Evaluation of Plasma Amino Acid Levels in Preterm Infants and Their Potential Correlation with Retinopathy of Prematurity

Abstract

Aim. The aim of this study is to ascertain whether the level of circulating amino acids (aa) is associated with retinopathy of prematurity (ROP). Methods. This is a randomized controlled study of 55 infants born at gestational age (GA) ≤32 weeks or birth weight (BW) ≤1500 grams. Serum samples were obtained from two groups: Group A comprised of 26 preterm infants with ROP and Group B comprised of 29 preterm infants without ROP. Plasma aa levels were analyzed using liquid chromatography with tandem mass spectrometry (LC-MS/MS). Correlation test and multivariate regression analysis were used to evaluate the relationship between plasma aa levels and variables. Results. The mean serum arginine and glutamine levels were significantly higher, but the mean lysine and aspartic acid levels were significantly lower in Group A, compared to Group B ( p = 0.04 , p = 0.002 , p = 0.029 , and p = 0.002 , respectively). In multivariate analysis, the mean arginine and lysine levels were significantly associated with the stage of the disease ( p = 0.03 and p = 0.01 , respectively). No significant differences were determined between the groups in terms of alanine, asparagine, valine, leucine, phenylalanine, tyrosine, serine, proline, citrulline, cysteine, ornithine, tryptophan, methionine, threonine, taurine, and isoleucine amino acids ( p > 0.05 , respectively). Conclusions. These results indicate a significant association between high arginine and glutamine, with low lysine and aspartic acid serum concentrations with ROP. Due to higher serum concentrations in ROP, extra arginine-glutamine supplementation in hyperoxic conditions may be unfavorable through pathways involving reactive oxygen, particularly in patients with ROP.

Plasma levels of amino acids and derivatives in retinopathy of prematurity

“…The pathogenesis of ROP as well as its comorbidities inevitably result in profound changes in metabolism and nutrition. Particularly, previous studies have indicated the importance of amino acids in ROP pathogenesis [4,5]. Better nutrition, especially supplementation of amino acids is essential for the synthesis of growth factors like insulin-like growth factor-1 (IGF-1), which plays a crucial role in the Ivyspring International Publisher progress of ROP [6].…”

Amino Acids Metabolism in Retinopathy: From Clinical and Basic Research Perspective

“…In terms of the potential as biomarkers, different amino acids have different characteristics, leading to various clinical applications. Glutamine and arginine tend to increase in peripheral blood samples from DR, AMD, and ROP patients according to the analysis of metabolomics [17][18][19][20][21]23,[25][26][27][28][29]43,45,52,55,56,58], which makes it possible and reasonable for glutamine and arginine to be the biomarkers used in early diagnosis of retinopathy. In addition, the level of alanine rises in DR patients in intraocular fluids, blood samples, and even in CSF and urine while not showing clear tendency in AMD and ROP [19,22,27,[31][32][33].…”

Nutrition strategies to prevent short-term adverse outcomes in preterm neonates

“…However, the group with worsened ROP also had a significantly lower mean gestation age, which may have affected the outcome. 18 Additionally, a case-control study further demonstrated elevated citrulline and aminoadipic acid in neonates with ROP. 19 Contrary to these findings, supplementation using a dipeptide of glutamine and arginine inhibited vascular endothelial growth factor expression and, therefore, neovascularisation in oxygen-induced retinopathy murine models.…”