Author : J. Al-Tu, Fadhil
Glutathione and other Antioxidant Status in Neonatal Hyperbilirubinemia with Severe G6PD Deficiency in Babylon Province : Iraq
karbala journal of pharmaceutical sciences,
Volume 1, Issue 1, Pages 12-25
The objectives of this study were an attempt to evaluate and to compare between some of the antioxidant and biochemical parameters investigated in severe G6PD-deficient neonates with hyperbilirubinemia with TSB≥ 15 mg/dl.
The study included a total of 236 full-term male neonates, 53 neonates were control and 183 of them with hyperbilirubinemia who were admitted in Babylon Hospital of Pediatric and Maternity / Babylon during 1st , Oct., 2007 and 12th, July, 2008 with age ranged between 1 – 28 days .
All the neonates were screened for erythrocyte G6PD enzyme activity measurement to confirm the diagnosis of G6PD deficiency. Of these subjects, 53 neonates (22.46%) of them showed a normal enzyme activity levels ; whereas the remaining 183 (77.54%) neonates were found to have neonatal hyperbilirubinemia with TSB levels ≥ 15 mg/dl. Among them, only 22 neonates were diagnosed to have severe G6PD deficiency and its percentages of incidence identified was 12.02%.
The results indicated that there was a significant negative correlation (r = − 0.203 , P < 0.05) between the decreased G6PD activity levels and the elevated TSB concentrations in severe G6PD-deficient hyperbilirubinemic neonates. These data suggest that the G6PD-deficient neonates are at increased risk for hyperbilirubinemia even in the nursery free from agents that can potentially cause hemolysis to G6PD-deficient red cells.
The mean ± SD of antioxidant status and oxidative stress parameters which include erythrocyte GSH, MDA, G-Red, G-Px and catalase were determined. There was a significant decrease in each of erythrocyte GSH, G-Red and catalase activity levels (P<0.05), whereas the lipid peroxidation end product MDA levels and G-Px activity levels were significantly increased in all hyperbilirubinemic neonates (P < 0.05) as compared with the control group.
G6PD activity values identified were found to be positively correlated with each of GSH concentrations, G-Red and catalase activity levels in which their values were found to decreased in patient groups, while it was found to be negatively correlated with each of G-Px activity and MDA levels in which their values were elevated in severe G6PD-deficient neonates. These data indicates an increases in free radical generation and thus antioxidant defense mechanisms is impaired in peroxidation associated with a significant elevation in MDA levels in the erythrocytes of the hyperbilirubinemic neonates with severe G6PD deficiency than that found in the control group which demonstrate the presence of an increased oxidative stress due to reduction in NADPH which is generated in RBCs by HMP-shunt only.