Jaundice, phototherapy and DNA damage in full-term neonates

Ramy, Nermin; Ghany, Eman Abdel Ghany Abdel; Alsharany, Walaa; Nada, Ayman; Darwish, Rania K.; Rabie, Walaa; Aly, Hany

doi:10.1038/jp.2015.166

Cited by 70 publications

(39 citation statements)

References 29 publications

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“…It may be thought that the increase in the risk of cancer is related with the long-term results of the genotoxic effect of phototherapy or hyperbilirubinemia itself. In studies conducted with Comet assays, it was shown that phototherapy caused DNA damage in peripheral blood lymphocytes and triggered apoptosis (22,23). It would be beneficial to consider such risks when deciding upon the initiation of therapy, especially in neonates with bilirubin levels below phototherapy limits.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…11 Additionally, in vivo experiments on human newborns have demonstrated DNA damage, alterations in cytokine levels, and evidence of oxidative stress after treatment with phototherapy. [12][13][14][15][16][17][18][19][20][21][22] This is concerning because all these conditions have been implicated in the pathogenesis of cancer. 28,29 Although the clinical importance of these alterations remains to be elucidated, they present a potential mechanism whereby phototherapy could be related to childhood cancer.…”

Section: Discussionmentioning

confidence: 99%

“…The potential for phototherapy to increase the incidence of cancer is supported by data from in vitro and in vivo studies. [11][12][13][14][15][16][17][18][19][20][21][22] It is important to determine whether phototherapy contributes to early childhood cancer to determine the optimal management of infants with neonatal hyperbilirubinemia. In this study, we used population-based data to investigate the association between phototherapy and cancer in the first year after birth.…”

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confidence: 99%

Neonatal Phototherapy and Infantile Cancer

et al. 2016

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OBJECTIVE: To determine whether neonatal phototherapy is associated with cancer in the first year after birth. METHODS:We analyzed a data set from the California Office of Statewide Health Planning and Development that was created by linking birth certificates, death certificates, and hospital discharge abstracts up to age 1 year. Subjects were 5 144 849 infants born in California hospitals at ≥35 weeks' gestation from 1998 to 2007. We used International Classification of Diseases, Ninth Revision codes to identify phototherapy at <15 days and discharge diagnoses of cancer at 61 to 365 days. We adjusted for potential confounding variables by using traditional and propensity-adjusted logistic regression models. RESULTS:Cancer was diagnosed in 58/178 017 infants with diagnosis codes for phototherapy and 1042/4 966 832 infants without such codes (32.6/100 000 vs 21.0/100 000; relative risk 1.6; 95% confidence interval [CI], 1.2-2.0, P = .002). In propensity-adjusted analyses, associations were seen between phototherapy and overall cancer (adjusted odds ratio [aOR] 1.4; 95% CI, 1.1-1.9), myeloid leukemia (aOR 2.6; 95% CI, 1.3-5.0), and kidney cancer (aOR 2.5; 95% CI, 1.2-5

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“…It increased significantly after exposure to phototherapy compared with prephototherapy values. The duration of phototherapy correlated positively with markers of DNA damage but the intensity of used light don't have any genotoxic impact [27] (Figure 4).…”

Section: Recents Studies Using Comest Assaymentioning

confidence: 99%

Comet Assay on Toxicogenetics; Several Studies in Recent Years on Several Genotoxicological Agents

Gharsalli¹

2016

J Environ Anal Toxicol

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Jaundice, phototherapy and DNA damage in full-term neonates

Abstract: Hyperbilirubinemia does not influence DNA damage, whereas both conventional and intensive phototherapy are associated with DNA damage in term infants with hyperbilirubinemia.

Cited by 70 publications

References 29 publications

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

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

Neonatal Phototherapy and Infantile Cancer

Comet Assay on Toxicogenetics; Several Studies in Recent Years on Several Genotoxicological Agents

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