Abstract
Background and aims: Preterm infants with sepsis have poorer long term outcome than preterm controls. Free radical production is increased during sepsis and the severity of oxidative stress is related to outcome. Preterm infants have reduced antioxidant defenses in the direct postnatal phase. We hypothesized that preterm infants are unable to up regulate the synthesis rate of the major intracellular antioxidant, glutathione (GSH), during sepsis, which could provide a mechanism through which sepsis might have a detrimental effect. The aim of this study was to quantify GSH synthesis rates in erythrocytes of preterm infants with sepsis and control subjects.
Methods: Preterm infants (birth weight < 1500 g) who were diagnosed with nosocomial sepsis (according to CDC criteria) and matched controls were included. [U-13C]glycine, a precursor for GSH synthesis, was administered within 24 hours after onset of symptoms to determine fractional synthesis rate (FSR). Glycine enrichment in GSH was determined using liquid chromatography coupled to isotope ratio mass spectrometry (LC-IRMS). Absolute synthesis rate was calculated from the FSR and GSH concentration. In plasma, oxidative stress markers were determined.
Results: Gestational age (271/7±21/7 weeks), birth weight (872±220 g), age at study (9±5 days) and weight at study (909±246 g) were not significantly different between groups (n=7 each). GSH synthesis rates and concentration were not statistically different (figure).
Conclusion: Preterm infants did not upregulate the GSH synthesis in response to sepsis, but GSH concentrations were not lowered by sepsis either.
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Rook, D., Schierbeek, H., De Groot, J. et al. 18 Preterm Infants Do Not Upregulate Gsh Synthesis During Sepsis. Pediatr Res 68 (Suppl 1), 12 (2010). https://doi.org/10.1203/00006450-201011001-00018
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DOI: https://doi.org/10.1203/00006450-201011001-00018