Related Experiment Videos
Effect of phototherapy on the physiologic cholestasis of the neonate
Insights
Phototherapy (PT) significantly reduces serum total bile acids (STBA) and conjugated cholic acid (CCA) in newborns with jaundice. This suggests PT enhances bile acid excretion, impacting neonatal bile acid metabolism.
Area of Science:
- Neonatal Medicine
- Hepatology
- Biochemistry
Background:
- Phototherapy (PT) is a standard treatment for neonatal hyperbilirubinemia.
- Previous studies suggest PT increases bile acid excretion in adults with liver cirrhosis.
Purpose of the Study:
- To investigate the effect of PT on serum bile acid levels in neonates with unconjugated nonhemolytic hyperbilirubinemia.
- To determine if PT influences specific bile acid fractions.
Main Methods:
- 13 neonates with hyperbilirubinemia received 12 hours of PT.
- Serum levels of total bile acids (STBA) and specific bile acid fractions (CCA, CCDCA, CLCA, SLCG) were measured before and after PT.
Main Results:
- PT resulted in a statistically significant reduction in STBA and CCA levels (p < 0.02).
- No significant effect was observed on CCDCA, CLCA, or SLCG levels.
- The reduction in STBA and CCA was proportional, suggesting a specific effect on CCA.
Conclusions:
- Phototherapy can decrease STBA and CCA levels in neonates.
- This effect is likely due to increased biliary excretion and reduced intestinal absorption of bile acids.
- PT's impact on bile acid metabolism in neonates warrants further investigation.
Abstract:
Phototherapy (PT) has been reported to increase bile acid excretion in the bile of adults with liver cirrhosis. We investigated the effect of PT on the levels of serum total bile acids (STBA), conjugated cholic acid (CCA), conjugated chenodeoxycholic acid (CCDCA), conjugated lithocholic acid (CLCA), and sulfolithocholylglycine (SLCG) in 13 neonates with unconjugated nonhemolytic hyperbilirubinemia before and after 12 h of PT. The treatment produced a statistically significant (p less than 0.02) reduction in both STBA and CCA levels, whereas no effect on the other fractions was observed. The percentage of reduction was the same for STBA and CCA concentrations, indicating that the effect is related to a specific reduction in CCA levels. The magnitude of the expected decrease in the level of serum bilirubin is not correlated with that in bile acids in individual cases. The data are interpreted as suggesting that PT can affect the metabolism of bile acids by decreasing STBA and CCA levels in neonates through an increase in their biliary excretion associated with the reduced intestinal absorption of CCA occurring in newborns.