Gülşah AĞIRTAŞ, Nilufer GUZOGLU, Ozgül AKBAŞ, Üçler KISA, Didem ALİEFENDİOĞLU

Yenidoğanlarda Fototerapi Tedavisinin Oksidatif Stres ve İnflamatuar Yanıt Üzerine Etkisi

Amaç: Oksidatif stresin bir nedeni fototerapi ile oluşan fotodinamik reaksiyonlardır. Fototerapinin bağışıklık sisteminde farklı etkilere yol açan sitokin üretimini değiştirdiği düşünülmektedir. Bu çalışmanın amacı, hiperbilirubinemik yenidoğanlarda ışık yayan diyot (LED) fototerapi ve konvansiyonel fototerapinin oksidatif stres ve inflamatuar yanıt üzerindeki etkilerini araştırmaktır. Gereç ve Yöntemler: Fototerapi ile tedavi edilen 30 term yenidoğan çalışma grubuna alındı. Çalışma grubu LED fototerapi (n=15) ve konvansiyonel fototerapi (n=15) alt gruplarına ayrıldı. Kontrol grubu 30 günlük sağlıklı yenidoğanlardan oluşturuldu. Fototerapi öncesi, fototerapinin 24. saati ve fototerapi tedavisi sonrası kan örnekleri alındı. Gruplar arasında bilirubin, malonaldehit (MDA), toplam oksidatif stres (TOS), toplam antioksidan kapasite (TAC), TNF-α, IL-6 ve IL-8 düzeyleri değerlendirildi. Bulgular: Konvansiyonel fototerapi grubunda fototerapi öncesi ve sonrası MDA ve TAC açısından anlamlı fark yoktu. Bununla birlikte, fototerapi sırasında ve sonrasında TOS seviyeleri, konvansiyonel fototerapi grubunda fototerapi öncesine göre anlamlı derecede yüksekti. Aynı grupta IL-8 seviyeleri fototerapi sırasında fototerapi sonrası ile karşılaştırıldığında anlamlı derecede yüksekti. LED fototerapi grubunda ise oksidatif stres ve inflamatuar yanıt parametrelerinde farklılık yoktu. Sonuç: Konvansiyonel fototerapi oksidatif stresi artırırken ve inflamatuar yanıtın bazı aşamalarında etki gösterirken, LED fototerapinin antioksidan savunma sistemleri ve inflamatuar yanıt üzerinde herhangi bir etkisi gösterilememiştir.

Anahtar Kelimeler:

Hiperbilirubinemi, inflamatuar yanıt, fototerapi, oksidatif stres

THE EFFECT OF PHOTOTHERAPY TREATMENT ON OXIDATIVE STRESS AND INFLAMMATORY RESPONSE IN NEWBORNS

Objective: A reason for oxidative stress is photodynamic reactions with phototherapy. It is thought that phototherapy changes cytokine production which leads to different effects on the immune system. The aim of this study is to investigate the effects of light-emitting diode (LED) phototherapy and conventional phototherapy on oxidative stress and inflammatory response in neonatal hyperbilirubinemia. Material and Methods: Thirty-term newborns treated with phototherapy were enrolled on the study group. The study group was divided into LED phototherapy (n=15) and conventional phototherapy (n=15) subgroups. The control group consisted of 30-term healthy newborns. Blood samples were taken before phototherapy, at the 24th hours of phototherapy and after phototherapy treatment. Bilirubin, malonaldehyde (MDA), total oxidative stress (TOS), total antioxidant capacity (TAC), TNF- α, IL-6 and IL-8 levels were evaluated between groups. Results: There were no significant differences in MDA and TAC in the conventional phototherapy group both before and after phototherapy. However, TOS levels were significantly higher during and after phototherapy than before phototherapy in the conventional phototherapy group. In the same group, IL-8 levels were significantly higher during phototherapy than after phototherapy levels. Whereas, there were no significant differences in oxidative stress and inflammatory response parameters in the LED phototherapy group. Conclusion: While conventional phototherapy increases oxidative stress and acts at some stages of the inflammatory response, there are no effects of LED phototherapy on antioxidant defence systems and inflammatory response.

Keywords:

Hyperbilirubinemia, inflammatory response, phototherapy, oxidative stress,

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