinc with potentially toxic levels (zinc > 200) in only neonates with severe hyperbilirubinemia. Conclusions Phototherapy increases serum zinc level by reducing bilirubin level so that additional supplementation of this element can lead potentially to zinc toxicity.
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Affiliation(s)
- Ziba Mosayebi
- Breastfeeding Research Center, Family Health Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Maral Rahmani
- Tehran University of Medical Sciences, Tehran, IR Iran
| | | | - Mahdi Sheikh
- Maternal, Fetal and Neonatal Research Center, Family Health Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Mamak Shariat
- Maternal, Fetal and Neonatal Research Center, Family Health Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Golnaz Rezaeizadeh
- Maternal, Fetal and Neonatal Research Center, Family Health Institute, Tehran University of Medical Sciences, Tehran, IR Iran
- Maternal, Fetal and Neonatal Research Center, Vali-Asr Hospital, Imam Khomeini Hospital Complex, Tehran, IR Iran
- Corresponding author: Golnaz Rezaeizadeh, Maternal, Fetal and Neonatal Research Center, Vali-Asr Hospital, Imam Khomeini Hospital Complex, P. O. Box: 1419733141, Tehran, IR Iran. Tel: +98-2166591316, Fax: +98-2166591315, E-mail:
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70
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Gökdoğan Ç, Genç A, Gülbahar Ö, Gökdoğan O, Helvacı A, Bezgin SÜ, Memiş L. Auditory evoked potentials in a newborn Wistar rat model of hyperbilirubinemia. Braz J Otorhinolaryngol 2016; 82:144-50. [PMID: 26727606 PMCID: PMC9449037 DOI: 10.1016/j.bjorl.2015.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 01/06/2015] [Indexed: 11/24/2022] Open
Abstract
Introduction Hyperbilirubinemia is a common health problem in newborns. Its effects can be different according to the level and duration of the hyperbilirubinemia. The toxic effect of bilirubin on the auditory system can be seen as a sensory neural hearing loss or auditory neuropathy spectrum disorder (ANSD). Objective The purpose of our study was to determine the effects of toxic bilirubin level on the auditory system by using Auditory Brainstem Response audiometry. Methods Rats are used as animal models due to their low cost and easy attainability. Auditory Brainstem Response was used for auditory assessment. In this study, three groups were established: experimental, control and placebo groups. Results In the experimental group, which consists of rats with hyperbilirubinemia, sensory neural hearing loss was found bilaterally in 4 rats (66.67%) and unilaterally in 2 rats (16.67%) and auditory neuropathy spectrum disorder was found unilaterally in 1 rat (8.33%). Auditory Brainstem Response thresholds were significantly elevated compared to control and placebo groups (p < 0.05). Conclusion Hyperbilirubinemia of newborn rats may result both in sensory neural hearing loss and auditory neuropathy spectrum disorder.
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Jiang X, Xiang T, Xie Y, Wang R, Zhao W, Sun S, Zhao CS. Functional polyethersulfone particles for the removal of bilirubin. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2016; 27:28. [PMID: 26704545 DOI: 10.1007/s10856-015-5642-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 11/27/2015] [Indexed: 06/05/2023]
Abstract
In this study, polyethersulfone/poly (glycidyl methacrylate) particles are prepared via in situ cross-linked polymerization coupled with a phase inversion technique. The surfaces of these particles are then further modified by grafting amino groups using tetraethylenepentamine, dethylenetriamine, ethylenediamine, or 1,6-hexanediamine for the removal of bilirubin. The particles are characterized by Flourier transform infrared spectroscopy, thermogravimetric analysis, and scanning electron microscopy. Batch adsorption experiments are performed to verify the adsorption capability, and the effect of bilirubin initial concentration, bovine serum albumin concentration, and solution ionic strength on the adsorption is also investigated. In addition, both adsorption kinetic and isotherm models are applied to analyze the adsorption process of bilirubin, and a particle column is used to further study the bilirubin removal ability.To prove that the method was a universal portal to prepare functional particles, polysulfone, polystyrene, and poly(vinylidene fluoride) based functional particles were also prepared and used for the removal of bilirubin. This study and the results indicated that the particles had a great potential to be used in hemoperfusion treatment for hyperbilirubinemia.
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Affiliation(s)
- Xin Jiang
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065, People's Republic of China
| | - Tao Xiang
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065, People's Republic of China
| | - Yi Xie
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065, People's Republic of China
| | - Rui Wang
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065, People's Republic of China
| | - Weifeng Zhao
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065, People's Republic of China
| | - Shudong Sun
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065, People's Republic of China.
| | - Chang-Sheng Zhao
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065, People's Republic of China.
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, 610064, People's Republic of China.
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Efficacy of Human Adipose Tissue-Derived Stem Cells on Neonatal Bilirubin Encephalopathy in Rats. Neurotox Res 2016; 29:514-24. [PMID: 26818600 DOI: 10.1007/s12640-016-9599-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 12/04/2015] [Accepted: 12/28/2015] [Indexed: 10/22/2022]
Abstract
Kernicterus is a neurological syndrome associated with indirect bilirubin accumulation and damages to the basal ganglia, cerebellum and brain stem nuclei particularly the cochlear nucleus. To mimic haemolysis in a rat model such that it was similar to what is observed in a preterm human, we injected phenylhydrazine in 7-day-old rats to induce haemolysis and then infused sulfisoxazole into the same rats at day 9 to block bilirubin binding sites in the albumin. We have investigated the effectiveness of human adiposity-derived stem cells as a therapeutic paradigm for perinatal neuronal repair in a kernicterus animal model. The level of total bilirubin, indirect bilirubin, brain bilirubin and brain iron was significantly increased in the modelling group. There was a significant decreased in all severity levels of the auditory brainstem response test in the two modelling group. Akinesia, bradykinesia and slip were significantly declined in the experience group. Apoptosis in basal ganglia and cerebellum were significantly decreased in the stem cell-treated group in comparison to the vehicle group. All severity levels of the auditory brainstem response tests were significantly decreased in 2-month-old rats. Transplantation results in the substantial alleviation of walking impairment, apoptosis and auditory dysfunction. This study provides important information for the development of therapeutic strategies using human adiposity-derived stem cells in prenatal brain damage to reduce potential sensori motor deficit.
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73
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Pazar A, Kolgazi M, Memisoglu A, Bahadir E, Sirvanci S, Yaman A, Yeğen BÇ, Ozek E. The neuroprotective and anti-apoptotic effects of melatonin on hemolytic hyperbilirubinemia-induced oxidative brain damage. J Pineal Res 2016; 60:74-83. [PMID: 26511903 DOI: 10.1111/jpi.12292] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 10/26/2015] [Indexed: 12/16/2022]
Abstract
Melatonin exerts protection in several inflammatory and neurodegenerative disorders. To investigate the neuroprotective effects of melatonin in an experimental hemolysis-induced hyperbilirubinemia, newborn Sprague-Dawley rats (25-40 g, n = 72) were injected with phenylhydrazine hydrochloride (PHZ; 75 mg/kg) and the injections were repeated at the 24th hour. Rats were treated with saline or melatonin (10 mg/kg) 30 min before the first and second PHZ injections and 24 h after the 2nd PHZ injections. Control rats (n = 24) were injected with saline, but not PHZ. At sixth hours after the last injections of saline or melatonin, all rats were decapitated. Tumor necrosis factor (TNF)-α, IL-1β, IL-10 and brain-derived neurotrophic factor (BDNF) and S100B levels in the plasma were measured. Brain tissue malondialdehyde (MDA), glutathione (GSH) levels and myeloperoxidase (MPO) activities were measured, and brain tissues were evaluated for apoptosis by TUNEL method. In the saline-treated PHZ group, hemoglobin, hematocrit levels were reduced, and total/direct bilirubin levels were elevated when compared to control group. Increased plasma TNF-α, IL-1β levels, along with decreased BDNF, S100B and IL-10 values were observed in the saline-treated PHZ group, while these changes were all reversed in the melatonin-treated group. Increased MDA levels and MPO activities in the brain tissues of saline-treated hyperbilirubinemic rats, concomitant with depleted brain GSH stores, were also reversed in the melatonin-treated hyperbilirubinemic rats. Increased TUNEL(+) cells in the hippocampus of saline-treated PHZ group were reduced by melatonin treatment. Melatonin exerts neuroprotective and anti-apoptotic effects on the oxidative neuronal damage of the newborn rats with hemolysis and hyperbilirubinemia.
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Affiliation(s)
- Asilay Pazar
- Department of Paediatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - Meltem Kolgazi
- Department of Physiology, Acibadem University School of Medicine, Istanbul, Turkey
| | - Aslı Memisoglu
- Division of Neonatology, Department of Paediatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - Elif Bahadir
- Department of Physiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Serap Sirvanci
- Department of Histology and Embryology, Marmara University School of Medicine, Istanbul, Turkey
| | - Akan Yaman
- Division of Neonatology, Department of Paediatrics, Marmara University School of Medicine, Istanbul, Turkey
| | - Berrak Ç Yeğen
- Department of Physiology, Marmara University School of Medicine, Istanbul, Turkey
| | - Eren Ozek
- Division of Neonatology, Department of Paediatrics, Marmara University School of Medicine, Istanbul, Turkey
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Peng Z, Yang Y, Luo J, Nie C, Ma L, Cheng C, Zhao C. Nanofibrous polymeric beads from aramid fibers for efficient bilirubin removal. Biomater Sci 2016; 4:1392-401. [DOI: 10.1039/c6bm00328a] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Polymer based hemoperfusion has been developed as an effective therapy to remove the extra bilirubin from patients.
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Affiliation(s)
- Zihang Peng
- College of Polymer Science and Engineering
- State Key Laboratory of Polymer Materials Engineering
- Sichuan University
- Chengdu 610065
- China
| | - Ye Yang
- College of Polymer Science and Engineering
- State Key Laboratory of Polymer Materials Engineering
- Sichuan University
- Chengdu 610065
- China
| | - Jiyue Luo
- College of Polymer Science and Engineering
- State Key Laboratory of Polymer Materials Engineering
- Sichuan University
- Chengdu 610065
- China
| | - Chuanxiong Nie
- College of Polymer Science and Engineering
- State Key Laboratory of Polymer Materials Engineering
- Sichuan University
- Chengdu 610065
- China
| | - Lang Ma
- College of Polymer Science and Engineering
- State Key Laboratory of Polymer Materials Engineering
- Sichuan University
- Chengdu 610065
- China
| | - Chong Cheng
- College of Polymer Science and Engineering
- State Key Laboratory of Polymer Materials Engineering
- Sichuan University
- Chengdu 610065
- China
| | - Changsheng Zhao
- College of Polymer Science and Engineering
- State Key Laboratory of Polymer Materials Engineering
- Sichuan University
- Chengdu 610065
- China
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Gökdoğan Ç, Altınyay Ş, Gündüz B, Kemaloğlu YK, Bayazıt Y, Uygur K. Management of children with auditory neuropathy spectrum disorder (ANSD). Braz J Otorhinolaryngol 2015; 82:493-9. [PMID: 26781981 PMCID: PMC9444594 DOI: 10.1016/j.bjorl.2015.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 08/09/2015] [Accepted: 08/21/2015] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION ANSD is a challenging problem. OBJECTIVE To present our experience on management of the children with ANSD with respect to clinical data. METHODS This retrospective study included all children younger than 16 years of age who applied to the department between 2005 and 2013 (with the exception of newborn hearing screening NHS referrals). The data were derived from pure tone, OAEs and ABR tests, and further medical risk factors of the subjects were evaluated. RESULTS ANSD was recognized in 74 ears of 40 children (B/U: 34/6) among 1952 children with SNHL (2.04%) detected among 9520 applicants to the department (0.42%). The clinical tests revealed that hearing loss greater than 15dB was present in both ears of 38 cases. The degree of hearing loss was profound in 48% children, severe in 12% children, moderate in 28% children, mild in 10% children and normal in 5% children. ABRs were absent/abnormal in 37/3 ears and CMs were detected in all. Acoustic reflexes were absent in all ears. Rehabilitation was managed by CI and hearing aids in 15 and 23 cases, respectively. FM system was given to two cases displaying normal hearing but poor speech discrimination in noisy environments. CONCLUSION ANSD is a relatively challenging problem for the audiology departments because of its various clinical features and difficulties in management. Our patients with ANSD most commonly displayed profound hearing loss. The number of overlooked cases may be minimized by performing ABR and OAE in every case referred with the suspicion of hearing loss.
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Affiliation(s)
- Çağıl Gökdoğan
- Gazi University Hospital, Department of Audiology, Ankara, Turkey.
| | - Şenay Altınyay
- Gazi University Hospital, Department of Audiology, Ankara, Turkey
| | - Bülent Gündüz
- Gazi University Hospital, Department of Audiology, Ankara, Turkey
| | | | | | - Kemal Uygur
- Gazi University Hospital, Department of ENT-HNS, Ankara, Turkey
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Corujo-Santana C, Falcón-González JC, Borkoski-Barreiro SA, Pérez-Plasencia D, Ramos-Macías Á. Relación entre hiperbilirrubinemia neonatal e hipoacusia neurosensorial. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2015; 66:326-31. [DOI: 10.1016/j.otorri.2014.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Accepted: 10/20/2014] [Indexed: 10/24/2022]
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77
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Corujo-Santana C, Falcón-González JC, Borkoski-Barreiro SA, Pérez-Plasencia D, Ramos-Macías Á. The Relationship Between Neonatal Hyperbilirubinemia and Sensorineural Hearing Loss. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2015. [DOI: 10.1016/j.otoeng.2014.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Barateiro A, Chen S, Yueh MF, Fernandes A, Domingues HS, Relvas J, Barbier O, Nguyen N, Tukey RH, Brites D. Reduced Myelination and Increased Glia Reactivity Resulting from Severe Neonatal Hyperbilirubinemia. Mol Pharmacol 2015; 89:84-93. [PMID: 26480925 DOI: 10.1124/mol.115.098228] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 10/14/2015] [Indexed: 01/16/2023] Open
Abstract
Bilirubin-induced neurologic dysfunction (BIND) and kernicterus has been used to describe moderate to severe neurologic dysfunction observed in children exposed to excessive levels of total serum bilirubin (TSB) during the neonatal period. Here we use a new mouse model that targets deletion of the Ugt1 locus and the Ugt1a1 gene in liver to promote hyperbilirubinemia-induced seizures and central nervous system toxicity. The accumulation of TSB in these mice leads to diffuse yellow coloration of brain tissue and a marked cerebellar hypoplasia that we characterize as kernicterus. Histologic studies of brain tissue demonstrate that the onset of severe neonatal hyperbilirubinemia, characterized by seizures, leads to alterations in myelination and glia reactivity. Kernicterus presents as axonopathy with myelination deficits at different brain regions, including pons, medulla oblongata, and cerebellum. The excessive accumulation of TSB in the early neonatal period (5 days after birth) promotes activation of the myelin basic protein (Mbp) gene with an accelerated loss of MBP that correlates with a lack of myelin sheath formation. These changes were accompanied by increased astroglial and microglial reactivity, possibly as a response to myelination injury. Interestingly, cerebellum was the area most affected, with greater myelination impairment and glia burden, and showing a marked loss of Purkinje cells and reduced arborization of the remaining ones. Thus, kernicterus in this model displays not only axonal damage but also myelination deficits and glial activation in different brain regions that are usually related to the neurologic sequelae observed after severe hyperbilirubinemia.
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Affiliation(s)
- Andreia Barateiro
- Research Institute for Medicines (iMed.UL) (A.B., A.F., D.B.) and Department of Biochemistry and Human Biology (A.F., D.B.), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal; Laboratory of Environmental Toxicology, Department of Pharmacology, and Chemistry and Biochemistry, University of California San Diego, La Jolla, California (S.C., M-F.Y., N.N., R.H.T.); Departamento de Biologia Experimental, Faculty of Medicine (H.S.D., J.R.) and Instituto de Biologia Molecular e Celular (J.R.), University of Porto, Porto, Portugal; Laboratory of Molecular Pharmacology, CHU de Québec Research Centre and Faculty of Pharmacy, Laval University, Québec, QC, Canada (O.B.)
| | - Shujuan Chen
- Research Institute for Medicines (iMed.UL) (A.B., A.F., D.B.) and Department of Biochemistry and Human Biology (A.F., D.B.), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal; Laboratory of Environmental Toxicology, Department of Pharmacology, and Chemistry and Biochemistry, University of California San Diego, La Jolla, California (S.C., M-F.Y., N.N., R.H.T.); Departamento de Biologia Experimental, Faculty of Medicine (H.S.D., J.R.) and Instituto de Biologia Molecular e Celular (J.R.), University of Porto, Porto, Portugal; Laboratory of Molecular Pharmacology, CHU de Québec Research Centre and Faculty of Pharmacy, Laval University, Québec, QC, Canada (O.B.)
| | - Mei-Fei Yueh
- Research Institute for Medicines (iMed.UL) (A.B., A.F., D.B.) and Department of Biochemistry and Human Biology (A.F., D.B.), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal; Laboratory of Environmental Toxicology, Department of Pharmacology, and Chemistry and Biochemistry, University of California San Diego, La Jolla, California (S.C., M-F.Y., N.N., R.H.T.); Departamento de Biologia Experimental, Faculty of Medicine (H.S.D., J.R.) and Instituto de Biologia Molecular e Celular (J.R.), University of Porto, Porto, Portugal; Laboratory of Molecular Pharmacology, CHU de Québec Research Centre and Faculty of Pharmacy, Laval University, Québec, QC, Canada (O.B.)
| | - Adelaide Fernandes
- Research Institute for Medicines (iMed.UL) (A.B., A.F., D.B.) and Department of Biochemistry and Human Biology (A.F., D.B.), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal; Laboratory of Environmental Toxicology, Department of Pharmacology, and Chemistry and Biochemistry, University of California San Diego, La Jolla, California (S.C., M-F.Y., N.N., R.H.T.); Departamento de Biologia Experimental, Faculty of Medicine (H.S.D., J.R.) and Instituto de Biologia Molecular e Celular (J.R.), University of Porto, Porto, Portugal; Laboratory of Molecular Pharmacology, CHU de Québec Research Centre and Faculty of Pharmacy, Laval University, Québec, QC, Canada (O.B.)
| | - Helena Sofia Domingues
- Research Institute for Medicines (iMed.UL) (A.B., A.F., D.B.) and Department of Biochemistry and Human Biology (A.F., D.B.), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal; Laboratory of Environmental Toxicology, Department of Pharmacology, and Chemistry and Biochemistry, University of California San Diego, La Jolla, California (S.C., M-F.Y., N.N., R.H.T.); Departamento de Biologia Experimental, Faculty of Medicine (H.S.D., J.R.) and Instituto de Biologia Molecular e Celular (J.R.), University of Porto, Porto, Portugal; Laboratory of Molecular Pharmacology, CHU de Québec Research Centre and Faculty of Pharmacy, Laval University, Québec, QC, Canada (O.B.)
| | - João Relvas
- Research Institute for Medicines (iMed.UL) (A.B., A.F., D.B.) and Department of Biochemistry and Human Biology (A.F., D.B.), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal; Laboratory of Environmental Toxicology, Department of Pharmacology, and Chemistry and Biochemistry, University of California San Diego, La Jolla, California (S.C., M-F.Y., N.N., R.H.T.); Departamento de Biologia Experimental, Faculty of Medicine (H.S.D., J.R.) and Instituto de Biologia Molecular e Celular (J.R.), University of Porto, Porto, Portugal; Laboratory of Molecular Pharmacology, CHU de Québec Research Centre and Faculty of Pharmacy, Laval University, Québec, QC, Canada (O.B.)
| | - Olivier Barbier
- Research Institute for Medicines (iMed.UL) (A.B., A.F., D.B.) and Department of Biochemistry and Human Biology (A.F., D.B.), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal; Laboratory of Environmental Toxicology, Department of Pharmacology, and Chemistry and Biochemistry, University of California San Diego, La Jolla, California (S.C., M-F.Y., N.N., R.H.T.); Departamento de Biologia Experimental, Faculty of Medicine (H.S.D., J.R.) and Instituto de Biologia Molecular e Celular (J.R.), University of Porto, Porto, Portugal; Laboratory of Molecular Pharmacology, CHU de Québec Research Centre and Faculty of Pharmacy, Laval University, Québec, QC, Canada (O.B.)
| | - Nghia Nguyen
- Research Institute for Medicines (iMed.UL) (A.B., A.F., D.B.) and Department of Biochemistry and Human Biology (A.F., D.B.), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal; Laboratory of Environmental Toxicology, Department of Pharmacology, and Chemistry and Biochemistry, University of California San Diego, La Jolla, California (S.C., M-F.Y., N.N., R.H.T.); Departamento de Biologia Experimental, Faculty of Medicine (H.S.D., J.R.) and Instituto de Biologia Molecular e Celular (J.R.), University of Porto, Porto, Portugal; Laboratory of Molecular Pharmacology, CHU de Québec Research Centre and Faculty of Pharmacy, Laval University, Québec, QC, Canada (O.B.)
| | - Robert H Tukey
- Research Institute for Medicines (iMed.UL) (A.B., A.F., D.B.) and Department of Biochemistry and Human Biology (A.F., D.B.), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal; Laboratory of Environmental Toxicology, Department of Pharmacology, and Chemistry and Biochemistry, University of California San Diego, La Jolla, California (S.C., M-F.Y., N.N., R.H.T.); Departamento de Biologia Experimental, Faculty of Medicine (H.S.D., J.R.) and Instituto de Biologia Molecular e Celular (J.R.), University of Porto, Porto, Portugal; Laboratory of Molecular Pharmacology, CHU de Québec Research Centre and Faculty of Pharmacy, Laval University, Québec, QC, Canada (O.B.)
| | - Dora Brites
- Research Institute for Medicines (iMed.UL) (A.B., A.F., D.B.) and Department of Biochemistry and Human Biology (A.F., D.B.), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal; Laboratory of Environmental Toxicology, Department of Pharmacology, and Chemistry and Biochemistry, University of California San Diego, La Jolla, California (S.C., M-F.Y., N.N., R.H.T.); Departamento de Biologia Experimental, Faculty of Medicine (H.S.D., J.R.) and Instituto de Biologia Molecular e Celular (J.R.), University of Porto, Porto, Portugal; Laboratory of Molecular Pharmacology, CHU de Québec Research Centre and Faculty of Pharmacy, Laval University, Québec, QC, Canada (O.B.)
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Vos B, Senterre C, Lagasse R, Levêque A. Newborn hearing screening programme in Belgium: a consensus recommendation on risk factors. BMC Pediatr 2015; 15:160. [PMID: 26475713 PMCID: PMC4609128 DOI: 10.1186/s12887-015-0479-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 10/08/2015] [Indexed: 01/08/2023] Open
Abstract
Background Understanding the risk factors for hearing loss is essential for designing the Belgian newborn hearing screening programme. Accordingly, they needed to be updated in accordance with current scientific knowledge. This study aimed to update the recommendations for the clinical management and follow-up of newborns with neonatal risk factors of hearing loss for the newborn screening programme in Belgium. Methods A literature review was performed, and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system assessment method was used to determine the level of evidence quality and strength of the recommendation for each risk factor. The state of scientific knowledge, levels of evidence quality, and graded recommendations were subsequently assessed using a three-round Delphi consensus process (two online questionnaires and one face-to-face meeting). Results Congenital infections (i.e., cytomegalovirus, toxoplasmosis, and syphilis), a family history of hearing loss, consanguinity in (grand)parents, malformation syndromes, and foetal alcohol syndrome presented a ‘high’ level of evidence quality as neonatal risk factors for hearing loss. Because of the sensitivity of auditory function to bilirubin toxicity, hyperbilirubinaemia was assessed at a ‘moderate’ level of evidence quality. In contrast, a very low birth weight, low Apgar score, and hospitalisation in the neonatal intensive care unit ranged from ‘very low’ to ‘low’ levels, and ototoxic drugs were evidenced as ‘very low’. Possible explanations for these ‘very low’ and ‘low’ levels include the improved management of these health conditions or treatments, and methodological weaknesses such as confounding effects, which make it difficult to conclude on individual risk factors. In the recommendation statements, the experts emphasised avoiding unidentified neonatal hearing loss and opted to include risk factors for hearing loss even in cases with weak evidence. The panel also highlighted the cumulative effect of risk factors for hearing loss. Conclusions We revised the recommendations for the clinical management and follow-up of newborns exhibiting neonatal risk factors for hearing loss on the basis of the aforementioned evidence-based approach and clinical experience from experts. The next step is the implementation of these findings in the Belgian screening programme. Electronic supplementary material The online version of this article (doi:10.1186/s12887-015-0479-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bénédicte Vos
- Research Center Epidemiology, Biostatistics and Clinical Research, Université libre de Bruxelles (ULB), School of Public Health, Route de Lennik 808, Brussels, 1070, Belgium. .,Research Center Health Policy and Systems - International Health, Université libre de Bruxelles (ULB), School of Public Health, Route de Lennik 808, Brussels, 1070, Belgium. .,Centre d'Epidémiologie Périnatale (CEpiP), Route de Lennik 808, Brussels, 1070, Belgium.
| | - Christelle Senterre
- Research Center Epidemiology, Biostatistics and Clinical Research, Université libre de Bruxelles (ULB), School of Public Health, Route de Lennik 808, Brussels, 1070, Belgium.
| | - Raphaël Lagasse
- Research Center Health Policy and Systems - International Health, Université libre de Bruxelles (ULB), School of Public Health, Route de Lennik 808, Brussels, 1070, Belgium.
| | | | - Alain Levêque
- Research Center Epidemiology, Biostatistics and Clinical Research, Université libre de Bruxelles (ULB), School of Public Health, Route de Lennik 808, Brussels, 1070, Belgium. .,Research Center Health Policy and Systems - International Health, Université libre de Bruxelles (ULB), School of Public Health, Route de Lennik 808, Brussels, 1070, Belgium. .,Centre d'Epidémiologie Périnatale (CEpiP), Route de Lennik 808, Brussels, 1070, Belgium.
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Rance G, Starr A. Pathophysiological mechanisms and functional hearing consequences of auditory neuropathy. Brain 2015; 138:3141-58. [PMID: 26463676 DOI: 10.1093/brain/awv270] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 08/05/2015] [Indexed: 01/19/2023] Open
Abstract
The effects of inner ear abnormality on audibility have been explored since the early 20th century when sound detection measures were first used to define and quantify 'hearing loss'. The development in the 1970s of objective measures of cochlear hair cell function (cochlear microphonics, otoacoustic emissions, summating potentials) and auditory nerve/brainstem activity (auditory brainstem responses) have made it possible to distinguish both synaptic and auditory nerve disorders from sensory receptor loss. This distinction is critically important when considering aetiology and management. In this review we address the clinical and pathophysiological features of auditory neuropathy that distinguish site(s) of dysfunction. We describe the diagnostic criteria for: (i) presynaptic disorders affecting inner hair cells and ribbon synapses; (ii) postsynaptic disorders affecting unmyelinated auditory nerve dendrites; (iii) postsynaptic disorders affecting auditory ganglion cells and their myelinated axons and dendrites; and (iv) central neural pathway disorders affecting the auditory brainstem. We review data and principles to identify treatment options for affected patients and explore their benefits as a function of site of lesion.
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Affiliation(s)
- Gary Rance
- 1 Department of Audiology and Speech Pathology, The University of Melbourne, 550 Swanston Street, Parkville 3010 Australia
| | - Arnold Starr
- 2 Department of Neurology, The University of California (Irvine), 200 S. Manchester Ave., Suite 206, Orange, CA 92868-4280, USA
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Contreras ET, Giger U, Malmberg JL, Quimby JM, Schaffer PA. Bilirubin Encephalopathy in a Domestic Shorthair Cat With Increased Osmotic Fragility and Cholangiohepatitis. Vet Pathol 2015; 53:629-32. [PMID: 26354310 DOI: 10.1177/0300985815603433] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 7-month-old female domestic shorthair cat was diagnosed with chronic regenerative hemolytic anemia characterized by increased osmotic fragility of unknown etiology. At 13 months of age, the cat was evaluated for acute collapse. The cat was icteric with severe hyperbilirubinemia but no hematocrit changes. Severe obtundation and lateral recumbency progressed to tetraparesis and loss of proprioception in all 4 limbs, and a cerebellar or brainstem lesion was suspected. Postmortem examination revealed suppurative cholangiohepatitis and acute neuronal necrosis in the nuclei of the brainstem and cerebellum, consistent with bilirubin encephalopathy. This is the first known occurrence of cholangiohepatitis and bilirubin encephalopathy in an adult cat with chronic hemolytic anemia. Although rare, bilirubin encephalopathy should be considered a possible sequela to hyperbilirubinemia in adult patients. It remains unknown whether increased osmotic fragility was related to the cholangiohepatopathy.
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Affiliation(s)
- E T Contreras
- Department of Clinical Sciences, Veterinary Teaching Hospital, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - U Giger
- Section of Medical Genetics, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - J L Malmberg
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - J M Quimby
- Department of Clinical Sciences, Veterinary Teaching Hospital, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - P A Schaffer
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
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Role of extrahepatic UDP-glucuronosyltransferase 1A1: Advances in understanding breast milk-induced neonatal hyperbilirubinemia. Toxicol Appl Pharmacol 2015; 289:124-32. [PMID: 26342858 DOI: 10.1016/j.taap.2015.08.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/25/2015] [Accepted: 08/26/2015] [Indexed: 01/29/2023]
Abstract
Newborns commonly develop physiological hyperbilirubinemia (also known as jaundice). With increased bilirubin levels being observed in breast-fed infants, breast-feeding has been recognized as a contributing factor for the development of neonatal hyperbilirubinemia. Bilirubin undergoes selective metabolism by UDP-glucuronosyltransferase (UGT) 1A1 and becomes a water soluble glucuronide. Although several factors such as gestational age, dehydration and weight loss, and increased enterohepatic circulation have been associated with breast milk-induced jaundice (BMJ), deficiency in UGT1A1 expression is a known cause of BMJ. It is currently believed that unconjugated bilirubin is metabolized mainly in the liver. However, recent findings support the concept that extrahepatic tissues, such as small intestine and skin, contribute to bilirubin glucuronidation during the neonatal period. We will review the recent advances made towards understanding biological and molecular events impacting BMJ, especially regarding the role of extrahepatic UGT1A1 expression.
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83
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Photo-isomerization and oxidation of bilirubin in mammals is dependent on albumin binding. Anal Biochem 2015; 490:34-45. [PMID: 26297581 DOI: 10.1016/j.ab.2015.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 08/02/2015] [Accepted: 08/05/2015] [Indexed: 11/23/2022]
Abstract
The bilirubin (BR) photo-conversion in the human body is a protein-dependent process; an effective photo-isomerization of the potentially neurotoxic Z,Z-BR as well as its oxidation to biliverdin in the antioxidant redox cycle is possible only when BR is bound on serum albumin. We present a novel analytical concept in the study of linear tetrapyrroles metabolic processes based on an in-depth mapping of binding sites in the structure of human serum albumin (HSA). A combination of fluorescence spectroscopy, circular dichroism (CD) spectroscopy, and molecular modeling methods was used for recognition of the binding site for BR, its derivatives (mesobilirubin and bilirubin ditaurate), and the products of the photo-isomerization and oxidation (lumirubin, biliverdin, and xanthobilirubic acid) on HSA. The CD spectra and fluorescent quenching of the Trp-HSA were used to calculate the binding constants. The results of the CD displacement experiments performed with hemin were interpreted together with the findings of molecular docking performed on the pigment-HSA complexes. We estimated that Z,Z-BR and its metabolic products bind on two independent binding sites. Our findings support the existence of a reversible antioxidant redox cycle for BR and explain an additional pathway of the photo-isomerization process (increase of HSA binding capacity; the excess free [unbound] BR can be converted and also bound to HSA).
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Mishra S, Cheema A, Agarwal R, Deorari A, Paul V. Oral zinc for the prevention of hyperbilirubinaemia in neonates. Cochrane Database Syst Rev 2015; 2015:CD008432. [PMID: 26171899 PMCID: PMC7390467 DOI: 10.1002/14651858.cd008432.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Between 6% and 15% of neonates develop hyperbilirubinaemia requiring treatment. Successful management of neonatal hyperbilirubinaemia relies on prevention and early treatment, with phototherapy being the mainstay of treatment. Oral zinc has been reported to decrease the serum total bilirubin (STB), presumably by decreasing the enterohepatic circulation. OBJECTIVES To determine the effect of oral zinc supplementation compared to placebo or no treatment on the incidence of hyperbilirubinaemia in neonates during the first week of life and to assess the safety of oral zinc in enrolled neonates. SEARCH METHODS We searched CENTRAL (The Cochrane Library 2014, Issue 1), MEDLINE (1966 to November 30, 2014), and EMBASE (1990 to November 30, 2014). SELECTION CRITERIA Randomised controlled trials were eligible for inclusion if they enrolled neonates (term and preterm) to whom oral zinc, in a dose of 10 to 20 mg/day, was initiated within the first 96 hours of life, for any duration until day seven, compared with no treatment or placebo. DATA COLLECTION AND ANALYSIS We used the standard methods of The Cochrane Collaboration and its Neonatal Review Group for data collection and analysis. MAIN RESULTS Only one study met the criteria of inclusion in the review. This study compared oral zinc with placebo. Oral zinc was administered in a dose of 5 mL twice daily from day 2 to day 7 postpartum. The drug was administered into the mouth of the infant by the plastic measure provided with the bottle or with a spoon. Incidence of hyperbilirubinaemia, defined as serum total bilirubin (STB) ≥ 15 mg/dL, was similar between groups (N = 286; risk ratio (RR) 0.94, 95% confidence interval (CI) 0.58 to 1.52). Mean STB levels, mg/dL, at 72 ± 12 hours were comparable in both the groups (N = 286; mean difference (MD) -0.20; 95% CI -1.03 to 0.63). Although the duration of phototherapy in the zinc group was significantly shorter compared to the placebo group (N = 286; MD -12.80, 95% CI -16.93 to -8.67), the incidence of need for phototherapy was comparable across both the groups (N = 286; RR 1.20; 95% CI 0.66 to 2.18). Incidences of side effects like vomiting (N = 286; RR 0.65, 95% CI 0.19 to 2.25), diarrhoea (N = 286; RR 2.92, 95% CI 0.31 to 27.71), and rash (N = 286; RR 2.92, 95% CI 0.12 to 71.03) were found to be rare and statistically comparable between groups. AUTHORS' CONCLUSIONS The limited evidence available has not shown that oral zinc supplementation given to infants up to one week old reduces the incidence of hyperbilirubinaemia or need for phototherapy.
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Affiliation(s)
- Satish Mishra
- Lifeline Advanced Neonatal CentreNeonatologyCool RoadJalandharPanjabIndia144001
| | - Aminderjit Cheema
- Lifeline Advanced Neonatal CentreNeonatologyCool RoadJalandharPanjabIndia144001
| | - Ramesh Agarwal
- All India Institute of Medical SciencesDepartment of PediatricsNew DelhiIndia
| | - Ashok Deorari
- All India Institute of Medical SciencesDepartment of PediatricsNew DelhiIndia
| | - Vinod Paul
- All India Institute of Medical SciencesDepartment of PediatricsNew DelhiIndia
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Gibbs PEM, Miralem T, Maines MD. Biliverdin reductase: a target for cancer therapy? Front Pharmacol 2015; 6:119. [PMID: 26089799 PMCID: PMC4452799 DOI: 10.3389/fphar.2015.00119] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 05/20/2015] [Indexed: 12/30/2022] Open
Abstract
Biliverdin reductase (BVR) is a multifunctional protein that is the primary source of the potent antioxidant, bilirubin. BVR regulates activities/functions in the insulin/IGF-1/IRK/PI3K/MAPK pathways. Activation of certain kinases in these pathways is/are hallmark(s) of cancerous cells. The protein is a scaffold/bridge and intracellular transporter of kinases that regulate growth and proliferation of cells, including PKCs, ERK and Akt, and their targets including NF-κB, Elk1, HO-1, and iNOS. The scaffold and transport functions enable activated BVR to relocate from the cytosol to the nucleus or to the plasma membrane, depending on the activating stimulus. This enables the reductase to function in diverse signaling pathways. And, its expression at the transcript and protein levels are increased in human tumors and the infiltrating T-cells, monocytes and circulating lymphocytes, as well as the circulating and infiltrating macrophages. These functions suggest that the cytoprotective role of BVR may be permissive for cancer/tumor growth. In this review, we summarize the recent developments that define the pro-growth activities of BVR, particularly with respect to its input into the MAPK signaling pathway and present evidence that BVR-based peptides inhibit activation of protein kinases, including MEK, PKCδ, and ERK as well as downstream targets including Elk1 and iNOS, and thus offers a credible novel approach to reduce cancer cell proliferation.
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Affiliation(s)
- Peter E M Gibbs
- Department of Biochemistry and Biophysics, University of Rochester School of Medicine and Dentistry , Rochester, NY, USA
| | - Tihomir Miralem
- Department of Biochemistry and Biophysics, University of Rochester School of Medicine and Dentistry , Rochester, NY, USA
| | - Mahin D Maines
- Department of Biochemistry and Biophysics, University of Rochester School of Medicine and Dentistry , Rochester, NY, USA
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Impairment of enzymatic antioxidant defenses is associated with bilirubin-induced neuronal cell death in the cerebellum of Ugt1 KO mice. Cell Death Dis 2015; 6:e1739. [PMID: 25950469 PMCID: PMC4669693 DOI: 10.1038/cddis.2015.113] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 03/16/2015] [Accepted: 03/18/2015] [Indexed: 01/14/2023]
Abstract
Severe hyperbilirubinemia is toxic during central nervous system development. Prolonged and uncontrolled high levels of unconjugated bilirubin lead to bilirubin-induced encephalopathy and eventually death by kernicterus. Despite extensive studies, the molecular and cellular mechanisms of bilirubin toxicity are still poorly defined. To fill this gap, we investigated the molecular processes underlying neuronal injury in a mouse model of severe neonatal jaundice, which develops hyperbilirubinemia as a consequence of a null mutation in the Ugt1 gene. These mutant mice show cerebellar abnormalities and hypoplasia, neuronal cell death and die shortly after birth because of bilirubin neurotoxicity. To identify protein changes associated with bilirubin-induced cell death, we performed proteomic analysis of cerebella from Ugt1 mutant and wild-type mice. Proteomic data pointed-out to oxidoreductase activities or antioxidant processes as important intracellular mechanisms altered during bilirubin-induced neurotoxicity. In particular, they revealed that down-representation of DJ-1, superoxide dismutase, peroxiredoxins 2 and 6 was associated with hyperbilirubinemia in the cerebellum of mutant mice. Interestingly, the reduction in protein levels seems to result from post-translational mechanisms because we did not detect significant quantitative differences in the corresponding mRNAs. We also observed an increase in neuro-specific enolase 2 both in the cerebellum and in the serum of mutant mice, supporting its potential use as a biomarker of bilirubin-induced neurological damage. In conclusion, our data show that different protective mechanisms fail to contrast oxidative burst in bilirubin-affected brain regions, ultimately leading to neurodegeneration.
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Sarı S, Yavuz A, Batur A, Bora A, Caksen H. Brain magnetic resonance imaging and magnetic resonance spectroscopy findings of children with kernicterus. Pol J Radiol 2015; 80:72-80. [PMID: 25745520 PMCID: PMC4327183 DOI: 10.12659/pjr.892643] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 11/04/2014] [Indexed: 11/25/2022] Open
Abstract
Background The term kernicterus, or bilirubin encephalopathy, is used to describe pathological bilirubin staining of the basal ganglia, brain stem, and cerebellum, and is associated with hyperbilirubinemia. Kernicterus generally occurs in untreated hyperbilirubinemia or cases where treatment is delayed. Magnetic resonance imaging (MRI)-based studies have shown characteristic findings in kernicterus. The objective of our study was to describe the role of 1H magnetic resonance spectroscopy (MRS) in demonstrating these metabolic changes and to review conventional MRI findings of kernicterus. Material/Methods Forty-eight pediatric cases with kernicterus were included in this study. MRI and MRS examinations were performed on variable dates (10–29 days after birth). NAA, Cr, Cho, NAA/Cr, NAA/Cho, and Cho/Cr values were evaluated visually and by computer analysis. Results There was no statistically significant difference between the NAA and Cho levels in the acute kernicterus patients and the control group (healthy patients), whereas both were significantly elevated in the chronic kernicterus patients. Both the mean NAA/Cr and Cho/Cr ratio values were significantly higher in the acute and chronic cases compared to the control group. The NAA/Cho ratio value was statistically lower in the acute cases than in the control group while it was similar in the chronic cases. Conclusions Conventional MR imaging and 1H-MRS are important complementary tools in the diagnostics of neonatal bilirubin encephalopathy. This study provided important information for applying these MR modalities in the evaluation of neonates with bilirubin encephalopathy.
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Affiliation(s)
- Sahabettin Sarı
- Department of Pediatrics, Baskale State Hospital, Van Sehri, Turkey
| | - Alpaslan Yavuz
- Department of Radiology, Yuzuncuyil University Dursun Odabas Medical Center, Van, Turkey
| | - Aabdussamet Batur
- Department of Radiology, Yuzuncuyil University Dursun Odabas Medical Center, Van, Turkey
| | - Aydın Bora
- Department of Radiology, Yuzuncuyil University Dursun Odabas Medical Center, Van, Turkey
| | - Huseyin Caksen
- Department of Radiology, Yuzuncuyil University Dursun Odabas Medical Center, Van, Turkey
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Abstract
Advances in the care of neonatal hyperbilirubinemia have led to a decreased incidence of kernicterus. However, neonatal exposure to high levels of bilirubin continues to cause severe motor symptoms and cerebral palsy (CP). Exposure to moderate levels of unconjugated bilirubin may also cause damage to the developing central nervous system, specifically the basal ganglia and cerebellum. Brain lesions identified using magnetic resonance imaging following extreme hyperbilirubinemia have been linked to dyskinetic CP. Newer imaging techniques, such as diffusion tensor imaging or single-photon emission computed tomography, allow quantification of more subtle white matter injury following presumed exposure to unbound bilirubin, and may explain more subtle movement disorders. New categories of bilirubin-induced neurologic dysfunction, characterized by subtle bilirubin encephalopathy following moderate hyperbilirubinemia, have been implicated in long-term motor function. Further research is needed to identify subtle impairments resulting from moderate-severe neonatal hyperbilirubinemia, to understand the influence of perinatal risk factors on bilirubin toxicity, and to develop neuroprotective treatment strategies to prevent movement disorders due to bilirubin toxicity.
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Abstract
Neural disorders of the auditory nerve are associated with particular disorders of auditory perceptions dependent on processing of acoustic temporal cues. These include: (1) speech perception; (2) localizing a sound's origin in space; and (3) identifying sounds in background noise. Auditory neuropathy (AN) is a consequence of: (1) presynaptic disorders affecting inner hair cell ribbon synapses; (2) postsynaptic disorders of auditory nerve dendrites; and (3) postsynaptic disorders of auditory nerve axons. The etiologies of these disorders are diverse, similar to other cranial or peripheral neuropathies. The pathologies cause attenuated and dyssynchronous auditory nerve discharges. Therapies and management of patients with AN are reviewed.
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Affiliation(s)
- Arnold Starr
- Departments of Neurology and Neurobiology, University of California, Irvine, CA, USA.
| | - Gary Rance
- School of Audiology, University of Melbourne, Melbourne, Australia
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Zahir F, Rabbani G, Khan RH, Rizvi SJ, Jamal MS, Abuzenadah AM. The pharmacological features of bilirubin: the question of the century. ACTA ACUST UNITED AC 2015. [DOI: 10.1515/cmble-2015-0012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AbstractThis review looks at the toxicity and metabolism of bilirubin in terms of its pharmacological potential. Its role has gained importance as more research has revealed the functional significance and interrelationship between the gasotransmitters nitric oxide and carbon monoxide. The biological actions of bilirubin have mostly been characterized in the high micromolar range where toxic effects occur. However, it could also prove to be an important cytoprotector for brain tissue, which is inherently less equipped for antioxidant defense. Plasma bilirubin levels negatively correlate to a number of disease states. Higher levels of bilirubin that are still within the normal range provide a protective effect to the body. The effects on various disorders could be tested using controlled pharmacological upregulation of the molecule with animal models. At nanomolar concentrations, considerable benefits have been obtained when the molecule was delivered pharmacologically under in vitro or in vivo test conditions, particularly in neurodegenerative disorders and after tissue or organ transplantation. The induction of heme oxygenase-1 (HMOX-1) via the activation of nuclear factor erythroid 2-related factor or the use of bile pigments in the harvesting of diseased tissue are novel applications, and like every new therapy, should be used with caution. HMOX-1 is tissue specific, and in exceptional states, such as schizophrenia and specific types of renal disorder, the same therapy may have disastrous effects.
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Abstract
CONCLUSION This study suggests that hyperbilirubinemia in the neonatal rat can impair auditory function and induce peripheral nerve pathology by reducing neurofilament-positive cells in spiral ganglion neurons (SGNs). This finding indicates a potential connection between hyperbilirubinemia and auditory impairment. OBJECTIVE To establish a neonatal rat hyperbilirubinemia induced by hemolysis and assess the possible link between hyperbilirubinemia and auditory impairment. METHODS Wistar rats were divided into two groups - a bilirubin exposure group injected with phenylhydrazine hydrochloride at 7 and 28 days of age to induce hyperbilirubinemia, and a control group given saline. Auditory brainstem response (ABR) and distortion product otoacoustic emissions (DPOAEs) were determined to assess auditory function. Cochlea basilar membrane stretch preparations and cochlear frozen sections were examined for morphological changes in hair cells and SGNs. RESULTS At day 7, ABR wave I, III, and V latencies, and I-III, I-V interwave intervals (IWIs) in the experimental group were significantly prolonged compared with those in the control group. ABR thresholds were also elevated in the experimental group. We found no significant difference in DPOAEs in the bilirubin exposure group compared to the control group. The ABRs and DPOAEs in the experimental group were restored at age 28 days. Cochlear hair cells showed no signs of loss in either group; however, the total number of neurofilament-positive cells in SGNs was significantly reduced in the phenylhydrazine-treated animals.
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Affiliation(s)
- Qi Li
- Department of Otolaryngology, Nanjing Children's Hospital, Nanjing Medical University , Nanjing , Jiangsu
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Arnold C, Pedroza C, Tyson JE. Phototherapy in ELBW newborns: does it work? Is it safe? The evidence from randomized clinical trials. Semin Perinatol 2014; 38:452-64. [PMID: 25308614 DOI: 10.1053/j.semperi.2014.08.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Phototherapy is assumed to be both effective and safe for extremely low-birth-weight infants. Our objective was to critically assess the relevant evidence from randomized trials. In the decades-old Collaborative Phototherapy Trial, phototherapy reduced serum bilirubin but not neurodevelopmental impairments. In the recent and larger Neonatal Network Trial, aggressive phototherapy compared to conservative phototherapy reduced both peak serum bilirubin (7.0 vs. 9.8mg/dL) and profound impairment at 18-22 months adjusted age (relative risk = 0.68). However, both trials suggested that phototherapy increased deaths among the smallest infants. Conservative Bayesian analyses of ventilator-treated infants under 751g birth weight in the Network trial identified a 99% probability of increased deaths and 99% probability of reduced profound impairment with aggressive phototherapy. Potential strategies to optimize the risk/benefit ratio in achieving low serum bilirubin levels, e.g., use of lowered irradiance levels, light-emitting diode phototherapy units, cycled phototherapy, and/or porphyrin compounds, deserve rigorous evaluation.
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Affiliation(s)
- Cody Arnold
- Department of Pediatrics, Center for Clinical Research & Evidence-Based Medicine, University of Texas Health Science Center at Houston Medical School, Houston, TX.
| | - Claudia Pedroza
- Department of Pediatrics, Center for Clinical Research & Evidence-Based Medicine, University of Texas Health Science Center at Houston Medical School, Houston, TX
| | - Jon E Tyson
- Department of Pediatrics, Center for Clinical Research & Evidence-Based Medicine, University of Texas Health Science Center at Houston Medical School, Houston, TX
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93
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Hou C, Norcia AM, Madan A, Good WV. Visuocortical function in infants with a history of neonatal jaundice. Invest Ophthalmol Vis Sci 2014; 55:6443-9. [PMID: 25183760 DOI: 10.1167/iovs.14-14261] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE High concentrations of unconjugated bilirubin are neurotoxic and cause brain damage in newborn infants. However, the exact level of bilirubin that may be neurotoxic in a given infant is unknown. The aim of this study was to use a quantitative measure of neural activity, the swept parameter visual evoked potential (sVEP) to determine the relationship between neonatal bilirubin levels and visual responsivity several months later. METHODS We compared sVEP response functions over a wide range of contrast, spatial frequency, and Vernier offset sizes in 16 full-term infants with high bilirubin levels (>10 mg/dL) and 18 age-matched infants with no visible neonatal jaundice, all enrolled at 14 to 22 weeks of age. The group means of sVEP thresholds and suprathreshold response amplitudes were compared. The correlation between individual sVEP thresholds and bilirubin levels in jaundiced infants was studied. RESULTS Infants who had a history of neonatal jaundice showed lower response amplitudes (P < 0.05) and worse or immeasurable sVEP thresholds compared with control infants for all three measures (P < 0.05). Swept parameter visual evoked potential thresholds for Vernier offset were correlated with bilirubin level (P < 0.05), but spatial acuity and contrast sensitivity measures in the infants with neonatal jaundice were not (P > 0.05). CONCLUSIONS These results indicate that elevated neonatal bilirubin levels affect measures of visual function in infancy up to at least 14 to 22 weeks of postnatal age.
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Affiliation(s)
- Chuan Hou
- Smith-Kettlewell Eye Research Institute, San Francisco, California, United States
| | - Anthony M Norcia
- Department of Psychology, Stanford University, Stanford, California, United States
| | - Ashima Madan
- Stanford University School of Medicine, Pediatrics, Stanford, California, United States
| | - William V Good
- Smith-Kettlewell Eye Research Institute, San Francisco, California, United States
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94
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Bortolussi G, Baj G, Vodret S, Viviani G, Bittolo T, Muro AF. Age-dependent pattern of cerebellar susceptibility to bilirubin neurotoxicity in vivo in mice. Dis Model Mech 2014; 7:1057-68. [PMID: 25062689 PMCID: PMC4142726 DOI: 10.1242/dmm.016535] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Neonatal jaundice is caused by high levels of unconjugated bilirubin. It is usually a temporary condition caused by delayed induction of UGT1A1, which conjugates bilirubin in the liver. To reduce bilirubin levels, affected babies are exposed to phototherapy (PT), which converts toxic bilirubin into water-soluble photoisomers that are readily excreted out. However, in some cases uncontrolled hyperbilirubinemia leads to neurotoxicity. To study the mechanisms of bilirubin-induced neurological damage (BIND) in vivo, we generated a mouse model lacking the Ugt1a1 protein and, consequently, mutant mice developed jaundice as early as 36 hours after birth. The mutation was transferred into two genetic backgrounds (C57BL/6 and FVB/NJ). We exposed mutant mice to PT for different periods and analyzed the resulting phenotypes from the molecular, histological and behavioral points of view. Severity of BIND was associated with genetic background, with 50% survival of C57BL/6‑Ugt1−/− mutant mice at postnatal day 5 (P5), and of FVB/NJ-Ugt1−/− mice at P11. Life-long exposure to PT prevented cerebellar architecture alterations and rescued neuronal damage in FVB/NJ-Ugt1−/− but not in C57BL/6-Ugt1−/− mice. Survival of FVB/NJ-Ugt1−/− mice was directly related to the extent of PT treatment. PT treatment of FVB/NJ-Ugt1−/− mice from P0 to P8 did not prevent bilirubin-induced reduction in dendritic arborization and spine density of Purkinje cells. Moreover, PT treatment from P8 to P20 did not rescue BIND accumulated up to P8. However, PT treatment administered in the time-window P0–P15 was sufficient to obtain full rescue of cerebellar damage and motor impairment in FVB/NJ-Ugt1−/− mice. The possibility to modulate the severity of the phenotype by PT makes FVB/NJ-Ugt1−/− mice an excellent and versatile model to study bilirubin neurotoxicity, the role of modifier genes, alternative therapies and cerebellar development during high bilirubin conditions.
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Affiliation(s)
- Giulia Bortolussi
- International Centre for Genetic Engineering and Biotechnology (ICGEB), 34149 Trieste, Italy
| | - Gabriele Baj
- Basic Research and Integrative Neuroscience (BRAIN) Centre for Neuroscience, Department of Life Sciences, University of Trieste, 34127 Trieste, Italy
| | - Simone Vodret
- International Centre for Genetic Engineering and Biotechnology (ICGEB), 34149 Trieste, Italy
| | - Giulia Viviani
- International Centre for Genetic Engineering and Biotechnology (ICGEB), 34149 Trieste, Italy
| | - Tamara Bittolo
- Basic Research and Integrative Neuroscience (BRAIN) Centre for Neuroscience, Department of Life Sciences, University of Trieste, 34127 Trieste, Italy
| | - Andrés F Muro
- International Centre for Genetic Engineering and Biotechnology (ICGEB), 34149 Trieste, Italy
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95
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Aleman M, Madigan JE, Williams DC, Holliday TA. Brainstem auditory evoked responses in an equine patient population. Part II: foals. J Vet Intern Med 2014; 28:1318-24. [PMID: 24903742 PMCID: PMC4857935 DOI: 10.1111/jvim.12377] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 04/04/2014] [Accepted: 04/22/2014] [Indexed: 11/28/2022] Open
Abstract
Background Reports of the use of brainstem auditory evoked response (BAER) as a diagnostic modality in foals have been limited. Hypothesis/Objectives To describe BAER findings and associated causes of hearing loss in foals. Animals Study group 18 foals (15 neonatal, 3 nonneonatal), control group (5 neonatal foals). Methods Retrospective. BAER records from the Clinical Neurophysiology Laboratory were reviewed from the years of 1982 to 2013. Peak latencies, amplitudes, and interpeak intervals were measured when visible. Clinical data were extracted from the medical records. Foals were grouped under disease categories. Descriptive statistics were performed. Results Ten neonatal foals had complete absence of BAER bilaterally and 5 had findings within reference range. Abnormalities were associated with common neonatal disorders such as sepsis, neonatal encephalopathy, neonatal isoerythrolysis, and prematurity. BAER loss also was observed in foals with specific coat color patterns such as completely or mostly white with blue irides or lavender with pale yellow irides. An American Miniature foal with marked facial deformation also lacked BAER bilaterally. One nonneonatal foal with an intracranial abscess had no detectable BAER peaks bilaterally, and 2 older foals, 1 with presumed equine protozoal myeloencephalitis and the other with progressive scoliosis and ataxia, had BAER within normal limits. Conclusions and Clinical Importance In neonatal foals, BAER deficits commonly are complete and bilateral, and associated with common neonatal disorders and certain coat and eye color patterns. Sepsis, hypoxia, bilirubin toxicity, and prematurity should be investigated as potential causes of auditory loss in neonatal foals.
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Affiliation(s)
- M Aleman
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA
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96
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Simultaneous determination of bilirubin and its glucuronides in liver microsomes and recombinant UGT1A1 enzyme incubation systems by HPLC method and its application to bilirubin glucuronidation studies. J Pharm Biomed Anal 2014; 92:149-59. [DOI: 10.1016/j.jpba.2014.01.025] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 01/17/2014] [Accepted: 01/18/2014] [Indexed: 12/22/2022]
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97
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Hokkanen L, Launes J, Michelsson K. Adult neurobehavioral outcome of hyperbilirubinemia in full term neonates-a 30 year prospective follow-up study. PeerJ 2014; 2:e294. [PMID: 24688870 PMCID: PMC3961148 DOI: 10.7717/peerj.294] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 02/07/2014] [Indexed: 11/20/2022] Open
Abstract
Background. Neonatal hyperbilirubinemia (HB) may cause severe neurological damage, but serious consequences are effectively controlled by phototherapy and blood exchange transfusion. HB is still a serious health problem in economically compromised parts of the world. The long term outcome has been regarded favorable based on epidemiological data, but has not been confirmed in prospective follow-up studies extending to adulthood. Methods. We studied the long term consequences of HB in a prospective birth cohort of 128 HB cases and 82 controls. The cases are part of a neonatal at-risk cohort (n = 1196) that has been followed up to 30 years of age. HB cases were newborns ≥ 2500 g birth weight and ≥ 37 weeks of gestation who had bilirubin concentrations > 340 µmol/l or required blood exchange transfusion. Subjects with HB were divided into subgroups based on the presence (affected HB) or absence (unaffected HB) of diagnosed neurobehavioral disorders in childhood, and compared with healthy controls. Subjects were seen at discharge, 5, 9 and 16 years of life and parent’s and teacher’s assessments were recorded. At 30 years they filled a questionnaire about academic and occupational achievement, life satisfaction, somatic and psychiatric symptoms including a ADHD self-rating score. Cognitive functioning was tested using ITPA, WISC, and reading and writing tests at 9 years of life. Results. Compared to controls, the odds for a child with HB having neurobehavioral symptoms at 9 years was elevated (OR = 4.68). Forty-five per cent of the HB group were affected by cognitive abnormalities in childhood and continued to experience problems in adulthood. This was apparent in academic achievement (p < 0.0001) and the ability to complete secondary (p < 0.0001) and tertiary (p < 0.004) education. Also, the subgroup of affected HB reported persisting cognitive complaints e.g., problems with reading, writing and mathematics. Childhood symptoms of hyperactivity/impulsivity (p < 0.0001) and inattention (p < 0.02) were more common in HB groups, but in adulthood the symptoms were equal. The affected HB had lower scores in parameters reflecting life satisfaction, less controlled drinking, but not increased substance abuse. Discussion. Our results indicate that neonatal HB has negative consequences in adult age. A prospectively collected cohort with strict inclusion criteria enables to control most of the bias factors involved with retrospective data. The control and HB groups were remarkably similar at birth in terms of medical data, and the growth environment of the children, as well as the parents’ social groups, education, size of family, type of housing at birth and at 9 years of age. Our findings bear resemblance to disorders of the fronto-striatal network, and also symptoms of the ADHD spectrum were frequent in the HB group suggesting a link of HB to other neurodevelopmental disorders.
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Affiliation(s)
- Laura Hokkanen
- Institute of Behavioural Sciences, University of Helsinki , Helsinki , Finland
| | - Jyrki Launes
- Institute of Behavioural Sciences, University of Helsinki , Helsinki , Finland
| | - Katarina Michelsson
- Institute of Behavioural Sciences, University of Helsinki , Helsinki , Finland
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98
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Jiang ZD, Liu TT, Chen C. Brainstem auditory electrophysiology is supressed in term neonates with hyperbilirubinemia. Eur J Paediatr Neurol 2014; 18:193-200. [PMID: 24309481 DOI: 10.1016/j.ejpn.2013.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 11/05/2013] [Accepted: 11/08/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Whether hyperbilirubinemia suppresses electrophysiological activity of the neonatal auditory brainstem remains to be investigated. AIM To determine whether hyperbilirubinemia suppresses the brainstem auditory electrophysiology in term neonates. METHODS Maximum length sequence brainstem auditory evoked response (MLS BAER) was recorded shortly after confirming hyperbilirubinemia in 58 term neonates. Wave amplitudes of the response were analyzed in detail. RESULTS Compared with age-matched term controls, the neonates with hyperbilirubinemia showed a significant reduction in the amplitudes of MLS BAER waves III and particularly V at all click rates 91-910/s. The reduction tended to be more significant at higher than lower rates. Wave I amplitude was reduced at 910/s. V/I amplitude ratio was decreased at all click rates. Therefore, the amplitudes of MLS BAER, particularly later, waves were all reduced. The amplitudes of all MLS BAER waves tended to be reduced with the increase in total serum bilirubin level. All wave amplitudes were correlated with the level of total serum bilirubin at some or most click rates. CONCLUSIONS Brainstem auditory electrophysiology is suppressed in neonates with hyperbilirubinemia, which related to the severity of hyperbilirubinemia. Wave amplitudes are valuable BAER variables to detect functional impairment of the brainstem and auditory pathway in neonatal hyperbilirubinemia, and are recommended to be used in assessing bilirubin neurotoxicity to the neonatal brain.
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Affiliation(s)
- Ze D Jiang
- Division of Neonatology, Children's Hospital, Fudan University, Shanghai, China.
| | - T T Liu
- Division of Neonatology, Children's Hospital, Fudan University, Shanghai, China
| | - Cao Chen
- Division of Neonatology, Children's Hospital, Fudan University, Shanghai, China
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99
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Impaired function of the auditory brainstem in term neonates with hyperbilirubinemia. Brain Dev 2014; 36:212-8. [PMID: 23587715 DOI: 10.1016/j.braindev.2013.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 03/09/2013] [Accepted: 03/13/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We studied maximum length sequence brainstem auditory evoked response in term neonates with hyperbilirubinemia to further our understanding of hyperbilirubinemia on the neonatal auditory brainstem and to determine if maximum length sequence technique improves detection of brainstem auditory impairment due to bilirubin neurotoxicity. METHODS Maximum length sequence brainstem auditory evoked response was recorded and analysed shortly after confirming total serum bilirubin levels greater than 15mg/dL in fifty-seven term neonates with hyperbilirubinemia. RESULTS Most wave latencies and interpeak intervals in maximum length sequence brainstem auditory evoked response in the neonates with hyperbilirubinemia were correlated with the level of total serum bilirubin at some or most click rates used. Compared with age-matched normal term controls, wave V latency in these neonates was increased significantly at all 91-910/s click rates (p<0.05-0.001). The I-V and I-III interpeak intervals were also increased significantly at all these rates, and the III-V interval increased at 227-910/s clicks (p<0.05-0.001). The differences between the neonates with hyperbilirubinemia and the controls were more significant at higher than at lower click rates. The slopes of wave V latency-rate function and I-V and III-V interval-rate functions were all significantly increased. By comparison, the abnormalities in conventional BAER were less significant, with only I-III and I-V intervals were increased (both p<0.05). CONCLUSIONS Functional status of the auditory brainstem is impaired in neonatal hyperbilirubinemia. Maximum length sequence technique at high click rates improves detection of bilirubin neurotoxicity to the neonatal auditory brainstem, particularly for the more rostral regions.
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100
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Acute histologic chorioamnionitis is a risk factor for adverse neonatal outcome in late preterm birth after preterm premature rupture of membranes. PLoS One 2013; 8:e79941. [PMID: 24324586 PMCID: PMC3851174 DOI: 10.1371/journal.pone.0079941] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 09/30/2013] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The objective of this study was to determine whether acute histologic chorioamnionitis is associated with adverse neonatal outcomes in late preterm infants who were born after preterm PROM. METHODOLOGY/PRINCIPAL FINDINGS The relationship between the presence of acute histologic chorioamnionitis and adverse neonatal outcome was examined in patients with preterm PROM who delivered singleton preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Nonparametric statistics were used for data analysis. The frequency of acute histologic chorioamnionitis was 24% in patients with preterm PROM who delivered preterm newborns between 34 weeks and 36 6/7 weeks of gestation. Newborns born to mothers with histologic chorioamnionitis had significantly higher rates of adverse neonatal outcome (74% vs 51%; p<0.005) than those without histologic chorioamnionitis. This relationship remained significant after adjustment for gestational age at preterm PROM, gestational age at delivery, and exposure to antenatal corticosteroids. CONCLUSIONS/SIGNIFICANCE The presence of acute histologic chorioamnionitis is associated with adverse neonatal outcome in late preterm infants born to mothers with preterm PROM.
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