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Gou ZX, Zhou Y, Fan Y, Zhang F, Ning XM, Tang F, Lu LQ. Melatonin Improves Oxidative Stress Injury in Retinopathy of Prematurity by Targeting miR-23a-3p/Nrf2. Curr Eye Res 2024:1-13. [PMID: 39103986 DOI: 10.1080/02713683.2024.2380433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 06/13/2024] [Accepted: 07/10/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE Melatonin has promising protective effects for retinopathy. However, its roles in retinopathy of prematurity (ROP) and the underlying mechanisms remain unknown. We aimed to explore its roles and mechanisms in a ROP model. METHODS Hematoxylin and eosin staining were used to observe the morphology of the retina. Immunofluorescence was used to detect positive (Nrf2+ and VEGF+) cells. Immunohistochemistry was used to detect the level of nuclear expression of PCNA in retinal tissue. Transmission electron microscope (TEM) was used to observe the morphology and structure of pigment cells. qRT-PCR was used to assay the expression of miR-23a-3p, Nrf2, and HO-1. Western blotting was used to detect the expression of Nrf2, HO-1, β-actin, and Lamin B1. RESULTS Melatonin or miR-23a-3p antagomir treatment could ameliorate the Oxygen-induced pathological changes, increased the expression of Nrf2 and HO-1, SOD, and GSH-Px, and decreased the expression of VEGF, miR-23a-3p, MDA and the apoptosis in the ROP model. Further target prediction and luciferase reporter assays confirmed the targeted binding relationship between miR-23a-3p and Nrf2. CONCLUSION Our study showed that melatonin could ameliorate H2O2-induced apoptosis and oxidative stress injury in RGC cells by mediating miR-23a-3p/Nrf2 signaling pathway, thereby improving retinal degeneration.
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Affiliation(s)
- Zhi-Xian Gou
- Department of Pediatrics, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, P.R. China
- Department of Pediatrics, School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, P.R. China
| | - Yue Zhou
- Department of Pediatrics, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, P.R. China
- Department of Pediatrics, School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, P.R. China
| | - Yang Fan
- Department of Pediatrics, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, P.R. China
- Department of Pediatrics, School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, P.R. China
| | - Feng Zhang
- Department of Pediatrics, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, P.R. China
- Department of Pediatrics, School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, P.R. China
| | - Xue-Mei Ning
- Department of Pediatrics, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, P.R. China
- Department of Pediatrics, School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, P.R. China
| | - Fei Tang
- Clinic Medical College, Chengdu Medical College, Chengdu, P.R. China
| | - Li-Qun Lu
- Department of Pediatrics, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, P.R. China
- Department of Pediatrics, School of Clinical Medicine, Chengdu Medical College, Chengdu, Sichuan, P.R. China
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Sánchez-Borja C, Cristóbal-Cañadas D, Rodríguez-Lucenilla MI, Muñoz-Hoyos A, Agil A, Vázquez-López MÁ, Parrón-Carreño T, Nievas-Soriano BJ, Bonillo-Perales A, Bonillo-Perales JC. Lower plasma melatonin levels in non-hypoxic premature newborns associated with neonatal pain. Eur J Pediatr 2024; 183:3607-3615. [PMID: 38842550 PMCID: PMC11263426 DOI: 10.1007/s00431-024-05632-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 04/27/2024] [Accepted: 05/27/2024] [Indexed: 06/07/2024]
Abstract
We analyzed plasma melatonin levels in different groups of preterm newborns without hypoxia and their relationship with several perinatal variables like gestational age or neonatal pain. Prospective cohort study of preterm newborns (PTNB) without perinatal hypoxia, Apgar > 6 at 5 min, and oxygen needs on the third day of life. We compared melatonin levels at day 3 of life in different groups of non-hypoxic preterm infants (Student's t-tests, Mann-Whitney U, and chi2) and analyzed the relationship of melatonin with GA, birth weight, neonatal pain (Premature Infant Pain Profile (PIPP) scale), caffeine treatment, parenteral nutrition, or the development of free radical diseases (correlation study, linear regression) and factors associated with moderate/intense pain and free radical diseases (logistic regression analysis). Sixty-one preterm infants with gestational age (GA) of 30.7 ± 2.0 weeks with no oxygen requirements at day 3 of life were studied with plasma melatonin levels of 33.8 ± 12.01 pg/ml. Preterm infants weighing < 1250 g at birth had lower plasma melatonin levels (p = 0.05). Preterm infants with moderate or severe pain (PPIPP > 5) have lower melatonin levels (p = 0.01), and being preterm with PIPP > 5 is associated with lower plasma melatonin levels (p = 0.03). Being very preterm (GA < 32 GS), having low weight for gestational age (LWGA), receiving caffeine treatment, or requiring parenteral nutrition did not modify melatonin levels in non-hypoxic preterm infants (p = NS). Melatonin on day 3 of life in non-hypoxic preterm infants is not associated with later development of free radical diseases (BPD, sepsis, ROP, HIV, NEC). CONCLUSION We observed that preterm infants with moderate to severe pain have lower melatonin levels. These findings are relevant because they reinforce the findings of other authors that melatonin supplementation decreases pain and oxidative stress in painful procedures in premature infants. Further studies are needed to evaluate whether melatonin could be used as an analgesic in painful procedures in preterm infants. TRIAL REGISTRATION Trial registration was not required since this was an observational study. WHAT IS KNOWN • Melatonin is a potent antioxidant and free radical scavenger in newborns under stress conditions: hypoxia, acidosis, hypotension, painful procedures, or parenteral nutrition. • Pain stimulates the production of melatonin. • Various studies conclude that melatonin administration decreases pain during the neonatal period. WHAT IS NEW • Non-hypoxic preterm infants with moderate to severe pain (PIPP>5) have lower levels of melatonin. • Administration of caffeine and treatment with parenteral nutrition do not modify melatonin levels in non-hypoxic preterm infants.
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Affiliation(s)
| | | | | | | | - Ahmad Agil
- Department of Pharmacology, Institute Biohelath & Institute of Neuroscience, University of Granada, Granada, Spain
| | | | - Tesifón Parrón-Carreño
- Nursing, Physiotherapy, and Medicine Department, University of Almería, Ctra. de Sacramento, s/n, La Cañada, Almería, 01410, Spain
| | - Bruno José Nievas-Soriano
- Nursing, Physiotherapy, and Medicine Department, University of Almería, Ctra. de Sacramento, s/n, La Cañada, Almería, 01410, Spain.
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Mengying C, Pengfei C, Jinfeng H, Yi W, Wei L, Zhenhua G. Visualization of Risk Factors and Predictive Models for Early Death of Neonatal Gastric Perforation. Clin Pediatr (Phila) 2024; 63:986-994. [PMID: 37750300 DOI: 10.1177/00099228231201315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
A retrospective analysis was performed from May 2003 to October 2021 at our hospital. One hundred and eleven neonates diagnosed with gastric perforation were categorized into non-survivor and survivor groups based on prognosis. The mortality rate was 23.42%. Logistic regression was used to analyze the factors influencing the early neonatal death. The non-survivor groups showed more abdominal distension, vomiting, hypoxia, acidosis, hyperkalemia, and coagulation abnormalities. Serum potassium concentration (odds ratio [OR] 2.148, P = .043) was an independent risk factor; however, arterial partial pressure of oxygen (OR 0.977, P = .024), bicarbonate (OR 0.779, P = .023), and platelet count (OR 0.986, P = .014) had protective effects on neonatal death. Based on this, a visualized nomogram prediction model was constructed, patients who had a nomogram score of more than 163.787 was considered to have high risks of mortality, the area under the curve of this was up to 0.828 (95% confidence interval [0.733, 0.923]), the sensitivity was 80.0%, and the specificity was 76.9%.
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Affiliation(s)
- Cui Mengying
- Department of General Surgery & Neonatal Surgery, Liangjiang Wing, Children's Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Chen Pengfei
- Department of General Surgery & Neonatal Surgery, Liangjiang Wing, Children's Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Hou Jinfeng
- Department of General Surgery & Neonatal Surgery, Liangjiang Wing, Children's Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Wang Yi
- Department of General Surgery & Neonatal Surgery, Liangjiang Wing, Children's Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Liu Wei
- Department of General Surgery & Neonatal Surgery, Liangjiang Wing, Children's Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Guo Zhenhua
- Department of General Surgery & Neonatal Surgery, Liangjiang Wing, Children's Hospital of Chongqing Medical University, Chongqing, China
- Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
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Molloy EJ, El-Dib M, Soul J, Juul S, Gunn AJ, Bender M, Gonzalez F, Bearer C, Wu Y, Robertson NJ, Cotton M, Branagan A, Hurley T, Tan S, Laptook A, Austin T, Mohammad K, Rogers E, Luyt K, Wintermark P, Bonifacio SL. Neuroprotective therapies in the NICU in preterm infants: present and future (Neonatal Neurocritical Care Series). Pediatr Res 2024; 95:1224-1236. [PMID: 38114609 PMCID: PMC11035150 DOI: 10.1038/s41390-023-02895-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 12/21/2023]
Abstract
The survival of preterm infants has steadily improved thanks to advances in perinatal and neonatal intensive clinical care. The focus is now on finding ways to improve morbidities, especially neurological outcomes. Although antenatal steroids and magnesium for preterm infants have become routine therapies, studies have mainly demonstrated short-term benefits for antenatal steroid therapy but limited evidence for impact on long-term neurodevelopmental outcomes. Further advances in neuroprotective and neurorestorative therapies, improved neuromonitoring modalities to optimize recruitment in trials, and improved biomarkers to assess the response to treatment are essential. Among the most promising agents, multipotential stem cells, immunomodulation, and anti-inflammatory therapies can improve neural outcomes in preclinical studies and are the subject of considerable ongoing research. In the meantime, bundles of care protecting and nurturing the brain in the neonatal intensive care unit and beyond should be widely implemented in an effort to limit injury and promote neuroplasticity. IMPACT: With improved survival of preterm infants due to improved antenatal and neonatal care, our focus must now be to improve long-term neurological and neurodevelopmental outcomes. This review details the multifactorial pathogenesis of preterm brain injury and neuroprotective strategies in use at present, including antenatal care, seizure management and non-pharmacological NICU care. We discuss treatment strategies that are being evaluated as potential interventions to improve the neurodevelopmental outcomes of infants born prematurely.
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Affiliation(s)
- Eleanor J Molloy
- Paediatrics, Trinity College Dublin, Trinity Research in Childhood Centre (TRICC), Dublin, Ireland.
- Children's Hospital Ireland (CHI) at Tallaght, Dublin, Ireland.
- Neonatology, CHI at Crumlin, Dublin, Ireland.
- Neonatology, Coombe Women's and Infants University Hospital, Dublin, Ireland.
| | - Mohamed El-Dib
- Department of Pediatrics, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Janet Soul
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sandra Juul
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Alistair J Gunn
- Departments of Physiology and Paediatrics, School of Medical Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - Manon Bender
- Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Fernando Gonzalez
- Department of Neurology, Division of Child Neurology, University of California, San Francisco, California, USA
| | - Cynthia Bearer
- Division of Neonatology, Department of Pediatrics, Rainbow Babies & Children's Hospital, Cleveland, Ohio, USA
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Yvonne Wu
- Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Nicola J Robertson
- Institute for Women's Health, University College London, London, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Mike Cotton
- Department of Pediatrics, Duke University, Durham, North Carolina, USA
| | - Aoife Branagan
- Paediatrics, Trinity College Dublin, Trinity Research in Childhood Centre (TRICC), Dublin, Ireland
- Neonatology, Coombe Women's and Infants University Hospital, Dublin, Ireland
| | - Tim Hurley
- Paediatrics, Trinity College Dublin, Trinity Research in Childhood Centre (TRICC), Dublin, Ireland
| | - Sidhartha Tan
- Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Abbot Laptook
- Department of Pediatrics, Women and Infants Hospital, Brown University, Providence, Rhode Island, USA
| | - Topun Austin
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - Khorshid Mohammad
- Section of Neonatology, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Elizabeth Rogers
- Department of Pediatrics, University of California, San Francisco Benioff Children's Hospital, San Francisco, California, USA
| | - Karen Luyt
- Translational Health Sciences, University of Bristol, Bristol, UK
- Neonatology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Pia Wintermark
- Division of Neonatology, Montreal Children's Hospital, Montreal, Quebec, Canada
- McGill University Health Centre - Research Institute, Montreal, Quebec, Canada
| | - Sonia Lomeli Bonifacio
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
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5
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Pavlyshyn H, Sarapuk I, Kozak K. Peculiarities of melatonin levels in preterm infants. Wien Klin Wochenschr 2024; 136:146-153. [PMID: 36434409 DOI: 10.1007/s00508-022-02109-9] [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: 09/07/2022] [Accepted: 10/10/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Melatonin plays an important role in organism functioning, child growth, and development. Of particular importance is melatonin for preterm infants. The aim of our research was to study the peculiarities of melatonin levels depending on various factors in preterm infants with gestational age (GA) of less than 34 weeks. METHODS The study involved 104 preterm infants with GA less than 34 weeks who were treated in the neonatal intensive care unit (NICU). The level of melatonin in urine samples was determined by an enzyme-linked immunosorbent assay. RESULTS Melatonin concentration was significantly lower in extremely and very preterm infants compared to moderate preterm (3.57 [2.10; 5.06] ng/ml vs. 4.96 [3.20; 8.42] ng/ml, p = 0.007) and was positively correlated with GA (Spearman r = 0.32; p < 0.001). Positive correlations were revealed between melatonin levels and Apgar scores at the 1st (Spearman r = 0.31; p = 0.001) and 5th minutes after birth (Spearman r = 0.35; p < 0.001). Melatonin levels were lower in newborns with respiratory distress syndrome (p = 0.011). No significant correlations were found between melatonin concentration and birth weight (Spearman r = 0.15; p = 0.130). There were no associations of melatonin concentrations and mode of delivery (p = 0.914), the incidence of early-onset sepsis (p = 0.370) and intraventricular hemorrhages (p = 0.501), and mechanical ventilation (p = 0.090). The results of multiple regression showed that gestational age at birth was the most significant predictor of melatonin level in preterm infants (B = 0.507; p = 0.001). CONCLUSION Gestational age and the Apgar score were associated with decreased melatonin levels in preterm infants. The level of melatonin in extremely and very preterm infants was lower compared to moderate preterm infants.
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Affiliation(s)
- Halyna Pavlyshyn
- I. Horbachevsky Ternopil National Medical University, 1 Maydan Voli, 46001, Ternopil, Ukraine
| | - Iryna Sarapuk
- I. Horbachevsky Ternopil National Medical University, 1 Maydan Voli, 46001, Ternopil, Ukraine.
| | - Kateryna Kozak
- I. Horbachevsky Ternopil National Medical University, 1 Maydan Voli, 46001, Ternopil, Ukraine
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Garofoli F, Franco V, Accorsi P, Albertini R, Angelini M, Asteggiano C, Aversa S, Ballante E, Borgatti R, Cabini RF, Caporali C, Chiapparini L, Cociglio S, Fazzi E, Longo S, Malerba L, Materia V, Mazzocchi L, Naboni C, Palmisani M, Pichiecchio A, Pinelli L, Pisoni C, Preda L, Riboli A, Risso FM, Rizzo V, Rognone E, Simoncelli AM, Villani P, Tzialla C, Ghirardello S, Orcesi S. Fate of melatonin orally administered in preterm newborns: Antioxidant performance and basis for neuroprotection. J Pineal Res 2024; 76:e12932. [PMID: 38111174 DOI: 10.1111/jpi.12932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/10/2023] [Accepted: 12/06/2023] [Indexed: 12/20/2023]
Abstract
Preterm infants cannot counteract excessive reactive oxygen species (ROS) production due to preterm birth, leading to an excess of lipid peroxidation with malondialdehyde (MDA) production, capable of contributing to brain damage. Melatonin (ME), an endogenous brain hormone, and its metabolites, act as a free radical scavenger against ROS. Unfortunately, preterms have an impaired antioxidant system, resulting in the inability to produce and release ME. This prospective, multicenter, parallel groups, randomized, double-blind, placebo-controlled trial aimed to assess: (i) the endogenous production of ME in very preterm infants (gestational age ≤ 29 + 6 WE, 28 infants in the ME and 26 in the placebo group); (ii) the exogenous hormone availability and its metabolization to the main metabolite, 6-OH-ME after 15 days of ME oral treatment; (iii) difference of MDA plasma concentration, as peroxidation marker, after treatment. Blood was collected before the first administration (T1) and after 15 days of administration (T2). ME and 6-OH-ME were detected by liquid chromatography tandem mass spectrometry, MDA was measured by liquid chromatograph with fluorescence detection. ME and 6-OH-ME were not detectable in the placebo group at any study time-point. ME was absent in the active group at T1. In contrast, after oral administration, ME and 6-OH-ME resulted highly detectable and the difference between concentrations T2 versus T1 was statistically significant, as well as the difference between treated and placebo groups at T2. MDA levels seemed stable during the 15 days of treatment in both groups. Nevertheless, a trend in the percentage of neonates with reduced MDA concentration at T2/T1 was 48.1% in the ME group versus 38.5% in the placebo group. We demonstrated that very preterm infants are not able to produce endogenous detectable plasma levels of ME during their first days of life. Still, following ME oral administration, appreciable amounts of ME and 6-OH-ME were available. The trend of MDA reduction in the active group requires further clinical trials to fix the dosage, the length of ME therapy and to identify more appropriate indexes to demonstrate, at biological and clinical levels, the antioxidant activity and consequent neuroprotectant potential of ME in very preterm newborns.
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Affiliation(s)
- Francesca Garofoli
- 1Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Valentina Franco
- Department of Internal Medicine and Therapeutics, Clinical and Experimental Pharmacology Unit, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Patrizia Accorsi
- Unit of Child Neurology and Psychiatry, ASST-Spedali Civili of Brescia, Brescia, Italy
| | - Riccardo Albertini
- Laboratory of Clinical Chemistry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Micol Angelini
- 1Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carlo Asteggiano
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
| | - Salvatore Aversa
- Neonatal Intensive Care Unit, Children's Hospital, University Hospital "Spedali Civili" of Brescia, Brescia, Italy
| | - Elena Ballante
- Political and Social Sciences, University of Pavia, Pavia, Italy
- BioData Science Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Renato Borgatti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Child Neurology and Psychiatry Unit IRCCS Mondino Foundation, Pavia, Italy
| | | | - Camilla Caporali
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Luisa Chiapparini
- Radiodiagnostic Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Sara Cociglio
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Elisa Fazzi
- Unit of Child Neurology and Psychiatry, ASST-Spedali Civili of Brescia, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Stefania Longo
- 1Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Laura Malerba
- Unit of Child Neurology and Psychiatry, ASST-Spedali Civili of Brescia, Brescia, Italy
| | - Valeria Materia
- Neonatal Intensive Care Unit, Children's Hospital, University Hospital "Spedali Civili" of Brescia, Brescia, Italy
| | - Laura Mazzocchi
- Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
| | - Cecilia Naboni
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Child Neurology and Psychiatry Unit IRCCS Mondino Foundation, Pavia, Italy
| | - Michela Palmisani
- Department of Internal Medicine and Therapeutics, Clinical and Experimental Pharmacology Unit, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Anna Pichiecchio
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
| | - Lorenzo Pinelli
- Neuroradiology Department, Pediatric Neuroradiology Section, Spedali Civili, Brescia, Italy
| | - Camilla Pisoni
- 1Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Lorenzo Preda
- Radiodiagnostic Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Clinical, Surgical, Diagnostics and Pediatric sciences, University of Pavia, Italy
| | - Alice Riboli
- Hospital Pediatric Psychology, Unit of Psychology, Children's Hospital "Spedali Civili" of Brescia, Brescia, Italy
| | - Francesco M Risso
- Neonatal Intensive Care Unit, Children's Hospital, University Hospital "Spedali Civili" of Brescia, Brescia, Italy
| | - Vittoria Rizzo
- Laboratory of Clinical Chemistry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Elisa Rognone
- Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
| | - Anna M Simoncelli
- Radiodiagnostic Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Paola Villani
- Laboratory of Clinical Chemistry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Chryssoula Tzialla
- Neonatal and Pediatric Unit, Polo Ospedaliero Oltrepò, ASST Pavia, Pavia, Italy
| | - Stefano Ghirardello
- 1Neonatal Unit and Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Simona Orcesi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Child Neurology and Psychiatry Unit IRCCS Mondino Foundation, Pavia, Italy
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7
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Booker LA, Fitzgibbon C, Spong J, Deacon-Crouch M, Wilson DL, Skinner TC. Rapid Versus Slow Cooling Pasteurization of Donor Breast Milk: Does the Cooling Rate Effect Melatonin Reduction? Breastfeed Med 2023; 18:951-955. [PMID: 38100440 DOI: 10.1089/bfm.2023.0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Background and Objective: There is a question as to whether melatonin levels in breast milk are impacted by the cooling rate postpasteurization. Past research that has used in the Australian donor bank's breast milk Holder Pasteurization technique has reported varying findings regarding melatonin levels postpasteurization. Where breast milk was cooled slowly, a significant reduction in breast milk melatonin levels was observed. Conversely, where a rapid cooling method was used, there was no significant reduction in melatonin levels. The aim of this study was to investigate whether the cooling process between the different pasteurization techniques impact on melatonin levels in breast milk postpasteurization. Materials and Methods: Twenty-seven nighttime breast milk samples were collected, with each sample divided into three; one remained unpasteurized, one was pasteurized and rapidly cooled to 4°C, and the other was pasteurized and cooled slowly to 4°C. Results: Melatonin levels were significantly reduced in both the rapidly cooled and slow cooled breast milk samples when compared to their unpasteurized counterpart (p < 0.001). There was no significant difference in melatonin levels between the two cooling methods (p = 0.91). Conclusion: This study showed that both the rapid and cooling pasteurization processes had a similar reduction in melatonin levels in breast milk. However, even after pasteurization melatonin was still present. Therefore, it is recommended that donor banks still take into consideration circadian timing hormones such as melatonin and the time of day breast milk is expressed.
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Affiliation(s)
- Lauren A Booker
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
| | - Cheree Fitzgibbon
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
| | - Jo Spong
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Melissa Deacon-Crouch
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Danielle L Wilson
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Timothy C Skinner
- School of Psychology and Public Health, La Trobe University, Bendigo, Australia
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8
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Chen W, Zheng D, Yang C. The Emerging Roles of Ferroptosis in Neonatal Diseases. J Inflamm Res 2023; 16:2661-2674. [PMID: 37396013 PMCID: PMC10312340 DOI: 10.2147/jir.s414316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 06/13/2023] [Indexed: 07/04/2023] Open
Abstract
Ferroptosis is a novel type of programmed cell death involved in many diseases' pathological processes. Ferroptosis is characterized by lipid peroxidation, reactive oxygen species accumulation, and iron metabolism disorder. Newborns are susceptible to ferroptosis due to their special physiological state, which is prone to abnormal iron metabolism and the accumulation of reactive oxygen species. Recent studies have linked ferroptosis to a variety of diseases in the neonatal period (including hypoxic-ischemic encephalopathy, bronchopulmonary dysplasia, and necrotizing enterocolitis). Ferroptosis may become an effective target for the treatment of neonatal-related diseases. In this review, the ferroptosis molecular mechanism, metabolism characteristics of iron and reactive oxygen species in infants, the relationship between ferroptosis and common infant disorders, and the treatment of infant diseases targeted for ferroptosis are systematically summarized.
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Affiliation(s)
- Wenqian Chen
- Department of Neonatology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China
| | - Dali Zheng
- Key Laboratory of Stomatology of Fujian Province, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Changyi Yang
- Department of Neonatology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China
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9
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Booker LA, Lenz KE, Spong J, Deacon-Crouch M, Wilson DL, Nguyen TH, Skinner TC. High-Temperature Pasteurization Used at Donor Breast Milk Banks Reduces Melatonin Levels in Breast Milk. Breastfeed Med 2023. [PMID: 37257176 DOI: 10.1089/bfm.2023.0068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Background and Objective: Donor human milk banks are used when breast milk directly from mothers is unavailable or insufficient. Breast milk contains melatonin, which exhibits a 24-hour pattern. Melatonin promotes sleep onset and is barely detected in daytime milk but rises in the evening and peaks early in the morning. Melatonin supports the development of an infant's own circadian rhythm and is important for neurodevelopment. Currently, donor banks pasteurize breast milk using a Holder Pasteurization (HoP) technique where breast milk is treated at a high temperature (+62°) for 30 minutes before cooling to eliminate any pathogens before it is given to infants. It is not known how the pasteurization process affects the melatonin levels in breast milk. The aim of this study was to investigate whether the pasteurization process reduces melatonin levels in breast milk. Materials and Methods: Ten night-time breast milk samples were collected and each divided into two groups; one group remained unpasteurized and the other group was pasteurized using the HoP technique. Results: Melatonin levels between the unpasteurized and pasteurized groups were compared. Results showed that there was a significant reduction after pasteurization (mean ± standard deviation = 51.92 pg/mL ± 19.54 versus 39.66 pg/mL ± 13.05, p = 0.01). Conclusions: It is important to understand that pasteurization can reduce melatonin levels in breast milk because this hormone is considered important to support the neurodevelopment of infants, especially those born preterm. Further focus on the effect of pasteurization techniques on melatonin in donor breast milk is warranted.
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Affiliation(s)
- Lauren A Booker
- School of Psychology & Public Health, La Trobe University, Bendigo, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
| | - Katrin E Lenz
- School of Psychology & Public Health, La Trobe University, Bendigo, Victoria, Australia
| | - Jo Spong
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
- Rural Department of Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Melissa Deacon-Crouch
- Rural Department of Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Danielle L Wilson
- School of Psychology & Public Health, La Trobe University, Bendigo, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Trang H Nguyen
- Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Timothy C Skinner
- School of Psychology & Public Health, La Trobe University, Bendigo, Victoria, Australia
- Department of Psychology, Centre for Health and Society, University of Copenhagen, Copenhagen, Denmark
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10
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Balázs G, Balajthy A, Seri I, Hegyi T, Ertl T, Szabó T, Röszer T, Papp Á, Balla J, Gáll T, Balla G. Prevention of Chronic Morbidities in Extremely Premature Newborns with LISA-nCPAP Respiratory Therapy and Adjuvant Perinatal Strategies. Antioxidants (Basel) 2023; 12:1149. [PMID: 37371878 DOI: 10.3390/antiox12061149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
Less invasive surfactant administration techniques, together with nasal continuous airway pressure (LISA-nCPAP) ventilation, an emerging noninvasive ventilation (NIV) technique in neonatology, are gaining more significance, even in extremely premature newborns (ELBW), under 27 weeks of gestational age. In this review, studies on LISA-nCPAP are compiled with an emphasis on short- and long-term morbidities associated with prematurity. Several perinatal preventative and therapeutic investigations are also discussed in order to start integrated therapies as numerous organ-saving techniques in addition to lung-protective ventilations. Two thirds of immature newborns can start their lives on NIV, and one third of them never need mechanical ventilation. With adjuvant intervention, these ratios are expected to be increased, resulting in better outcomes. Optimized cardiopulmonary transition, especially physiologic cord clamping, could have an additively beneficial effect on patient outcomes gained from NIV. Organ development and angiogenesis are strictly linked not only in the immature lung and retina, but also possibly in the kidney, and optimized interventions using angiogenic growth factors could lead to better morbidity-free survival. Corticosteroids, caffeine, insulin, thyroid hormones, antioxidants, N-acetylcysteine, and, moreover, the immunomodulatory components of mother's milk are also discussed as adjuvant treatments, since immature newborns deserve more complex neonatal interventions.
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Affiliation(s)
- Gergely Balázs
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - András Balajthy
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - István Seri
- First Department of Pediatrics, School of Medicine, Semmelweis University, 1083 Budapest, Hungary
- Keck School of Medicine of USC, Children's Hospital of Los Angeles, Los Angeles, CA 90033, USA
| | - Thomas Hegyi
- Department of Pediatrics, Division of Neonatology, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ 08903, USA
| | - Tibor Ertl
- Departments of Neonatology and Obstetrics & Gynecology, University of Pécs Medical School, 7624 Pécs, Hungary
- MTA-PTE Human Reproduction Scientific Research Group, University of Pécs, 7624 Pécs, Hungary
| | - Tamás Szabó
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Tamás Röszer
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Ágnes Papp
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - József Balla
- Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- ELKH-UD Vascular Pathophysiology Research Group, Hungarian Academy of Sciences, University of Debrecen, 4032 Debrecen, Hungary
| | - Tamás Gáll
- Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - György Balla
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- ELKH-UD Vascular Pathophysiology Research Group, Hungarian Academy of Sciences, University of Debrecen, 4032 Debrecen, Hungary
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11
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Bell A, Hewins B, Bishop C, Fortin A, Wang J, Creamer JL, Collen J, Werner JK. Traumatic Brain Injury, Sleep, and Melatonin-Intrinsic Changes with Therapeutic Potential. Clocks Sleep 2023; 5:177-203. [PMID: 37092428 PMCID: PMC10123665 DOI: 10.3390/clockssleep5020016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/27/2023] [Accepted: 03/30/2023] [Indexed: 04/25/2023] Open
Abstract
Traumatic brain injury (TBI) is one of the most prevalent causes of morbidity in the United States and is associated with numerous chronic sequelae long after the point of injury. One of the most common long-term complaints in patients with TBI is sleep dysfunction. It is reported that alterations in melatonin follow TBI and may be linked with various sleep and circadian disorders directly (via cellular signaling) or indirectly (via free radicals and inflammatory signaling). Work over the past two decades has contributed to our understanding of the role of melatonin as a sleep regulator and neuroprotective anti-inflammatory agent. Although there is increasing interest in the treatment of insomnia following TBI, a lack of standardization and rigor in melatonin research has left behind a trail of non-generalizable data and ambiguous treatment recommendations. This narrative review describes the underlying biochemical properties of melatonin as they are relevant to TBI. We also discuss potential benefits and a path forward regarding the therapeutic management of TBI with melatonin treatment, including its role as a neuroprotectant, a somnogen, and a modulator of the circadian rhythm.
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Affiliation(s)
- Allen Bell
- Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
| | - Bryson Hewins
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (B.H.)
| | - Courtney Bishop
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (B.H.)
| | - Amanda Fortin
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (B.H.)
| | - Jonathan Wang
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (B.H.)
| | | | - Jacob Collen
- Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (B.H.)
| | - J. Kent Werner
- Walter Reed National Military Medical Center, Bethesda, MD 20814, USA
- School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA; (B.H.)
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12
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Melatonin in Newborn Infants Undergoing Surgery: A Pilot Study on Its Effects on Postoperative Oxidative Stress. Antioxidants (Basel) 2023; 12:antiox12030563. [PMID: 36978811 PMCID: PMC10044879 DOI: 10.3390/antiox12030563] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/18/2023] [Accepted: 02/19/2023] [Indexed: 02/26/2023] Open
Abstract
Surgery is frequently associated with excessive oxidative stress. Melatonin acts as an antioxidant and transient melatonin deficiency has been described in neonatal surgical patients. This randomized, blinded, prospective pilot study tested the hypothesis that oral melatonin supplementation in newborn infants undergoing surgery is effective in reducing perioperative oxidative stress. A total of twenty-three newborn infants requiring surgery were enrolled: 10 received a single dose of oral melatonin 0.5 mg/kg in the morning, before surgery (MEL group), and 13 newborns served as the control group (untreated group). Plasma concentrations of melatonin, Non-Protein-Bound Iron (NPBI), Advanced Oxidation Protein Products (AOPP), and F2-Isoprostanes (F2-IsoPs) were measured. Both in the pre- and postoperative period, melatonin concentrations were significantly higher in the MEL group than in the untreated group (preoperative: 1265.50 ± 717.03 vs. 23.23 ± 17.71 pg/mL, p < 0.0001; postoperative: 1465.20 ± 538.38 vs. 56.47 ± 37.18 pg/mL, p < 0.0001). Melatonin significantly increased from the pre- to postoperative period in the untreated group (23.23 ± 17.71 vs. 56.47 ± 37.18 pg/mL; pg/mL p = 0.006). In the MEL group, the mean blood concentrations of NPBI, F2-IsoPs, and AOPP significantly decreased from the pre- to the postoperative period (4.69 ± 3.85 vs. 1.65 ± 1.18 micromol/dL, p = 0.049; 128.40 ± 92.30 vs. 50.25 ± 47.47 pg/mL, p = 0.037 and 65.18 ± 15.50 vs. 43.98 ± 17.92 micromol/dL, p = 0.022, respectively). Melatonin concentration increases physiologically from the pre- to the postoperative period, suggesting a defensive physiologic response to counteract oxidative stress. The administration of exogenous melatonin in newborn infants undergoing surgery reduces lipid and protein peroxidation in the postoperative period, showing a potential role in protecting babies from the deleterious consequences of oxidative stress.
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13
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Pluta R, Furmaga-Jabłońska W, Januszewski S, Tarkowska A. Melatonin: A Potential Candidate for the Treatment of Experimental and Clinical Perinatal Asphyxia. Molecules 2023; 28:molecules28031105. [PMID: 36770769 PMCID: PMC9919754 DOI: 10.3390/molecules28031105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/11/2023] [Accepted: 01/18/2023] [Indexed: 01/24/2023] Open
Abstract
Perinatal asphyxia is considered to be one of the major causes of brain neurodegeneration in full-term newborns. The worst consequence of perinatal asphyxia is neurodegenerative brain damage, also known as hypoxic-ischemic encephalopathy. Hypoxic-ischemic encephalopathy is the leading cause of mortality in term newborns. To date, due to the complex mechanisms of brain damage, no effective or causal treatment has been developed that would ensure complete neuroprotection. Although hypothermia is the standard of care for hypoxic-ischemic encephalopathy, it does not affect all changes associated with encephalopathy. Therefore, there is a need to develop effective treatment strategies, namely research into new agents and therapies. In recent years, it has been pointed out that natural compounds with neuroprotective properties, such as melatonin, can be used in the treatment of hypoxic-ischemic encephalopathy. This natural substance with anti-inflammatory, antioxidant, anti-apoptotic and neurofunctional properties has been shown to have pleiotropic prophylactic or therapeutic effects, mainly against experimental brain neurodegeneration in hypoxic-ischemic neonates. Melatonin is a natural neuroprotective hormone, which makes it promising for the treatment of neurodegeneration after asphyxia. It is supposed that melatonin alone or in combination with hypothermia may improve neurological outcomes in infants with hypoxic-ischemic encephalopathy. Melatonin has been shown to be effective in the last 20 years of research, mainly in animals with perinatal asphyxia but, so far, no clinical trials have been performed on a sufficient number of newborns. In this review, we summarize the advantages and limitations of melatonin research in the treatment of experimental and clinical perinatal asphyxia.
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Affiliation(s)
- Ryszard Pluta
- Ecotech-Complex Analytical and Programme Centre for Advanced Environmentally-Friendly Technologies, Marie Curie-Skłodowska University in Lublin, 20-612 Lublin, Poland
- Correspondence: or
| | - Wanda Furmaga-Jabłońska
- Department of Neonate and Infant Pathology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Sławomir Januszewski
- Laboratory of Ischemic and Neurodegenerative Brain Research, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland
| | - Agata Tarkowska
- Department of Neonate and Infant Pathology, Medical University of Lublin, 20-093 Lublin, Poland
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14
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Weiss MD, Carloni S, Vanzolini T, Coppari S, Balduini W, Buonocore G, Longini M, Perrone S, Sura L, Mohammadi A, Rocchi MBL, Negrini M, Melandri D, Albertini MC. Human-rat integrated microRNAs profiling identified a new neonatal cerebral hypoxic-ischemic pathway melatonin-sensitive. J Pineal Res 2022; 73:e12818. [PMID: 35841265 PMCID: PMC9540681 DOI: 10.1111/jpi.12818] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 11/30/2022]
Abstract
Neonatal encephalopathy (NE) is a pathological condition affecting long-term neurodevelopmental outcomes. Hypothermia is the only therapeutic option, but does not always improve outcomes; hence, researchers continue to hunt for pharmaceutical compounds. Melatonin treatment has benefitted neonates with hypoxic-ischemic (HI) brain injury. However, unlike animal models that enable the study of the brain and the pathophysiologic cascade, only blood is available from human subjects. Therefore, due to the unavailability of neonatal brain tissue, assumptions about the pathophysiology in pathways and cascades are made in human subjects with NE. We analyzed animal and human specimens to improve our understanding of the pathophysiology in human neonates. A neonate with NE who underwent hypothermia and enrolled in a melatonin pharmacokinetic study was compared to HI rats treated/untreated with melatonin. MicroRNA (miRNA) analyses provided profiles of the neonate's plasma, rat plasma, and rat brain cortexes. We compared these profiles through a bioinformatics tool, identifying Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways common to HI brain injury and melatonin treatment. After evaluating the resulting pathways and the literature, to validate the method, the key proteins expressed in HI brain injury were investigated using cerebral cortexes. The upregulated miRNAs in human neonate and rat plasma helped identify two KEGG pathways, glioma and long-term potentiation, common to HI injury and melatonin treatment. A unified neonatal cerebral melatonin-sensitive HI pathway was designed and validated by assessing the expression of protein kinase Cα (PKCα), phospho (p)-Akt, and p-ERK proteins in rat brain cortexes. PKCα increased in HI-injured rats and further increased with melatonin. p-Akt and p-ERK returned phosphorylated to their basal level with melatonin treatment after HI injury. The bioinformatics analyses validated by key protein expression identified pathways common to HI brain injury and melatonin treatment. This approach helped complete pathways in neonates with NE by integrating information from animal models of HI brain injury.
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Affiliation(s)
- Michael D. Weiss
- Department of PediatricsUniversity of FloridaGainesvilleFloridaUSA
| | - Silvia Carloni
- Department of Biomolecular SciencesUniversity of Urbino Carlo BoUrbinoItaly
| | - Tania Vanzolini
- Department of Biomolecular SciencesUniversity of Urbino Carlo BoUrbinoItaly
| | - Sofia Coppari
- Department of Biomolecular SciencesUniversity of Urbino Carlo BoUrbinoItaly
| | - Walter Balduini
- Department of Biomolecular SciencesUniversity of Urbino Carlo BoUrbinoItaly
| | - Giuseppe Buonocore
- Department of Molecular and Developmental MedicineUniversity of SienaSienaItaly
| | - Mariangela Longini
- Department of Molecular and Developmental MedicineUniversity of SienaSienaItaly
| | - Serafina Perrone
- Neonatal UnitUniversity Medical Center of Parma (AOUP) and University of ParmaParmaItaly
| | - Livia Sura
- Department of PediatricsUniversity of FloridaGainesvilleFloridaUSA
| | - Atefeh Mohammadi
- Department of Biomolecular SciencesUniversity of Urbino Carlo BoUrbinoItaly
| | | | - Massimo Negrini
- Department of Morphology, Surgery and Experimental MedicineUniversity of FerraraFerraraItaly
| | - Davide Melandri
- O. U. Burns Center, Dermatology and Emilia Romagna Regional Skin Bank“M. Bufalini” HospitalCesenaItaly
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15
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Haskologlu IC, Erdag E, Sayiner S, Abacioglu N, Sehirli AO. Melatonin and REGN-CoV2 combination as a vaccine adjuvant for Omicron variant of SARS-CoV-2. Mol Biol Rep 2022; 49:4061-4068. [PMID: 35389130 PMCID: PMC8986966 DOI: 10.1007/s11033-022-07419-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 03/23/2022] [Indexed: 11/26/2022]
Abstract
The omicron variant (B.529) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which emerged in late 2021, caused panic worldwide due to its contagiousness and multiple mutations in the spike protein compared to the Delta variant (B.617.2). There is currently no specific antiviral available to treat Coronavirus disease 2019 (COVID-19). However, studies on neutralizing monoclonal antibodies (mAb) developed to fight COVID-19 are growing and gaining traction. REGN-COV2 (Regeneron or imdevimab-casirivimab combination), which has been shown in recent studies to be less affected by Omicron's RBD (receptor binding domain) mutations among other mAb cocktails, plays an important role in adjuvant therapy against COVID-19. On the other hand, it is known that melatonin, which has antioxidant and immunomodulatory effects, can prevent a possible cytokine storm, and other severe symptoms that may develop in the event of viral invasion. Along with all these findings, we believe it is crucial to evaluate the use of melatonin with REGN-COV2, a cocktail of mAbs, as an adjuvant in the treatment and prevention of COVID-19, particularly in immunocompromised and elderly patients.
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Affiliation(s)
| | - Emine Erdag
- Faculty of Pharmacy, Department of Pharmaceutical Chemistry, Near East University, Nicosia, Cyprus
| | - Serkan Sayiner
- Faculty of Veterinary Medicine, Department of Biochemistry, Near East University, Nicosia, Cyprus.,Diagnostic Laboratory, Animal Hospital, Near East University, Nicosia, Cyprus
| | - Nurettin Abacioglu
- Faculty of Pharmacy, Department of Pharmacology, Near East University, Nicosia, Cyprus
| | - Ahmet Ozer Sehirli
- Faculty of Dentistry, Department of Pharmacology, Near East University, Nicosia, Cyprus
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