Abstracto

Circulating nitric oxide, malondialdehyde and total antioxidant capacity levels among term septic neonates

Amira MM Hamed, Alaa-Eldin A Hassan, Mohammed Abo-Alwafa Aladawy, Mohammed H Hassan

Background: Neonatal sepsis with its high mortality rate still remains a diagnostic and treatment challenge for neonatal health care providers. Sepsis represents an oxidative stress condition when occurs in neonates due to rapid changes in tissue oxygen concentrations with immature antioxidant mechanisms. We aimed to study the serum levels of oxidants and antioxidants among term neonates with sepsis.

Patients and methods: A case-control study included 60 full term newborns with sepsis in addition to 30 healthy newborns as controls, recruited from NICU of Pediatric Department, Al-Azhar University Hospital, Assiut, Egypt. Full history, thorough clinical examination, Complete blood count (CBC), Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and blood culture were performed to all included patients. Serum levels of nitric oxide, malondialdehyde (MDA) and total antioxidant capacity (TAO) were assayed in all included neonates using colorimetric methods.

Results: The overall results showed statistically significant higher serum levels of MDA and NO with lower TAO levels among septic neonates when compared with the controls (p value<0.05) for both. Additionally, all the previously measured biochemical oxidative stress markers didn't show significant differences between early and late onset septic groups. Serum NO, MDA and TAO levels at cut-off points (0.514 μmol/l, 0.399 nmol/ml, and 0.591 mm/l respectively) showed high sensitivity (96.4%, 95%, and 98.8% respectively) and specificity (93%, 92% and 94% respectively). White blood cell counts were negatively correlated to TAO (r=-0.25, p<0.01) and positively correlated to MDA in a statistically significant manner among septic neonates (r=0.34, p<0.001).

Conclusion: There is strong evidence of involvement of oxidative stress in neonatal sepsis, mainly NO, MDA and TAO, and could be helpful in its diagnosis. Also, targeting of therapeutic strategies towards the pro-oxidant pathways may be beneficial in neonatal sepsis.