1
|
Berta DM, Woldu B, Yalew A, Chane E, Tamir M, Cherie N, Angelo AA, Mulatie Z, Alemayehu E, Kassie A, Teketelew BB. Hematological abnormality and associated factors in newborns with hyperbilirubinemia before and after phototherapy at University of Gondar Comprehensive Specialized Hospital. Sci Rep 2024; 14:18210. [PMID: 39107448 PMCID: PMC11303718 DOI: 10.1038/s41598-024-68871-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 07/29/2024] [Indexed: 08/10/2024] Open
Abstract
This study aimed to assess the magnitude of hematological toxicity and associated factors in newborns with hyperbilirubinemia. A cross-sectional study was conducted from April to December 2023. A total of 247 newborns were included. The data were collected using questionnaires and a data extraction sheet. Four 4 ml of blood was collected. A Sysmex KX-21 analyzer was used for blood analysis, and a Mindray BS-240 analyzer was used for bilirubin measurement. The data were entered into Epi-data and analyzed by SPSS. The logistic regression was used. The P value was set at 0.05. Before phototherapy, the hematological toxicities, such as anemia, leucopenia, and thrombocytopenia, were 45.7%, 22.2%, and 6.1%, respectively, whereas after phototherapy, anemia and thrombocytopenia, significantly increased, but the leucopenia, significantly decreased. The risk of developing anemia increased, 3.5, 2.7, and 2.1-fold among newborns with bilirubin > 18 mg/dl, with Rh blood group incompatibility, and treated with intensive phototherapy, respectively. Both low birth weight and intensive phototherapy increased the incidence of thrombocytopenia by 2 and 3.4-fold, respectively. Hematological toxicity was found to be a severe public health issue in newborns. Thus, strict follow-up and early detection of toxicity by considering aggravation factors are necessary.
Collapse
Affiliation(s)
- Dereje Mengesha Berta
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
| | - Berhanu Woldu
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Aregawi Yalew
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Elias Chane
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mebratu Tamir
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Negesse Cherie
- Department of Quality Assurance and Laboratory Management, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abiy Ayele Angelo
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zewudu Mulatie
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ermiyas Alemayehu
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Adamu Kassie
- Department of Medical Laboratory, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Bisrat Birke Teketelew
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| |
Collapse
|
2
|
El-Sheikh MR, Ahmed AY, ELMashad AERM, Talaye II, El-Hawary EES. Eosinophil count and tumor necrosis factor α in response to phototherapy treatment of neonatal hyperbilirubinemia: a cross sectional study. Ital J Pediatr 2022; 48:103. [PMID: 35725569 PMCID: PMC9208093 DOI: 10.1186/s13052-022-01302-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/13/2022] [Indexed: 11/14/2022] Open
Abstract
Background Phototherapy (PT) is the most often utilized technique for treating and preventing severe hyperbilirubinemia in the term and preterm newborns. PT's proven benefit is that it decreases the requirement for exchange transfusions. To investigate the effect of PT on allergic response mediators in neonates with hyperbilirubinemia treated by PT, eosinophil counts and tumor necrosis factor alfa levels have been assessed. Methods This cross-sectional study included 100 full-term infants with indirect hyperbilirubinemia in the first two weeks of life who were indicated for PT. They were investigated by tumor necrosis factor α and eosinophil counts before and 72 h after starting PT. The used tests were paired with Student’s t-test and Pearson coefficient. Results Relative and absolute eosinophil counts and tumor necrosis factor alfa were significantly higher after PT than before (p < 0.001). There was a significant positive correlation between total serum bilirubin and both tumor necrosis factor alfa and eosinophil % (r = 0.442 and r = 0.362, respectively, P < 0.001) before PT. There was a significant positive correlation between total serum bilirubin and both eosinophil count and eosinophil % (r = 0.281and r = 0.339), respectively (P < 0.001) after PT. There was a significant positive correlation between both tumor necrosis factor alfa and eosinophil % after PT (r = 0.545, P < 0.001). Conclusions Serum tumor necrosis factor-alpha and eosinophilic count increased after treatment of neonatal hyperbilirubinemia by PT, which indicates an allergic response to PT in neonates.
Collapse
Affiliation(s)
- Mai Rabie El-Sheikh
- Pediatric and Neonatology, Faculty of Medicine, Tanta University, El Bahr St.، Tanta Qism 2, Tanta, 31527, Gharbia Governorate, Egypt.
| | - Amira Youssef Ahmed
- Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Gharbia Governorate, Egypt
| | - Abd El-Rahman Mohamed ELMashad
- Pediatric and Neonatology, Faculty of Medicine, Tanta University, El Bahr St.، Tanta Qism 2, Tanta, 31527, Gharbia Governorate, Egypt
| | | | | |
Collapse
|
3
|
Feehan J, Tripodi N, Fraser S, Mikkelsen K, Thewlis A, Kiatos D, Husaric M, Apostolopoulos V. Polarized light therapy: Shining a light on the mechanism underlying its immunomodulatory effects. JOURNAL OF BIOPHOTONICS 2020; 13:e201960177. [PMID: 31816155 PMCID: PMC7065605 DOI: 10.1002/jbio.201960177] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/03/2019] [Accepted: 12/05/2019] [Indexed: 06/10/2023]
Abstract
This study investigates the immunomodulatory effects of polychromatic polarized light therapy (PLT) on human monocyte cells. While there is some evidence demonstrating a clinical effect in the treatment of certain conditions, there is little research into its mechanism of action. Herein, U937 monocyte cells were cultured and exposed to PLT. The cells were then analyzed for change in expression of genes and cell surface markers relating to inflammation. It was noted that 6 hours of PLT reduced the expression of the CD14, MHC I and CD11b receptors, and increased the expression of CD86. It was also shown that PLT caused downregulation of the genes IL1B, CCL2, NLRP3 and NOD1, and upregulation of NFKBIA and TLR9. These findings imply that PLT has the capacity for immunomodulation in human immune cells, possibly exerting an anti-inflammatory effect.
Collapse
Affiliation(s)
- Jack Feehan
- Osteopathy Group, College of Health and BiomedicineVictoria UniversityVictoriaAustralia
- Australian Institute for Musculoskeletal Science (AIMSS)University of Melbourne and Western HealthSt AlbansVictoriaAustralia
| | - Nicholas Tripodi
- Institute for Health and SportVictoria UniversityVictoriaAustralia
- First Year CollegeVictoria UniversityVictoriaAustralia
| | - Sarah Fraser
- Institute for Health and SportVictoria UniversityVictoriaAustralia
| | | | - April Thewlis
- Osteopathy Group, College of Health and BiomedicineVictoria UniversityVictoriaAustralia
| | - Dimitrios Kiatos
- Osteopathy Group, College of Health and BiomedicineVictoria UniversityVictoriaAustralia
- Institute for Health and SportVictoria UniversityVictoriaAustralia
| | - Maja Husaric
- Institute for Health and SportVictoria UniversityVictoriaAustralia
- First Year CollegeVictoria UniversityVictoriaAustralia
| | | |
Collapse
|
4
|
Faulhaber FRS, Faulhaber GAM, Marcondes NA, Procianoy RS, Silveira RC. Expression of neutrophil surface markers in icteric neonates before and after phototherapy. CYTOMETRY PART B-CLINICAL CYTOMETRY 2018; 94:895-900. [DOI: 10.1002/cyto.b.21734] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 07/09/2018] [Accepted: 07/27/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Fabrízia Rennó Sodero Faulhaber
- Programa de Pós‐Graduação em Saúde da Criança e do AdolescenteUniversidade Federal do Rio Grande do Sul Porto Alegre Brazil
- Serviço de Onco‐Hematologia PediátricaHospital Nossa Senhora da Conceição Porto Alegre Brazil
| | - Gustavo Adolpho Moreira Faulhaber
- Laboratório Zanol Porto Alegre Brazil
- Programa de Pós Graduação em Medicina: Ciências MédicasUniversidade Federal do Rio Grande do Sul Porto Alegre Brazil
- Departmento de Medicina InternaUniversidade Federal do Rio Grande do Sul Porto Alegre Brazil
| | | | - Renato Soibelmann Procianoy
- Programa de Pós‐Graduação em Saúde da Criança e do AdolescenteUniversidade Federal do Rio Grande do Sul Porto Alegre Brazil
- Departmento de PediatriaUniversidade Federal do Rio Grande do Sul Porto Alegre Brazil
- Departmento de PediatriaHospital de Clínicas de Porto Alegre Porto Alegre Brazil
| | - Rita C. Silveira
- Programa de Pós‐Graduação em Saúde da Criança e do AdolescenteUniversidade Federal do Rio Grande do Sul Porto Alegre Brazil
- Departmento de PediatriaUniversidade Federal do Rio Grande do Sul Porto Alegre Brazil
- Departmento de PediatriaHospital de Clínicas de Porto Alegre Porto Alegre Brazil
| |
Collapse
|
5
|
Eyada IK, El Saie AL, Ibrahem GA, Riad NM. Effect of phototherapy on B and T lymphocytes in Egyptian infants suffering from neonatal jaundice. Allergol Immunopathol (Madr) 2017; 45:290-296. [PMID: 27890454 DOI: 10.1016/j.aller.2016.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 09/06/2016] [Accepted: 09/21/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Neonatal jaundice is one of the most common problems that affect newborn infants, and phototherapy is usually used for treatment. OBJECTIVES Evaluation of the effect of phototherapy on neonatal immune system through measuring the percentage of B and T lymphocytes and determining the frequency of development of infections and need for hospitalisation during the first six months of life. METHODS A prospective cohort study was conducted on 50 full term new-borns; 25 with indirect hyperbilirubinaemia and treated with conventional phototherapy and 25 healthy matched neonates as untreated controls. The percentages of CD19+, CD4+ and CD8+ lymphocytes were measured by flow cytometry before phototherapy and 72h after exposure. Follow-up of the study group for the occurrence of infections for a period of six months after phototherapy. RESULTS The study showed a significant difference in CD19+ lymphocytes percentage between patients before phototherapy and controls (P value<0.01), also a significant correlation between serum levels of total bilirubin in patients and CD19+ lymphocytes percentage (P value<0.05). There was no significant difference between the percentages of CD19+, CD4+ and CD8+ lymphocytes in patients before or after 72h of exposure to phototherapy (P value>0.05). Also, there was no correlation between the percentages of CD19+, CD4+ and CD8+ lymphocytes after 72h of exposure to phototherapy and the occurrence of infections (Gastrointestinal tract and Respiratory tract infection) after six months of follow-up (P value>0.05). More studies are needed with larger number of patients to determine the effect of phototherapy on immune system.
Collapse
Affiliation(s)
- I K Eyada
- Pediatrics and Neonatology Department, Faculty of Medicine, Cairo University, Egypt
| | - A L El Saie
- Pediatrics and Neonatology Department, Faculty of Medicine, Cairo University, Egypt
| | - G A Ibrahem
- Pediatric and Neonatology Department, Shobra al Aam Hospital, Egypt
| | - N M Riad
- Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Egypt.
| |
Collapse
|
6
|
Chaudhari H, Goyal S, Patil C. Neonates with sickle cell disease are vulnerable to blue light phototherapy-induced oxidative stress and proinflammatory cytokine elevations. Med Hypotheses 2016; 96:78-82. [PMID: 27959283 DOI: 10.1016/j.mehy.2016.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 09/27/2016] [Indexed: 11/24/2022]
Abstract
Sickle cell disease is a frequent genetic anomaly characterized by altered molecular structure of hemoglobin resulting into crescent-like deformation of the red blood corpuscles. Neonatal jaundice is a frequent co-morbidity in sickle cell disease. Phototherapy induces isomerization of bilirubin rendering it extractable through urine and hence it is used as a routine treatment of neonatal jaundice. An exposure to light phototherapy as a treatment of neonatal jaundice induces oxidative stress. It is hypothesized that such exposure of neonates with sickle cell disease to the blue light phototherapy as a treatment of neonatal jaundice induces severe oxidative stress and increases the levels of proinflammatory cytokines. This hypothesis is supported with two case studies of sickle cell disease suffering neonates who were exposed to blue light phototherapy to treat jaundice. In both these cases, exposure to phototherapy induced oxidative stress (increased lipid peroxidation and superoxide dismutase, slight change in activity of catalase and GSH) and elevated the levels of proinflammatory cytokine (TNFα, IL-1, and IL-6) in the sickle cell disease suffering neonates. These observations warrant further investigations to determine the consequences and clinical significance of the blue phototherapy-induced oxidative and proinflammatory stress in Sickle cell disease suffering neonates exposed to phototherapy as a treatment of jaundice.
Collapse
Affiliation(s)
- Hemakshi Chaudhari
- Department of Clinical Pharmacy, R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, Dist - Dhulia, Maharashtra, India
| | - Sameer Goyal
- Department of Pharmacology, R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, Dist- Dhulia, Maharashtra, India
| | - Chandragouda Patil
- Department of Pharmacology, R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, Dist- Dhulia, Maharashtra, India.
| |
Collapse
|