Bilirubin isomer distribution in jaundiced neonates during phototherapy with LED light centered at 497 nm (turquoise) vs. 459 nm (blue)

Ebbesen, Finn; Madsen, Poul Thøis; Vandborg, Pernille Kure; Jakobsen, Lasse Hjort; Trydal, Torleif; Vreman, Hendrik J.

doi:10.1038/pr.2016.115

Cited by 28 publications

(31 citation statements)

References 25 publications

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“…Ennever and Dresing reached the same conclusion by calculating the quantum yield for the formation of ( EZ )‐cyclobilirubin from ( EZ )‐bilirubin . The basis of the clinical effect of green light phototherapy has been confirmed, and a clinical effect has been confirmed using LED light closer to monochromatic light . The development of a radiometer to evaluate light sources, however, is not progressing, and evaluation has to be carried out in consideration of light sources with several wavelengths, reported by Kuboi et al .…”

Section: Mechanism Of Phototherapy For Human Neonatal Hyperbilirubinemiamentioning

confidence: 99%

“…Given that a new phototherapy light source that does not produce wavelengths 400–450 nm and is clinically effective has been developed and the radiometer can evaluate the energy of the light source based on the theoretical evidence of phototherapy for neonatal hyperbilirubinemia, it is necessary to examine whether such adverse reactions will decrease using them. The adverse reactions of green light phototherapy include effects on the observer's vision and the phototoxicity of bilirubin to human cells in vitro .…”

Section: Adverse Reactions Of Phototherapy For Neonatal Hyperbilirubimentioning

confidence: 99%

“…5 The basis of the clinical effect of green light phototherapy has been confirmed, 40,41 and a clinical effect has been confirmed using LED light closer to monochromatic light. 42,43 The development of a radiometer to evaluate light sources, however, is not progressing, and evaluation has to be carried out in consideration of light sources with several wavelengths, reported by Kuboi et al 44 (ZE)-Bilirubin, which is less markedly generated using the long wavelength region of visible light, 39 has to be re-evaluated regarding its in vivo effect in phototherapy for human neonatal hyperbilirubinemia. 42 Adverse reactions of phototherapy for neonatal hyperbilirubinemia Important adverse reactions of phototherapy for neonatal hyperbilirubinemia include the subclinical carcinogenic risk, the effect of aggressive phototherapy on extremely low-birthweight (ELBW) infants, 8 and bronze baby syndrome.…”

Section: Mechanism Of Phototherapy For Human Neonatal Hyperbilirubinemiamentioning

confidence: 99%

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Phototherapy for neonatal hyperbilirubinemia

Itoh

Okada

Kuboi

et al. 2017

Pediatrics International

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Approximately 60 years ago in England, phototherapy for neonatal hyperbilirubinemia was used in clinical practice. It was introduced in Japan approximately 50 years ago. At that time, the mechanism underlying the serum bilirubin concentration decrease by phototherapy was still unknown. The mechanism was identified by chemists, biochemists, and pediatricians. Clarification started with the report that unconjugated bilirubin was excreted into bile after photoirradiation in Gunn rats. After confirmation of the molecular structure of bilirubin on X-ray analysis, the mechanism for bile excretion of unconjugated bilirubin was verified based on geometric configurational photoisomers in the Gunn rat. Finally, the reaction and excretion of structural bilirubin photoisomers was proved to be the main mechanism for the decrease in serum bilirubin during phototherapy for neonatal hyperbilirubinemia, which differs from the mechanism in the Gunn rat. The most effective and safest light source and the optimal method to evaluate phototherapy, however, remain unknown. Moreover, as for bronze baby syndrome, which is a well-known adverse reaction to phototherapy, the etiology is unclear. Hence, we review phototherapy for hyperbilirubinemia including a fundamental understanding of the bilirubin photochemical reactions, and discuss the subclinical carcinogenic risk of phototherapy and the increased mortality rate of extremely low-birthweight infants due to aggressive phototherapy, which is becoming an increasing problem.

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Section: Mechanism Of Phototherapy For Human Neonatal Hyperbilirubinemiamentioning

confidence: 99%

Section: Adverse Reactions Of Phototherapy For Neonatal Hyperbilirubimentioning

confidence: 99%

Section: Mechanism Of Phototherapy For Human Neonatal Hyperbilirubinemiamentioning

confidence: 99%

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Phototherapy for neonatal hyperbilirubinemia

Itoh

Okada

Kuboi

et al. 2017

Pediatrics International

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“…Accordingly, we expect that green light is the most suitable light for phototherapy. Nevertheless, there are no reports on the efficacy of green LED phototherapy, especially green LED phototherapy investigated using HPLC in vivo …”

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confidence: 99%

“…Nevertheless, there are no reports on the efficacy of green LED phototherapy, especially green LED phototherapy investigated using HPLC in vivo. [11][12][13] In this study, we conducted a prospective non-blinded randomized controlled trial (RCT) to compare the clinical efficacy of green LED phototherapy with that of blue LED phototherapy.…”

mentioning

confidence: 99%

Green light‐emitting diode phototherapy for neonatal hyperbilirubinemia: Randomized controlled trial

Kuboi¹,

Kusaka

Okada

et al. 2019

Pediatrics International

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Background The main photochemical pathway in phototherapy for neonatal hyperbilirubinemia is the production and elimination (in bile or urine) of cyclobilirubin, which is a structural photoisomer of bilirubin, and which is most efficiently produced by green light. Green light‐emitting diode (LED) phototherapy, however, has not been evaluated in the clinical setting because it is not recommended in American Academy of Pediatrics guidelines. We therefore compared the efficacy of green LED phototherapy and blue LED phototherapy in patients with neonatal hyperbilirubinemia. Methods In this prospective randomized controlled trial, neonates with hyperbilirubinemia were randomly allocated to a green LED or blue LED phototherapy group. Both groups underwent 24 h of phototherapy, and blood was sampled before and after 24 h of phototherapy. Total serum bilirubin (TSB) was measured using enzymatic methods and bilirubin photoisomers were measured on high‐performance liquid chromatography. Results Thirty‐four infants were randomized (green, n = 16; blue, n = 18). TSB decreased significantly from 15.3 ± 1.5 to 13.9 ± 1.5 mg/dL in the green LED group (P < 0.01) and from 16.2 ± 1.3 to 14.5 ± 1.7 mg/dL in the blue LED group (P < 0.01) after 24 h of phototherapy. No significant difference was found in TSB reduction after phototherapy between the groups. Conclusions Both light sources produced a significant reduction in TSB, indicating clinical effectiveness.

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