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Wang J, Guo G, Li A, Cai WQ, Wang X. Challenges of phototherapy for neonatal hyperbilirubinemia (Review). Exp Ther Med 2021; 21:231. [PMID: 33613704 PMCID: PMC7859475 DOI: 10.3892/etm.2021.9662] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/22/2020] [Indexed: 12/18/2022] Open
Abstract
Phototherapy is universally recognized as the first option for treating neonatal jaundice due to its unparalleled efficiency and safety in reducing the high serum free bilirubin levels and limiting its neurotoxic effects. However, several studies have suggested that phototherapy may elicit a series of short- and long-term adverse reactions associated with pediatric diseases, including hemolysis, allergic diseases, DNA damage or even cancer. The aim of the present review was to summarize the etiology, mechanism, associated risks and therapeutic strategies for reducing high neonatal serum bilirubin levels. In order to shed light on the negative effects of phototherapy and to encourage implementation of a reasonable and standardized phototherapy scheme in the clinic, the present review sought to highlight the current understanding of the adverse reactions of phototherapy, as it is necessary to further study the mechanism underlying the development of the adverse effects of phototherapy in infants in order to explore novel therapeutic alternatives.
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Affiliation(s)
- Juan Wang
- Department of Biochemistry and Molecular Biology, Health Science Center, Yangtze University, Jingzhou, Hubei 434023, P.R. China.,Department of Pediatrics, The Second School of Clinical Medicine and Jingzhou Central Hospital, Yangtze University, Jingzhou, Hubei 434023, P.R. China
| | - Genxin Guo
- Department of Thoracic Surgery, Xiantao First People's Hospital of Yangtze University, Xiantao, Hubei 433000, P.R. China
| | - Aimin Li
- Department of Pediatrics, The Second School of Clinical Medicine and Jingzhou Central Hospital, Yangtze University, Jingzhou, Hubei 434023, P.R. China
| | - Wen-Qi Cai
- Department of Biochemistry and Molecular Biology, Health Science Center, Yangtze University, Jingzhou, Hubei 434023, P.R. China
| | - Xianwang Wang
- Department of Biochemistry and Molecular Biology, Health Science Center, Yangtze University, Jingzhou, Hubei 434023, P.R. China
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Ouyang X, Yang J, Hong Z, Wu Y, Xie Y, Wang G. Mechanisms of blue light-induced eye hazard and protective measures: a review. Biomed Pharmacother 2020; 130:110577. [PMID: 32763817 DOI: 10.1016/j.biopha.2020.110577] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/23/2020] [Accepted: 07/26/2020] [Indexed: 12/22/2022] Open
Abstract
The risk of blue light exposure to human health has attracted increased research attention. Blue light, with relatively high energy, can cause irreversible photochemical damage to eye tissue. Excessive exposure of the eye to blue light tends to cause a series of alterations, such as oxidative stress, mitochondrial apoptosis, inflammatory apoptosis, mitochondrial apoptosis and DNA damage, resulting in the development of dry eye disease, glaucoma, and keratitis. Accordingly, physical protection, chemical and pharmaceutical protective measures, gene therapy, and other methods are widely used in the clinical treatment of blue light hazard. We reviewed the studies on possible blue light-induced signaling pathways and mechanisms in the eye and summarized the therapeutic approaches to addressing blue light hazard.
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Affiliation(s)
- Xinli Ouyang
- Key Laboratory of Biological Medicines in Universities of Shandong Province, Weifang Medical University, Weifang, 261053, China
| | - Jing Yang
- Key Laboratory of Biological Medicines in Universities of Shandong Province, Weifang Medical University, Weifang, 261053, China
| | - Zexin Hong
- Key Laboratory of Biological Medicines in Universities of Shandong Province, Weifang Medical University, Weifang, 261053, China
| | - Yide Wu
- Key Laboratory of Biological Medicines in Universities of Shandong Province, Weifang Medical University, Weifang, 261053, China
| | - Yongfang Xie
- Key Laboratory of Biological Medicines in Universities of Shandong Province, Weifang Medical University, Weifang, 261053, China.
| | - Guohui Wang
- Key Laboratory of Biological Medicines in Universities of Shandong Province, Weifang Medical University, Weifang, 261053, China.
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Jiao Y, Jin Y, Meng H, Wen M. An analysis on treatment effect of blue light phototherapy combined with Bifico in treating neonatal hemolytic jaundice. Exp Ther Med 2018; 16:1360-1364. [PMID: 30112064 PMCID: PMC6090439 DOI: 10.3892/etm.2018.6340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 06/13/2018] [Indexed: 11/19/2022] Open
Abstract
This study aimed to discuss and evaluate the clinical effect of blue light phototherapy combined with bifico in treating neonatal hemolytic jaundice. One hundred and twenty cases with neonatal hemolytic jaundice were randomly divided into treatment group and control group, 60 cases in each group. Neonatal patients in the control group were treated with traditional treatment, including administration of enzyme inducer phenobarbital and blue light phototherapy for 8 consecutive hours every day. Neonatal patients in the treatment group received bifico orally based on traditional treatment. Clinical effects of the two groups were observed after one course of treatment (7 days as one course). During the first course, serum bilirubin level in the treatment group treated with blue light phototherapy combined with bifico declined more rapidly (P<0.01) and more significantly (P<0.01) than that in the control group, and the mean time for eliminating jaundice was significantly reduced (P<0.05). The total effective rate was 91.67% in the treatment group, while that was 85.00% in the control group, which suggested that the treatment effect of the treatment group was better than that of the control group and the difference between the two groups was statistically significant (P<0.05). Compared with traditional treatment, the treatment effect of blue light phototherapy combined with bifico in treating neonatal hemolytic jaundice is significantly improved and the speed of eliminating jaundice is also higher. Thus, it is worthy to be applied in clinical practice.
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Affiliation(s)
- Yan Jiao
- Department of Neonatology, People's Hospital of Rizhao, Rizhao, Shandong 276826, P.R. China
| | - Yuting Jin
- Department of Neonatology, People's Hospital of Rizhao, Rizhao, Shandong 276826, P.R. China
| | - Huanhuan Meng
- Department of Neonatology, People's Hospital of Rizhao, Rizhao, Shandong 276826, P.R. China
| | - Meizhang Wen
- Department of Neonatology, People's Hospital of Rizhao, Rizhao, Shandong 276826, P.R. China
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Zhang M, Wang L, Wang Y, Tang J. The influence of massage on neonatal hyperbilirubinemia: a meta-analysis of randomized controlled trials. J Matern Fetal Neonatal Med 2018; 32:3109-3114. [PMID: 29631455 DOI: 10.1080/14767058.2018.1455183] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Introduction: The efficacy of massage to treat neonatal hyperbilirubinemia remains controversial. We conducted a systematic review and meta-analysis to explore the influence of massage on the neonatal hyperbilirubinemia. Methods: We search PubMed, Embase, Web of science, EBSCO, and Cochrane Library databases through November 2017 for randomized controlled trials (RCTs) assessing the effect of massage on neonatal hyperbilirubinemia. This meta-analysis is performed using the random-effect model. Results: Six RCTs involving 357 patients are included in the meta-analysis. Overall, compared with the control group in neonatal hyperbilirubinemia, massage therapy is associated with substantially reduced serum bilirubin level within 4 d (mean difference (MD) = -2.31; 95% CI = -2.92 to -1.70; p < .00001) and transcutaneous bilirubin level within 4 d for neonatal hyperbilirubinemia (MD = -1.97; 95% CI = -2.55 to -1.39; p < .00001), but results no remarkable impact on serum bilirubin level on 2 d (MD = -0.82; 95% CI = -2.16-0.52; p = .23), transcutaneous bilirubin level on 2 d (MD = -0.17; 95% CI = -1.34 to 1.00; p = .77), frequency of defecation daily on 2 d (MD = 0.57; 95% CI = -0.03 to 1.16; p = .06), and frequency of defecation daily within 4 d (MD = 0.83; 95% CI = -0.11 to 1.76; p = .08). Conclusions: Massage therapy can significantly reduce serum bilirubin level and transcutaneous bilirubin level within 4 d, but demonstrates no influence on serum bilirubin level and transcutaneous bilirubin level on 2 d, frequency of defecation daily on 2 and 4 d for neonatal hyperbilirubinemia.
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Affiliation(s)
- Min Zhang
- a Department of Pediatrics , The First Affiliated Hospital of Anhui Medical University , Hefei , Anhui , China
| | - Lili Wang
- a Department of Pediatrics , The First Affiliated Hospital of Anhui Medical University , Hefei , Anhui , China
| | - Yang Wang
- a Department of Pediatrics , The First Affiliated Hospital of Anhui Medical University , Hefei , Anhui , China
| | - Jiulai Tang
- a Department of Pediatrics , The First Affiliated Hospital of Anhui Medical University , Hefei , Anhui , China
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Ma K, Yao D, Chen J, Li Y, Zhao C, Liang G. Molecular synergistic strategy to fabricate bilirubin medical adsorbent material for hyperbilirubinemia hemoperfusion. INT J POLYM MATER PO 2017. [DOI: 10.1080/00914037.2017.1376198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Kaiwang Ma
- School of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, P. R. China
| | - Dahu Yao
- College of Chemical Engineering and Pharmaceutics, Henan University of Science and Technology, Luoyang, P. R. China
| | - Junping Chen
- School of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, P. R. China
| | - Yang Li
- School of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, P. R. China
| | - Chonggao Zhao
- The First Affiliated Hospital, Henan University of Science and Technology, Luoyang, P. R. China
| | - Gaofeng Liang
- School of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, P. R. China
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Ma KW, Yao DH, Li Y, Li GD, Cherukury H, Jing AH, Liang GF. Synergistic effects of polymer adsorbents on the performance of bilirubin hemoperfusion. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2017; 28:2053-2065. [PMID: 28859538 DOI: 10.1080/09205063.2017.1370300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Neonatal hyperbilirubinemia (jaundice) is a common disease with high incidence. Currently, the clinical inefficiency of adult bilirubin hemoperfusion medical adsorbent is a major technical barrier for the application of hemoperfusion treatment to rescue the severe neonatal jaundice. Based on the well-known principle of synergistic effects, a series of customized bilirubin polymeric compounds, comprised of one or more of the following components (glycidyl methacrylate, sodium acrylate, methacrylic acid isooctyl, hexamethylene diamine, albumin), were designed and fabricated based on molecular design. Their adsorption performances upon bilirubin were investigated and compared under the same conditions, and the compound with the highest adsorption performance was then subject to preliliminary safety assessments and compared with a commercial one (BS330). The results showed that positive synergistic effects appeared on the adsorption performance to adsorb bilirubin based on this study, and the one comprised of glycidyl methacrylate+sodium acrylate+methacrylic acid isoocty+hexamethylene diamine+albumin possesses the highest adsorption performance as well as outome clinical acceptable medical safety assessments, and its adsorption efficiency was up to 46% while the commerical one's was about 26% under the same conditions. This study sheds a new light on how to design and develop hemoperfusion bilirubin adsorbents with good overall clinical performance, as well as providing a novel idea and experimental referrences for future related topics.
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Affiliation(s)
- Kai-Wang Ma
- a School of Medical Technology & Engineering , Henan University of Science & Technology , Luoyang , P. R. China
| | - Da-Hu Yao
- b College of Chemical Engineering & Pharmaceutics , Henan University of Science & Technology , Luoyang , P. R. China
| | - Yang Li
- a School of Medical Technology & Engineering , Henan University of Science & Technology , Luoyang , P. R. China
| | - Guang-da Li
- a School of Medical Technology & Engineering , Henan University of Science & Technology , Luoyang , P. R. China
| | - Hemanth Cherukury
- c Department of Pharmaceutical Sciences , University of California-Irvine , Irvine , CA , USA
| | - Ai-Hua Jing
- a School of Medical Technology & Engineering , Henan University of Science & Technology , Luoyang , P. R. China
| | - Gao-Feng Liang
- a School of Medical Technology & Engineering , Henan University of Science & Technology , Luoyang , P. R. China
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Banda C. Transport of neonates with severe jaundice on phototherapy: Implications for regional areas. J Paediatr Child Health 2016; 52:785. [PMID: 27439646 DOI: 10.1111/jpc.13196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 01/15/2016] [Accepted: 02/01/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Clever Banda
- University of Queensland Hervey Bay Rural Clinical School, Hervey Bay Hospital, Urraween, Queensland, Australia
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Bellini C, Risso FM. Phototherapy in transport for neonates with unconjugated hyperbilirubinaemia. J Paediatr Child Health 2016; 52:356. [PMID: 27124857 DOI: 10.1111/jpc.13130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 11/26/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Carlo Bellini
- Neonatal Intensive Care Unit, Neonatal Emergency Transport Service, IRCCS Gaslini Institute, Genoa, Italy
| | - Francesco Maria Risso
- Neonatal Intensive Care Unit, Neonatal Emergency Transport Service, IRCCS Gaslini Institute, Genoa, Italy
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