Department of Pediatrics, Division of Neonatology.
Department of Pediatrics, Division of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine.
Blood Coagul Fibrinolysis. 2024 Jul 1;35(5):227-231. doi: 10.1097/MBC.0000000000001297. Epub 2024 May 10.
We aimed to evaluate the effect of hyperbilirubinemia and phototherapy on total apoptotic, platelet-derived, endothelial-derived, and tissue factor (TF)-positive apoptotic microparticle (MP) levels in neonates with nonhemolytic pathologic hyperbilirubinemia.
Thirty-three term neonates with nonhemolytic pathologic hyperbilirubinemia and 25 healthy term neonates were included. MP levels were analyzed by flow cytometry using peripheral blood samples only once for the neonates in the control group and twice for the neonates in the study group (before and after phototherapy). Annexin V-positive MPs were defined as apoptotic MPs. Platelet-derived MPs were defined as those containing CD31. MPs containing CD144 were defined as endothelial-derived MPs, and MPs expressing TF were identified as those containing CD142.
The rates of total apoptotic and endothelial-derived apoptotic MPs were significantly higher in the study group than the control group before phototherapy (P = 0.012 and P = 0.003, respectively) and after phototherapy (P = 0.046 and P = 0.001, respectively). Total apoptotic, platelet-derived, endothelial-derived, and TF-positive apoptotic MPs did not show any significant differences before and after phototherapy in the study group (P = 0.908, P = 0.823, P = 0.748, and P = 0.437, respectively).
Our study demonstrated that total apoptotic and endothelial-derived apoptotic MPs are increased in cases of nonhemolytic pathologic hyperbilirubinemia. We showed that phototherapy does not have a significant effect on apoptotic MP levels. Further studies are needed to evaluate the risk of elevated apoptotic MPs on the development of thromboembolism in neonates with nonhemolytic pathologic hyperbilirubinemia.
评估非溶血性病理性高胆红素血症患儿的高胆红素血症和光疗对总凋亡、血小板衍生、内皮衍生和组织因子（TF）阳性凋亡微粒（MP）水平的影响。
纳入 33 例非溶血性病理性高胆红素血症的足月新生儿和 25 例健康足月新生儿。仅对对照组新生儿进行一次外周血样本的 MP 水平分析，对研究组新生儿进行两次分析（光疗前后）。用流式细胞术分析 Annexin V 阳性 MP 为凋亡 MP。血小板衍生 MP 定义为含有 CD31 的 MP。含有 CD144 的 MP 定义为内皮衍生 MP，表达 TF 的 MP 鉴定为含有 CD142 的 MP。
在光疗前和光疗后，研究组总凋亡和内皮衍生凋亡 MP 的比例均显著高于对照组（P=0.012 和 P=0.003；P=0.046 和 P=0.001）。光疗前后，研究组总凋亡、血小板衍生、内皮衍生和 TF 阳性凋亡 MP 均无显著差异（P=0.908、P=0.823、P=0.748 和 P=0.437）。
本研究表明非溶血性病理性高胆红素血症时总凋亡和内皮衍生凋亡 MP 增加。我们表明光疗对凋亡 MP 水平没有显著影响。需要进一步研究来评估非溶血性病理性高胆红素血症患儿升高的凋亡 MP 对血栓栓塞形成风险的影响。
