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Effect of an exchange transfusion on plasma antioxidants in the newborn
J H Lindeman1, E G Lentjes, E Houdkamp
1Department of Pediatrics, University Hospital, Leiden, The Netherlands.
Insights
Exchange transfusion in newborns with rhesus hemolytic disease altered plasma antioxidants. While some antioxidants increased, others decreased, impacting free radical metabolism.
Area of Science:
- Neonatal Medicine
- Biochemistry
- Pediatric Hematology
Background:
- Rhesus hemolytic disease is a condition in newborns requiring intervention.
- Exchange transfusion is a common treatment for severe neonatal jaundice and hemolytic disease.
- The impact of exchange transfusion on plasma antioxidant status in newborns is not fully understood.
Purpose of the Study:
- To investigate the effects of exchange transfusion on plasma antioxidant concentrations in newborns with rhesus hemolytic disease.
- To assess changes in both primary and secondary antioxidants post-transfusion.
- To evaluate the influence of exchange transfusion on lipid peroxidation.
Main Methods:
- Plasma samples were collected from newborns before and after exchange transfusion.
- Concentrations of various antioxidants including vitamin C, uric acid, thiols, vitamin E, ceruloplasmin, and transferrin were measured.
- Iron, ferritin, and latent iron-binding capacity were also assessed.
- Thiobarbituric acid reactive substances (TBARS) were measured as an indicator of lipid peroxidation.
Main Results:
- Exchange transfusion led to decreased iron and ferritin levels and increased ceruloplasmin and transferrin concentrations.
- Secondary antioxidant levels showed variable changes: vitamin C and bilirubin decreased, vitamin E increased, while uric acid and thiols remained stable.
- The total peroxyl-radical trapping capacity of secondary antioxidants did not change significantly.
- A decrease in thiobarbituric acid reactive substances (TBARS) was observed, correlating with lower levels in donor blood.
Conclusions:
- Exchange transfusion causes rapid and variable alterations in plasma prooxidant and antioxidant profiles in newborns with rhesus hemolytic disease.
- These changes may significantly influence the newborn's free radical metabolism.
- The study highlights the complex biochemical shifts occurring during exchange transfusion therapy.
Abstract:
The effect of an exchange transfusion on antioxidants in the plasma of newborns with rhesus hemolytic disease was studied. The antioxidant concentrations in donor blood were similar to normal adult values except for the lower vitamin C concentrations. Exchange transfusion decreased the newborns' iron and ferritin levels and increased their ceruloplasmin and transferrin (primary antioxidants) concentrations and latent iron-binding capacity. The changes in secondary antioxidant concentrations were variable; uric acid and thiols were stable, vitamin C and bilirubin fell, and vitamin E rose. The total peroxyl-radical trapping capacity of the secondary antioxidants did not change significantly. The fall in levels of thiobarbituric acid reactive substances, an index of lipid peroxidation, was related to the lower levels present in the donor blood. Exchange transfusion rapidly produced variable changes in the concentrations of prooxidant and antioxidant substances in plasma and may thus influence free radical metabolism in the newborn.