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Plasma chain-breaking antioxidants in preterm infants with good and poor short-term outcome
P Luukkainen1, R Aejmelaeus, H Alho
1Medical School, University of Tampere, Finland.
Insights
High plasma total peroxyl radical-trapping capability (TRAP) in preterm infants, linked to elevated uric acid, indicates a poor short-term prognosis and potential complications.
Area of Science:
- Biochemistry
- Neonatal Medicine
- Oxidative Stress Research
Background:
- Complications of prematurity are often linked to oxidative stress and insufficient antioxidant defenses.
- Preterm infants have unique physiological challenges impacting their antioxidant capacity.
Purpose of the Study:
- To investigate the relationship between plasma total peroxyl radical-trapping capability (TRAP) and short-term outcomes in preterm infants.
- To identify key antioxidant components contributing to TRAP and their association with infant health outcomes.
Main Methods:
- Measured plasma TRAP and antioxidant concentrations (uric acid, ascorbic acid, alpha-tocopherol, etc.) in 21 preterm infants.
- Compared TRAP levels between infants with good and poor short-term outcomes (e.g., intraventricular hemorrhage, bronchopulmonary dysplasia).
- Analyzed blood samples at 3 and 10 days postpartum, with adult samples for comparison.
Main Results:
- At day 3, preterm infants with poor outcomes showed significantly higher TRAP than good outcome or adult control groups, primarily due to elevated uric acid.
- The good outcome group had lower concentrations of unidentified antioxidants.
- By day 10, TRAP decreased in both infant groups, but ascorbate and unidentified antioxidants declined more in the poor outcome group.
Conclusions:
- Elevated plasma TRAP, associated with high uric acid levels, is linked to a poor short-term prognosis in preterm infants.
- Antioxidant dynamics, particularly the reduction of ascorbate and unidentified fractions, differ between preterm infants with good and poor outcomes.
- Further research is needed to elucidate the role of specific antioxidants in neonatal oxidative stress and disease prevention.
Abstract:
Many complications of prematurity have been suggested to result from free radical generation and an inadequacy of antioxidative capacity. We measured the plasma total peroxyl radical-trapping capability (TRAP) and concentrations of the main chain-breaking antioxidants contributing to it, i.e. uric acid, ascorbic acid, alpha-tocopherol, protein sulfhydryl groups and bilirubin, in 21 preterm infants with a mean birth weight of 1440 g and gestational age of 30 wk. The infants were divided into two groups according to their short-term outcome; the good outcome group (GOG) (N = 11) with no signs of morbidity and the poor outcome group (POG) (N = 10) with intraventricular haemorrhage and/or bronchopulmonary dysplasia and/or retinopathy. Arterial blood samples were obtained 3 and 10 days postpartum. TRAP was measured with a chemiluminescent method. As a comparison, venous blood samples from 13 adults (aged from 18 to 34) were used. At day 3 the poor outcome group had significantly higher TRAP than the good outcome or control group, mainly because of elevated uric acid concentration. Also the concentration of unidentified antioxidants was significantly lower in GOG. By day 10 the TRAP decreased substantially in both groups. However, from the components of TRAP, both ascorbate and the unidentified fraction decreased more in POG (p = 0.017 and 0.021, respectively). Furthermore in POG on day 10 urate concentration did not significantly differ from day 3 values. In conclusion, in preterm infants high TRAP was associated with high plasma uric acid concentration and a poor short-term prognosis.