In an infant’s body, all the systems undergo significant changes in order to adapt to the new, extrauterine environment and challenges which it poses. Fragile homeostasis can be easily disrupted as the defensive mechanisms are yet imperfect. The activity of antioxidant enzymes, i.e., superoxide dismutase, catalase, and glutathione peroxidase, is low; therefore, neonates are especially vulnerable to oxidative stress. Free radical burden significantly contributes to neonatal illnesses such as sepsis, retinopathy of premature, necrotizing enterocolitis, bronchopulmonary dysplasia, or leukomalacia. However, newborns have an important ally—an inducible heme oxygenase-1 (HO-1) which expression rises rapidly in response to stress stimuli. HO-1 activity leads to production of carbon monoxide (CO), free iron ion, and biliverdin; the latter is promptly reduced to bilirubin. Although CO and bilirubin used to be considered noxious by-products, new interesting properties of those compounds are being revealed. Bilirubin proved to be an efficient free radicals scavenger and modulator of immune responses. CO affects a vast range of processes such as vasodilatation, platelet aggregation, and inflammatory reactions. Recently, developed nanoparticles consisting of PEGylated bilirubin as well as several kinds of molecules releasing CO have been successfully tested on animal models of inflammatory diseases. This paper focuses on the role of heme metabolites and their potential utility in prevention and treatment of neonatal diseases.
Introduction. Turner syndrome (TS) is one of the most common chromosomal aberrations. Patients with TS reach a final height that is 20 cm shorter than the average female height in a given population. Recombinant human growth hormone (rhGH) therapy is used, which improves the height gain and allows to achieve a more satisfying final stature. Materials and methods. In this study, we analyzed data of 13 patients of the University Children's Hospital in Lublin diagnosed with TS. All of the participants were qualified for the growth hormone therapy program and all of them received rhGH for at least 3 years. Results. The patients' mean height at initiation of therapy was 119.9 ± 19 cm. In all cases, height was <3pc for age and sex. In the first three years of therapy, patients took a mean dose of growth hormone 0.05 ± 0.01 mg/kg/day. After initiating rhGH, the mean height velocity (HV) in the first year of therapy was the greatest and reached 7.77 ± 1.85 cm/year, it was also higher in patients with lower initial height and in those who started therapy earlier. In the second and third year of rGH therapy, the height velocity clearly decreased. Neither the hormone dosage or the age at initiation of therapy significantly affected the three-year treatment effect. After three years of therapy, no side effects, which would be the basis for discontinuation of treatment, were observed. Conclusions. In most patients with TS, rhGH therapy at a dose of 0.05 Evaluation of the results of Turner syndrome patients during the first three years of recombinant human growth hormone therapy (± 0.011) mg/kg/day causes a significant increase in the height velocity especially in first year of treatment.
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