Effects of Melatonin Treatment in Septic Newborns

Gitto, Eloisa; Karbownik, Małgorzata; Reíter, Russel J.; Tan, Dun Xian; Cuzzocrea, Salvatore; Chiurazzi, Pietro; Cordaro, S; Corona, Giuseppina; Trimarchi, Giuseppe; Barberi, Ignazio

doi:10.1203/00006450-200112000-00021

Cited by 474 publications

(387 citation statements)

References 22 publications

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“…However, the number of patients in control group did not reach the initially planned level because most infants hospitalized during the study period had major respiratory, cardiac and neurological problems partly because of the fact that our NICU is a tertiary care neonatal referral unit in South Marmara region of Turkey. The infants were classified into four groups according to the criteria defined by Gitto et al 17 group 1 (high probable sepsis), group 2 (probable sepsis), group 3 (possible sepsis) and group 4 (no sepsis, control group). Infants with neonatal convulsion, neonatal hypoglycemia, neonatal hyperbilirubinemia who had no signs of clinical and laboratory infection were referred to as the control group.…”

Section: Methodsmentioning

confidence: 99%

Comparison of serum amyloid A concentrations with those of C-reactive protein and procalcitonin in diagnosis and follow-up of neonatal sepsis in premature infants

et al. 2008

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Objective: The purpose of this study was to determine the role of serum amyloid A (SAA) in diagnosis of neonatal sepsis and evaluation of clinical response to antibiotic therapy. We also aimed to compare the efficiency of SAA with that of C-reactive protein (CRP) and procalcitonin (PCT) in diagnosis and follow-up of neonatal sepsis in preterm infants.Study Design: A total of 163 infants were enrolled in this prospective study. The infants were classified into four groups: group 1 (high probable sepsis), group 2 (probable sepsis), group 3 (possible sepsis) and group 4 (no sepsis, control group). Blood samples for whole blood count, CRP, PCT, SAA and culture were obtained before initiating antibiotic treatment. This procedure was repeated three times at 48 h, 7 and 10 days.Result: Initial CRP, PCT and SAA levels were found to be positive in 73.2, 75.6 and 77.2% of all infants, respectively. Sensitivities of CRP, PCT and SAA at 0 h were 72.3, 74.8 and 76.4%, respectively. Although it was not statistically significant, SAA was found to be more sensitive than CRP and PCT in diagnosis of neonatal sepsis. The area under the curve (AUC) for CRP, PCT and SAA at 0 h were 0.870, 0.870 and 0.875, respectively. Although the AUC for SAA at 0 h was higher than PCT and CRP, the difference was not statistically significant. Conclusion:SAA is an accurate and reliable marker for diagnosis and follow-up of neonatal sepsis. It is especially useful at the onset of inflammation for rapid diagnosis of neonatal sepsis and can be safely and accurately used in combination with other sepsis markers such as CRP and PCT in diagnosis and follow-up of neonatal sepsis in preterm infants.

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Section: Methodsmentioning

confidence: 99%

Comparison of serum amyloid A concentrations with those of C-reactive protein and procalcitonin in diagnosis and follow-up of neonatal sepsis in premature infants

et al. 2008

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“…Melatonin prevents multiple organ failure, circulatory failure, and mitochondrial damage in model of experimental sepsis [137], and reduces mortality in septic children together with lipid peroxidation as an index of inflammation [138]. Melatonin was shown to improve clinical outcome in terms of infection and organ failure in randomized clinical trials, thus being a promising antioxidant molecule in antioxidant therapy to combat sepsis [132][133][134]137].…”

Section: Role Of Melatonin In Maintaining and Restoring Human Healthmentioning

confidence: 99%

Melatonin: A pleiotropic molecule regulating inflammation

Radogna

Diederich

Ghibelli

2010

Biochemical Pharmacology

308

247

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Melatonin is a neurohormone produced by the pineal gland that regulates sleep and circadian functions. Melatonin also regulates inflammatory and immune processes acting as both an activator and inhibitor of these responses. Melatonin demonstrates endocrine, but also paracrine and autocrine effects in the leukocyte compartment: on one side, leukocytes respond to melatonin in a circadian fashion; on the other side, leukocytes are able to synthesize melatonin by themselves.With its endocrine and paracrine effects, melatonin differentially modulates pro-inflammatory enzymes, controls production of inflammatory mediators such as cytokines and leukotrienes and regulates the lifespan of leukocytes by interfering with apoptotic processes. Moreover, its potent anti-oxidant ability allows scavenging of oxidative stress in the inflamed tissues. The interesting timing of pro-and anti-inflammatory effects, such as those affecting lipoxygenase activity, suggests that melatonin might promote early phases of inflammation on one hand and contribute to its attenuation on the other hand, in order to avoid complications of chronic inflammation. This review aims at giving a comprehensive overview of the various inflammatory pathways regulated by this pleiotropic hormone.

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“…Melatonin, which works as a free radical scavenger, given to a small number of term infants with sepsis has been associated with higher platelet counts within 24 to 48 hours after treatment. 37 Thrombocytopenia contributes to morbidity and mortality of NEC and is a poor prognostic sign. Evidence supports that platelet destruction is the major contributor to thrombocytopenia in NEC, although depressed platelet production may also contribute.…”

Section: Pathophysiology Of Thrombocytopeniamentioning

confidence: 99%

Hematologic Abnormalities in Severe Neonatal Necrotizing Enterocolitis: 25 Years Later

Kling

Hutter

2003

J Perinatol

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Necrotizing enterocolitis (NEC), the most common surgical emergency in newborns, remains a therapeutic challenge for clinicians. The hematological manifestations associated with NEC were first described 25 years ago. This review discusses current knowledge of the pathophysiology involved in disturbances in megakaryocytopoiesis, coagulation, leukopoiesis, and erythropoiesis that accompany the clinical entity NEC. The discussion includes current understanding of and potential strategies for treating the hematopoietic disturbances that occur secondary to NEC.

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Effects of Melatonin Treatment in Septic Newborns

Cited by 474 publications

References 22 publications

Comparison of serum amyloid A concentrations with those of C-reactive protein and procalcitonin in diagnosis and follow-up of neonatal sepsis in premature infants

Comparison of serum amyloid A concentrations with those of C-reactive protein and procalcitonin in diagnosis and follow-up of neonatal sepsis in premature infants

Melatonin: A pleiotropic molecule regulating inflammation

Hematologic Abnormalities in Severe Neonatal Necrotizing Enterocolitis: 25 Years Later

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