Phototherapy increases DNA damage in lymphocytes of hyperbilirubinemic neonates

Tatlı, Mustafa Mansur; Minnet, Coskun; Koçyiğit, Abdürrahim; Karadağ, Ahmet

doi:10.1016/j.mrgentox.2007.06.013

Cited by 68 publications

(40 citation statements)

References 15 publications

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“…First, phototherapy may alter the Th2/Th1 cytokine profile, increasing the levels of tumor necrosis factor-α, IL-1-β, and IL-8 and a reducing the level of IL-6 in newborn infants (18,19). Second, phototherapy causing DNA damage to lymphocytes can affect the genes regulating the Th2/Th1 switch (20,21). Third, UV light, despite being a small component of phototherapy, can activate the inflammatory pathways, leading to allergic diseases or autoimmune disorders (22).…”

Section: Articlesmentioning

confidence: 99%

Neonatal jaundice and risks of childhood allergic diseases: a population-based cohort study

et al. 2015

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Background:Only a few studies have systemically analyzed the association between neonatal jaundice and childhood-onset allergic diseases. Methods: From 2000 to 2007, 27,693 neonates with newly diagnosed neonatal jaundice and 55,367 matched nonneonatal jaundice cohorts were identified. The incidences and hazard ratios (HRs) of five allergic diseases, namely allergic conjunctivitis (AC), allergic rhinitis (AR), atopic dermatitis (AD), asthma, and urticaria, by the end of 2008 were calculated. results: The incidence density and HRs of the five allergic diseases were greater in the neonatal jaundice cohort than in the nonneonatal jaundice cohort, and the HRs declined modestly with age. The HRs for AR (HR = 2.51, 95% confidence interval (CI) = 2.43-2.59) and AD (HR = 2.51, 95% CI = 2.40-2.62) were the highest, and that for urticaria was the lowest (HR = 2.06, 95% CI = 1.94-2.19). The HRs of allergic diseases were substantially greater for boys and those requiring phototherapy. The HRs of the allergic diseases, except urticaria (HR = 2.49, 95% CI = 1.57-3.97), were not significantly different between the neonatal jaundice regardless of whether the patients received exchange transfusion. conclusion: Neonatal jaundice is associated with the development of allergic diseases in early childhood.

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Section: Articlesmentioning

confidence: 99%

Neonatal jaundice and risks of childhood allergic diseases: a population-based cohort study

et al. 2015

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“…More recent studies have confirmed DNA damage in vivo from phototherapy. [11][12][13][14] Epidemiologic studies have focused on leukemia. Three studies from northern Europe found no association.…”

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confidence: 99%

Retrospective Cohort Study of Phototherapy and Childhood Cancer in Northern California

et al. 2016

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OBJECTIVE: To investigate the association between neonatal phototherapy use and childhood cancer.METHODS: This retrospective cohort study included 499 621 children born at ≥35 weeks' gestation from 1995 to 2011 in Kaiser Permanente Northern California hospitals, who survived to hospital discharge and were followed ≥60 days. We obtained data on home and inpatient phototherapy, covariates, and cancer incidence from electronic records. We used propensity-adjusted Cox and Poisson models to control for confounding and unequal follow-up times.RESULTS: There were 60 children with a diagnosis of cancer among 39 403 exposed to phototherapy (25 per 100 000 person-years), compared with 651 of 460 218 unexposed children (18 per 100 000 person-years; incidence rate ratio [IRR] 1.4; P = .01). Phototherapy was associated with increased rates of any leukemia (IRR 2.1; P = .0007), nonlymphocytic leukemia (IRR 4.0; P = .0004), and liver cancer (IRR 5.2; P = .04). With adjustment for a propensity score that incorporated bilirubin levels, chromosomal disorders, congenital anomalies, and other covariates, associations were no longer statistically significant: Adjusted hazard ratios (95% confidence intervals) were 1.0 (0.7-1.6) for any cancer, 1.6 (0.8-3.5) for any leukemia, 1.9 (0.6-6.9) for nonlymphocytic leukemia, and 1.4 (0.2-12) for liver cancer. Upper limits of 95% confidence intervals for adjusted 10-year excess risk were generally <0.1% but reached 4.4% for children with Down syndrome. CONCLUSIONS:Although phototherapy use was associated with increased cancer rates (particularly nonlymphocytic leukemia), control for confounding variables eliminated or attenuated the associations. Nonetheless, the possibility of even partial causality suggests that avoiding unnecessary phototherapy may be prudent.

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“…Although phototherapy has some known adverse effects including skin rash, diarrhea, dehydration, and oxidative stress, no other method with fewer adverse effects that can be used conveniently has yet been developed for the treatment of hyperbilirubinemia (1,2). In addition to the above-mentioned adverse effects, it has been shown that phototherapy might also have adverse effects on chromosomes in some animal and clinical studies (3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

The effect of phototherapy on sister chromatid exchange with different light density in newborn hyperbilirubinemia

Kanmaz¹,

Okur²,

Díllí³

et al. 2018

Turk Pediatri Ars

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Aim: Concerns of possible genotoxic effects of hyperbilirubinemia and phototherapy were raised from experimental and observational studies in neonates. The purpose of this study was to assess the effect of hyperbilirubinemia and phototherapy with three different methods on DNA damage by investigating sister chromatid exchange frequency. Material and Methods: Patients whose gestational ages were >37 weeks and bilirubin levels above phototherapy limits were enrolled into three groups and each group was planned to receive 25 babies. Group 1 received enhanced light-emitting diode phototherapy, group 2 had light-emitting diode phototherapy, and group 3 received conventional phototherapy. Infants with hyperbilirubinemia but did not require phototherapy comprised the control group, which was subdivided into two groups regarding bilirubin levels (10mg/dL). Blood samples were collected before and after phototherapy for sister chromatid exchange frequency and samples were examined by a biologist who was blinded to the study groups. Results: The mean pre-treatment sister chromatid exchange frequency was 1.41±0.34/cell, post-treatment 2.65±0.68/cell, and 1.61±0.61/ cell for the control group (p<0.05). A statistically significant increase in sister chromatid exchange frequency after phototherapy was observed in all three intervention groups (p values: 0.01, 0.01, and 0.008, respectively). When the treatment groups were compared with each other in terms of irradiance, no significant difference was found (p=0.08). Conclusions: Phototherapy causes an increase in the frequency of sister chromatid exchange regardless of the irradiance. Phototherapy could have some genotoxic adverse effects on chromosomes; however, further investigations are warranted to enlighten as to whether these effects are permanent or clinically important.

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Phototherapy increases DNA damage in lymphocytes of hyperbilirubinemic neonates

Cited by 68 publications

References 15 publications

Neonatal jaundice and risks of childhood allergic diseases: a population-based cohort study

Neonatal jaundice and risks of childhood allergic diseases: a population-based cohort study

Retrospective Cohort Study of Phototherapy and Childhood Cancer in Northern California

The effect of phototherapy on sister chromatid exchange with different light density in newborn hyperbilirubinemia

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