Am J Perinatol 2020; 37(09): 929-932
DOI: 10.1055/s-0039-1691746
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Effect of Neonatal Phototherapy on Eosinophil Levels in Nonsevere Hyperbilirubinemia

Ceren Can
1   Department of Pediatric Immunology and Allergy, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
,
Şahin Hamilcıkan
2   Department of Pediatrics, Bagcılar Training and Research Hospital, Istanbul, Turkey
› Author Affiliations
Further Information

Publication History

06 February 2019

18 April 2019

Publication Date:
24 May 2019 (online)

Abstract

Objective The purpose of the research was to determine the impact of phototherapy (PT) on eosinophil levels in neonates with nonsevere bilirubin levels (<20 mg/dL) treated with PT.

Study Design This observational pilot study included term neonates with early neonatal hyperbilirubinemia.

Results Ninety-six term neonates were included in the study. The male-to-female ratio was 1.23. Hyperbilirubinemia was most frequently related to ABO group incompatibility (49%). Fifty-two neonates (54.1%) were born by normal spontaneous delivery. After PT, while total serum bilirubin, hemoglobin, hematocrit, leukocyte, and neutrophil levels were found to be significantly decreased, eosinophil levels were significantly increased (p = 0.01). No significant difference was found regarding lymphocyte and basophil levels after PT. A statistically significant correlation was found between bilirubin and eosinophil levels before PT (r 2 = 0.28, p = 0.03). No correlation between eosinophil levels and treatment age, gender, diagnosis of hyperbilirubinemia, and delivery route before PT was found. After PT, eosinophil levels increased, while other blood cell series were found to be decreased. The correlation between the bilirubin levels and eosinophil was found to be negative (r 2 = − 0.32, p = 0.02) after PT.

Conclusion PT may increase serum eosinophil levels in term neonates with nonsevere hyperbilirubinemia.

 
  • References

  • 1 Cashore WJ, Oh W, Brodersen R. Reserve albumin and bilirubin toxicity index in infant serum. Acta Paediatr Scand 1983; 72 (03) 415-419
  • 2 Ebbesen F, Nyboe J. Postnatal changes in the ability of plasma albumin to bind bilirubin. Acta Paediatr Scand 1983; 72 (05) 665-670
  • 3 American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004; 114 (01) 297-316
  • 4 Bonilla MA, Menell JS. Disorders of white blood cells. In: Lanzkowsky's Manual of Pediatric Hematology and Oncology. Chap. 13. Elsevier Inc.; 2016: 209-238
  • 5 Aspberg S, Dahlquist G, Kahan T, Källén B. Is neonatal phototherapy associated with an increased risk for hospitalized childhood bronchial asthma?. Pediatr Allergy Immunol 2007; 18 (04) 313-319
  • 6 Gloria-Bottini F, Bottini E. Is there a role of early neonatal events in susceptibility to allergy?. Int J Biomed Sci 2010; 6 (01) 8-12
  • 7 Aspberg S, Dahlquist G, Kahan T, Källén B. Confirmed association between neonatal phototherapy or neonatal icterus and risk of childhood asthma. Pediatr Allergy Immunol 2010; 21 (4 Pt 2): e733-e739
  • 8 Heidarzadeh Arani M, Mosaiebi Z, Movahedian AH, Aabedi AR. The relation between neonatal phototherapy and childhood asthma. Indian J Allergy Asthma Immunol 2011; 25: 97-101
  • 9 Ku MS, Sun HL, Sheu JN, Lee HS, Yang SF, Lue KH. Neonatal jaundice is a risk factor for childhood asthma: a retrospective cohort study. Pediatr Allergy Immunol 2012; 23 (07) 623-628
  • 10 Sun HL, Lue KH, Ku MS. Neonatal jaundice is a risk factor for childhood allergic rhinitis: a retrospective cohort study. Am J Rhinol Allergy 2013; 27 (03) 192-196
  • 11 Huang L, Bao Y, Xu Z. , et al. Neonatal bilirubin levels and childhood asthma in the US Collaborative Perinatal Project, 1959-1965. Am J Epidemiol 2013; 178 (12) 1691-1697
  • 12 Singh M, Ranjan Das R. Probiotics for allergic respiratory diseases--putting it into perspective. Pediatr Allergy Immunol 2010; 21 (2 Pt 2): e368-e376
  • 13 Liu Y, Li P, Lu J. , et al. Bilirubin possesses powerful immunomodulatory activity and suppresses experimental autoimmune encephalomyelitis. J Immunol 2008; 181 (03) 1887-1897
  • 14 Floch MH, Binder HJ, Filburn B, Gershengoren W. The effect of bile acids on intestinal microflora. Am J Clin Nutr 1972; 25 (12) 1418-1426
  • 15 Dani C, Martelli E, Tronchin M. , et al. Bilirubin influence on oxidative lung damage and surfactant surface tension properties. Pediatr Pulmonol 2004; 38 (03) 179-185
  • 16 Haga Y, Tempero MA, Zetterman RK. Unconjugated bilirubin inhibits in vitro major histocompatibility complex-unrestricted cytotoxicity of human lymphocytes. Biochim Biophys Acta 1996; 1316 (01) 29-34
  • 17 Haga Y, Tempero MA, Kay D, Zetterman RK. Intracellular accumulation of unconjugated bilirubin inhibits phytohemagglutinin-induced proliferation and interleukin-2 production of human lymphocytes. Dig Dis Sci 1996; 41 (07) 1468-1474
  • 18 Kurt A, Aygun AD, Kurt AN, Godekmerdan A, Akarsu S, Yilmaz E. Use of phototherapy for neonatal hyperbilirubinemia affects cytokine production and lymphocyte subsets. Neonatology 2009; 95 (03) 262-266
  • 19 Procianoy RS, Silveira RC, Fonseca LT, Heidemann LA, Neto EC. The influence of phototherapy on serum cytokine concentrations in newborn infants. Am J Perinatol 2010; 27 (05) 375-379
  • 20 Tatli MM, Minnet C, Kocyigit A, Karadag A. Phototherapy increases DNA damage in lymphocytes of hyperbilirubinemic neonates. Mutat Res 2008; 654 (01) 93-95
  • 21 Aycicek A, Kocyigit A, Erel O, Senturk H. Phototherapy causes DNA damage in peripheral mononuclear leukocytes in term infants. J Pediatr (Rio J) 2008; 84 (02) 141-146
  • 22 Lee JJ, Dimina D, Macias MP. , et al. Defining a link with asthma in mice congenitally deficient in eosinophils. Science 2004; 305 (5691): 1773-1776
  • 23 Humbles AA, Lloyd CM, McMillan SJ. , et al. A critical role for eosinophils in allergic airways remodeling. Science 2004; 305 (5691): 1776-1779
  • 24 Castro M, Mathur S, Hargreave F. , et al; Res-5-0010 Study Group. Reslizumab for poorly controlled, eosinophilic asthma: a randomized, placebo-controlled study. Am J Respir Crit Care Med 2011; 184 (10) 1125-1132
  • 25 Haldar P, Brightling CE, Hargadon B. , et al. Mepolizumab and exacerbations of refractory eosinophilic asthma. N Engl J Med 2009; 360 (10) 973-984
  • 26 Aydın B, Beken S, Zenciroğlu A, Dilli D, Okumuş N. Blood eosinophil levels in newborns with severe indirect hyperbilirubinemia treated with phototherapy. Iran J Pediatr 2014; 24 (03) 267-272
  • 27 Beken S, Aydin B, Zenciroğğlu A. , et al. The effects of phototherapy on eosinophil and eosinophilic cationic protein in newborns with hyperbilirubinemia. Fetal Pediatr Pathol 2014; 33 (03) 151-156
  • 28 Keshavan P, Deem TL, Schwemberger SJ, Babcock GF, Cook-Mills JM, Zucker SD. Unconjugated bilirubin inhibits VCAM-1-mediated transendothelial leukocyte migration. J Immunol 2005; 174 (06) 3709-3718