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Gao Y, Ling Y, Li J, Xu Y, Ge J, Xia Q. Neuropathological implication of high blood bilirubin in patients and model rats with depression. Brain Res Bull 2024; 215:111028. [PMID: 38992775 DOI: 10.1016/j.brainresbull.2024.111028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 07/02/2024] [Accepted: 07/04/2024] [Indexed: 07/13/2024]
Abstract
PURPOSE Elevated bilirubin levels have been associated with major depressive disorder (MDD); however, the exact impact of bilirubin on MDD and the underlying molecular mechanisms remain unclear. Here, we explored the influence of bilirubin on MDD and sought to identify the mechanisms via which bilirubin induces depressive-like behavior. PATIENTS AND METHODS Forty patients who were diagnosed with MDD and received treatment with selective serotonin reuptake inhibitors (SSRIs) were included, with 43 healthy volunteers serving as controls. Clinical symptoms were evaluated using Hamilton depression rating scale-24 (HAMD-24) and the Hamilton anxiety rating scale. Serum concentrations of total bilirubin (TBIL) and indirect bilirubin (IBIL) were measured at baseline and after treatment using an automated biochemical analyzer. The connection between clinical symptoms and TBIL or IBIL was examined using Pearson correlation. Chronic restraint stress (CRS) was employed to generate a rat model of depression. TBIL, IBIL in rat serum were measured by ELISA. Reactive oxygen species (ROS) contents in rat hippocampal tissues were quantified by flow cytometry. The levels of microglial markers and the extent of neuronal damage in the rat hippocampus were assessed by immunofluorescence and transmission electron microscopy, respectively. RESULTS Serum TBIL and IBIL levels were higher in patients with MDD than in the healthy controls. After treatment with SSRIs, the serum levels of TBIL and IBIL in MDD patients were significantly reduced. The levels of TBIL and IBIL were associated with HAMD-24 in MDD patients. Compared with the controls, the serum levels of TBIL, IBIL and the hippocampal ROS contents were elevated in CRS-exposed rats. Fluoxetine lowered inflammatory factor levels, mitigated oxidative stress. CONCLUSION Our findings indicate a possible correlation between elevated serum bilirubin and depressive symptoms. Increases in ROS levels, along with neuronal damage, may represent pathological mechanisms underlying MDD.
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Affiliation(s)
- Yejun Gao
- School of Pharmacy, Anhui Medical University, Hefei, China; Affiliated Psychological Hospital of Anhui Medical University, Hefei, China; Hefei Fourth People's Hospital, Hefei, China; Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, China; Anhui Clinical Research Center for Mental Disorders, Hefei, China; Anhui Mental Health Center, Hefei, China.
| | - Yian Ling
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China; Hefei Fourth People's Hospital, Hefei, China; Anhui Mental Health Center, Hefei, China.
| | - Jing Li
- School of Pharmacy, Anhui Medical University, Hefei, China; Affiliated Psychological Hospital of Anhui Medical University, Hefei, China; Hefei Fourth People's Hospital, Hefei, China; Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, China; Anhui Clinical Research Center for Mental Disorders, Hefei, China; Anhui Mental Health Center, Hefei, China.
| | - Yayun Xu
- School of Pharmacy, Anhui Medical University, Hefei, China; Affiliated Psychological Hospital of Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Institute of Innovative Drugs, Hefei, China; The Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Medical University, Hefei, China.
| | - Jinfang Ge
- School of Pharmacy, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Institute of Innovative Drugs, Hefei, China; The Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Medical University, Hefei, China.
| | - Qingrong Xia
- School of Pharmacy, Anhui Medical University, Hefei, China; Affiliated Psychological Hospital of Anhui Medical University, Hefei, China; Hefei Fourth People's Hospital, Hefei, China; Psychopharmacology Research Laboratory, Anhui Mental Health Center, Hefei, China; Anhui Clinical Research Center for Mental Disorders, Hefei, China; Anhui Mental Health Center, Hefei, China.
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Gemuhay HM, Ali S, Kibusi S. Experiences and Challenges of Mothers in Caring for Infants with Delayed Developmental Milestones: A Case of Dodoma Region, Tanzania. East Afr Health Res J 2024; 8:86-98. [PMID: 39234343 PMCID: PMC11371068 DOI: 10.24248/eahrj.v8i1.753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 02/20/2024] [Indexed: 09/06/2024] Open
Abstract
Background Delayed Developmental Milestones is a physical disability affecting the child development, occurs when the child fails to attain normal milestones compared to other children. Globally, 180-200 million infants have signs of developmental delay, and 86% are from developing countries. In Dar es Salaam, proportion of children with cognitive delay is 12.3%. Objectives This study explored the experiences and challenges of mothers in caring for infants with delayed developmental milestones. Methods In-depth interviews with ten mothers explored their experiences and identified challenges they encountered while caring for infants with delayed developmental milestones. NVIVO plus software was used for content analysis. Results Results showed that parents raising infants with delayed developmental milestones had negative experiences on the cause and types of delayed milestones. They lost hope. They were facing different challenges like lack of specialists, conflict in marriage and stigma. Conclusion Mothers of infants with delayed developmental milestones had negative experiences about this problem and they face many challenges in caring the infants.
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Affiliation(s)
| | - Saada Ali
- Department of Clinical Nursing, School of Nursing and Public Health
| | - Stephen Kibusi
- Department of Public Health, School of Nursing and Public Health, University of Dodoma, Dodoma, Tanzania
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Guzelkaya M, Onal E, Gelinci E, Kumral A, Cakan-Akdogan G. A zebrafish model for studying the mechanisms of newborn hyperbilirubinemia and bilirubin-induced neurological damage. Front Cell Dev Biol 2023; 11:1275414. [PMID: 38033855 PMCID: PMC10682072 DOI: 10.3389/fcell.2023.1275414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/26/2023] [Indexed: 12/02/2023] Open
Abstract
Unresolved neonatal hyperbilirubinemia may lead to the accumulation of excess bilirubin in the body, and bilirubin in neural tissues may induce toxicity. Bilirubin-induced neurological damage (BIND) can result in acute or chronic bilirubin encephalopathy, causing temporary or lasting neurological dysfunction or severe damage resulting in infant death. Although serum bilirubin levels are used as an indication of severity, known and unknown individual differences affect the severity of the symptoms. The mechanisms of BIND are not yet fully understood. Here, a zebrafish newborn hyperbilirubinemia model is developed and characterized. Direct exposure to excess bilirubin induced dose- and time-dependent toxicity linked to the accumulation of bilirubin in the body and brain. Introduced bilirubin was processed by the liver, which increased the tolerance of larvae. BIND in larvae was demonstrated by morphometric measurements, histopathological analyses and functional tests. The larvae that survived hyperbilirubinemia displayed mild or severe morphologies associated with defects in eye movements, body posture and swimming problems. Interestingly, a plethora of mild to severe clinical symptoms were reproduced in the zebrafish model.
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Affiliation(s)
| | - Ebru Onal
- Izmir Biomedicine and Genome Center, Izmir, Turkiye
- Institute of Health Sciences, Dokuz Eylül University, Izmir, Turkiye
| | | | - Abdullah Kumral
- Izmir Biomedicine and Genome Center, Izmir, Turkiye
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkiye
| | - Gulcin Cakan-Akdogan
- Izmir Biomedicine and Genome Center, Izmir, Turkiye
- Department of Medical Biology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkiye
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Alfaifi JA, Alqahtani YA, Alqahtani MM, Alqarni A, Alshahrani A, Alshomrani RA. Knowledge and Attitudes of Parents Regarding Neonatal Jaundice in Bisha City, Saudi Arabia. Cureus 2023; 15:e44916. [PMID: 37814740 PMCID: PMC10560542 DOI: 10.7759/cureus.44916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 10/11/2023] Open
Abstract
Background Neonatal jaundice (NNJ) is one of the most common neonatal illnesses around the world. It continues to be a leading cause of avoidable brain damage, physical and mental impairment, and death in neonates. Neonatal morbidity due to NNJ has a significant impact and cost on families and healthcare resources. The majority of instances are addressed without intervention, but others require assessment and assistance in the form of follow-up or treatment. Inadequate family awareness and understanding of this frequent newborn condition can contribute to delays and difficulties. Aim This study aimed to assess the knowledge and attitudes of parents regarding NNJ in Bisha City, Saudi Arabia. Methodology A cross-sectional study involving 242 participants was carried out. Data were collected using an online questionnaire. The knowledge score differences between groups were analyzed using a Wilcoxon rank sum test and the Kruskal-Wallis rank test. Results In this study of 242 participants from Bisha, we found that the majority were female (155, 64.0%), employed (129, 53.3%), and held a postgraduate degree (150, 62.0%). Regarding knowledge of NNJ, 109 (45.0%) have correctly defined it as yellow pigmentation in the sclera and 64 (26.4%) as yellow pigmentation of the skin. Of most participants, 132 (54.5%) recognized that NNJ could cause complications, but 53 (40.2%) of these were unaware of what these complications might be. Notably, only 89 (36.8%) of respondents believed they had sufficient knowledge about NNJ. The median knowledge score was 3.0 (IQR, 1.0-4.0), and higher scores were significantly associated with being female and reporting sufficient knowledge about the disease. Strategies suggested for improving awareness included campaigns (98, 40.5%) and social networking programs (81, 33.5%). The data suggest a need for enhanced public education regarding NNJ. Conclusion The study highlights the need for increased awareness and education among parents in Bisha, Saudi Arabia, about NNJ. The findings suggest that campaigns and social networking programs could effectively educate people about the condition. Additionally, the study provides insights into the factors associated with higher knowledge scores, such as gender and having a child with NNJ. The results of this study may help healthcare professionals develop effective educational programs and interventions to improve parents' knowledge and attitudes toward NNJ.
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Affiliation(s)
| | | | | | - Anas Alqarni
- College of Medicine, University of Bisha, Bisha, SAU
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Magai DN, Mwaniki M, Abubakar A, Mohammed S, Gordon AL, Kalu R, Mwangi P, Koot HM, Newton CR. Neonatal jaundice and developmental impairment among infants in Kilifi, Kenya. Child Care Health Dev 2020; 46:336-344. [PMID: 31978271 PMCID: PMC7187241 DOI: 10.1111/cch.12750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 01/07/2020] [Accepted: 01/19/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Neonatal jaundice (NNJ) is common in sub-Saharan Africa (SSA), and it is associated with sepsis. Despite the high incidence, little has been documented about developmental impairments associated with NNJ in SSA. In particular, it is not clear if sepsis is associated with greater impairment following NNJ. METHODS We followed up 169 participants aged 12 months (57 cases and 112 controls) within the Kilifi Health Demographic Surveillance System. The diagnosis of NNJ was based on clinical laboratory measurement of total serum bilirubin on admission, whereas the developmental outcomes were assessed using the Developmental Milestones Checklist and Kilifi Development Inventory. RESULTS There were significant differences between the cases and controls in all developmental domains. Cases scored lower in language functioning (mean [M] = 6.5, standard deviation [SD] = 4.3 vs. M = 8.9, SD = 4.6; p < .001); psychomotor functioning (Mdn = 23, interquartile range [IQR] = 17-34 vs. Mdn = 31.0, IQR = 22.0-44.0; Mann-Whitney U = 4,122, p = .002); and socio-emotional functioning ([Mdn = 30.0, IQR = 27.0-33.0 vs. Mdn = 34.0, IQR = 30.0-37.0], Mann-Whitney U = 4,289, p < .001). There was no evidence of association between sepsis and psychomotor (rpb = -.2, p = .214), language (rpb = -.1, p = .510), and socio-emotional functioning (rpb = .0, p = .916). Significant and medium to large portions of the variance (34-64%) in the developmental outcomes among children who survived NNJ were associated with home birth, low maternal education, and feeding problems during the first days of life. CONCLUSIONS NNJ is associated with developmental impairments in the early childhood years; however, NNJ associated with sepsis does not lead to more severe impairment. Prenatal and postnatal care services are needed to reduce the negative impact of NNJ for children from low resourced settings.
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Affiliation(s)
- Dorcas N. Magai
- Centre for Geographic Medicine Research CoastKenya Medical Research InstituteKilifiKenya,Department of Clinical, Neuro‐ and Developmental Psychology, Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Michael Mwaniki
- Centre for Geographic Medicine Research CoastKenya Medical Research InstituteKilifiKenya,Department of Clinical Research, Public Health Outcomes and EvaluationAfya Research AfricaNairobiKenya
| | - Amina Abubakar
- Centre for Geographic Medicine Research CoastKenya Medical Research InstituteKilifiKenya,Department of Public HealthPwani UniversityKilifiKenya,Institute for Human DevelopmentThe Aga Khan UniversityNairobiKenya,Department of PsychiatryUniversity of OxfordOxfordUK
| | - Shebe Mohammed
- Centre for Geographic Medicine Research CoastKenya Medical Research InstituteKilifiKenya
| | - Anne L. Gordon
- Faculty of Life Sciences and MedicineKing's College LondonLondonUK
| | - Raphael Kalu
- Centre for Geographic Medicine Research CoastKenya Medical Research InstituteKilifiKenya
| | - Paul Mwangi
- Centre for Geographic Medicine Research CoastKenya Medical Research InstituteKilifiKenya
| | - Hans M. Koot
- Department of Clinical, Neuro‐ and Developmental Psychology, Public Health Research InstituteVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Charles R. Newton
- Centre for Geographic Medicine Research CoastKenya Medical Research InstituteKilifiKenya,Department of Public HealthPwani UniversityKilifiKenya,Department of PsychiatryUniversity of OxfordOxfordUK
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