OXIDATIVE STRESS AND INFLAMMATORY ALTERATIONS DURING PHOTOTHERAPY OF NEONATAL ICTERUS: SYSTEMATIC REVIEW AND META-ANALYSIS
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Keywords
Neonatal Jaundice, Oxidative Stress, Malondialdehyde, Total Antioxidant Capacity, Total Oxidative Stress, Cytokines, TNF-α, IL-6
Abstract
Purpose: Phototherapy is used in the treatment of neonatal hyperbilirubinemia. There are contravening reports on its its adverse effect. This meta-analysis was conducted to substantiate the impact of phototherapy on the parameters indicating oxidative stress and pro-inflammatory cytokines.
Methods: The relevant clinical studies were searched on PubMed, Google Scholar, Stanford University High-Wire Press, Clinical trial registry, and on Semantic Scholar published up to 30th July 2022. Newcastle-Ottawa Scale was used to assess the study qualities. The overall estimate was calculated in terms of odds ratio with 95% confidence interval using random effect model. The sensitivity and subgroup analysis were carried out along with the qualitative assessment of the publication bias. All the analysis was carried out using RevMan 5.
Results: Total 1735 participants from 31 pertinent studies were used for the quantitative analysis. The pooled estimates of the phototherapy-exposed group were compared with the control group. Our analysis revealed that phototherapy used in treating neonatal jaundice induced significant oxidative stress and increased the levels of inflammatory cytokines. Overall estimate measure i.e., mean difference was found to be significant [1.39 (0.79 1.99)] for MDA (nmol per ml), [-0.87 (-1.35 -0.39)] for MDA (nmol per litre) [-0.25 (-0.34 -0.15)] for TAC, [-81.68 (-105.50 -57.85)] for TNF-α, and non-significant for TOS and IL-6 i.e [1.36(-2.67 5.39)] and [1.96 (-0.89 4.81)] respectively
Conclusion: Therapeutic exposure to phototherapy in treating neonatal jaundice induces a rise in oxidative stress and inflammatory cytokine levels. The short and long-term clinical outcomes may have clinical significance.
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Hemakshi Chaudhari
Department of Clinical Pharmacy, R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, Dist- Dhulia, Maharashtra, India
Chandrakant Gawli
Department of Pharmacology, R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, Dist- Dhulia, Maharashtra India
Anoop Kumar
Department of Pharmacology and Clinical research, Delhi Pharmaceutical Sciences & Research University (DPSRU), New Delhi India
Dr. Chandragouda R. Patil.
Professor and HOD, Department of Pharmacology, R.C.Patel Institute of Pharmaceutical Education and Research Karwand Naka, Shirpur, Dist- Dhule, Maharashtra (425405), Tel No :( 02563) 255189 (Office); 09823400240 (Mobile)Fax :( 02563) 251808