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Reference spectrophotometric values for glucose-6-phosphate dehydrogenase activity in two-to six-month-old infants on
Germana Bancone1,2, Day Day Poe1, Gornpan Gornsawun1
1Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, 63110, Thailand.
Insights
Establishing normal Glucose-6-phosphate dehydrogenase (G6PD) activity in infants is crucial for safe drug use. This study provides reference values for infants aged 2-6 months, aiding in preventing drug-induced haemolysis.
Area of Science:
- Biochemistry
- Paediatrics
- Pharmacology
Background:
- Glucose-6-phosphate dehydrogenase (G6PD) deficiency hinders malaria elimination and antibiotic use.
- Lack of reference ranges for G6PD activity in infants risks drug-induced haemolysis and limits maternal treatment options.
Purpose of the Study:
- Establish age-specific G6PD normal values in infants.
- Support clinical use of tafenoquine in lactating women.
- Enable safer antibiotic treatment for infants.
Main Methods:
- Utilized the gold standard spectrophotometric assay.
- Collected data from 78 healthy infants aged 2-6 months.
- Analyzed G6PD activity relative to age and adult values.
Main Results:
- A reference normal value of 10.18 IU/gHb (100% activity) was established for infants aged 2-6 months.
- G6PD activity showed a non-significant trend of decrease with age.
- Infant G6PD activity was approximately 140% of adult levels.
Conclusions:
- Age-specific G6PD activity thresholds are necessary for paediatric populations.
- Implementing these thresholds can prevent drug-induced haemolysis in infants.
- This research supports safer therapeutic interventions for infants and breastfeeding mothers.
Background:
Glucose-6-phosphate dehydrogenase (G6PD) deficiency represents a barrier to the full deployment of anti-malarial drugs for vivax malaria elimination and of first-line antibiotics. Lack of established reference ranges for G6PD activity in breast-fed infants puts them at risk of drug-induced haemolysis and restricts access to safe treatment of their mothers.
Methods:
The present work was undertaken to establish age-specific G6PD normal values using the gold standard spectrophotometric assay to support the future clinical use of tafenoquine in lactating women and safer antibiotic treatment in infants.
Results:
Spectrophotometric results collected at the Thai-Myanmar border from 78 healthy infants between the ages of 2 and 6 months showed a trend of decreased enzymatic activity with increasing age (which did not reach statistical significance when comparing 2-3 months old against 4-6 months old infants) and provided a reference normal value of 100% activity for infants 2-6 months old of 10.18IU/gHb.
Conclusions:
Normal reference G6PD activity in 2-6-month-old infants was approximately 140% of that observed in G6PD normal adults from the same population. Age specific G6PD activity thresholds should be used in paediatric populations to avoid drug-induced haemolysis.
