Maurice J Huizing1, Moreyba Borges-Luján2, Giacomo Cavallaro3, Gema E González-Luis2, Genny Raffaeli3,4, Pilar Bas-Suárez5, Jaap A Bakker6, Rob M Moonen7, Eduardo Villamor1. 1. Department of Pediatrics, Maastricht University Medical Centre (MUMC+), School for Oncology and Developmental Biology (GROW), Maastricht, Netherlands. 2. Department of Neonatology, Complejo Hospitalario Universitario Insular Materno-Infantil (CHUIMI) de Canarias, Las Palmas de Gran Canaria, Spain. 3. Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy. 4. Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. 5. Department of Pediatrics, Hospital Vithas Santa Catalina, Las Palmas de Gran Canaria, Spain. 6. Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, Netherlands. 7. Department of Pediatrics, Zuyderland Medical Center, Heerlen, Netherlands.
Abstract
Background: Amino acids are increasingly recognized as bioactive molecules in numerous physiological and pathophysiological pathways. The non-essential amino acid glutamate is vasoactive in the rat ductus arteriosus (DA) and a decrease in its levels within the 1st days of life has been associated with the presence of patent DA (PDA) in extremely preterm infants. However, these findings have not been confirmed in other studies. Objective: To investigate the possible association between amino acid concentrations in the 1st day of life and the presence of PDA in a cohort of 121 newborns with gestational age (GA) below 30 weeks and birth weight (BW) below 1,500 g. Methods: Plasma samples were collected 6-12 h after birth and amino acid concentrations were determined by tandem mass spectrometry. Besides PDA, we analyzed the potential association of amino acid concentrations with infant sex, small for GA (SGA, defined as BW < third percentile), antenatal corticosteroids, chorioamnionitis, and preeclampsia. Group differences were analyzed by ANOVA adjusted for GA and BW. A Bonferroni significance threshold of P < 0.0024 was used to correct for multiple testing. Results: PDA was found in 48 of the 121 infants examined. We observed higher mean levels of glutamate in infants with PDA (147.0 μmol/L, SD 84.0) as compared with those without (106.7 μmol/L, SD 49.1, P = 0.0006). None of the other amino acid concentrations in the PDA group reached the level of statistical significance that was pre-set to correct for multiple comparisons. Glutamate levels were not significantly affected by infant sex, being SGA, or by exposure to antenatal corticosteroids, clinical chorioamnionitis, or preeclampsia. Conclusion: Our study not only does not confirm the previous findings of low glutamate levels in preterm infants with PDA, but we have even found elevated glutamate concentrations associated with PDA. Nevertheless, despite the high statistical significance, the difference in glutamate levels may lack clinical significance or may be an epiphenomenon associated with the particular clinical condition of infants with PDA.
Background: Amino acids are increasingly recognized as bioactive molecules in numerous physiological and pathophysiological pathways. The non-essential amino acid glutamate is vasoactive in the rat ductus arteriosus (DA) and a decrease in its levels within the 1st days of life has been associated with the presence of patent DA (PDA) in extremely preterm infants. However, these findings have not been confirmed in other studies. Objective: To investigate the possible association between amino acid concentrations in the 1st day of life and the presence of PDA in a cohort of 121 newborns with gestational age (GA) below 30 weeks and birth weight (BW) below 1,500 g. Methods: Plasma samples were collected 6-12 h after birth and amino acid concentrations were determined by tandem mass spectrometry. Besides PDA, we analyzed the potential association of amino acid concentrations with infant sex, small for GA (SGA, defined as BW < third percentile), antenatal corticosteroids, chorioamnionitis, and preeclampsia. Group differences were analyzed by ANOVA adjusted for GA and BW. A Bonferroni significance threshold of P < 0.0024 was used to correct for multiple testing. Results: PDA was found in 48 of the 121 infants examined. We observed higher mean levels of glutamate in infants with PDA (147.0 μmol/L, SD 84.0) as compared with those without (106.7 μmol/L, SD 49.1, P = 0.0006). None of the other amino acid concentrations in the PDA group reached the level of statistical significance that was pre-set to correct for multiple comparisons. Glutamate levels were not significantly affected by infant sex, being SGA, or by exposure to antenatal corticosteroids, clinical chorioamnionitis, or preeclampsia. Conclusion: Our study not only does not confirm the previous findings of low glutamate levels in preterm infants with PDA, but we have even found elevated glutamate concentrations associated with PDA. Nevertheless, despite the high statistical significance, the difference in glutamate levels may lack clinical significance or may be an epiphenomenon associated with the particular clinical condition of infants with PDA.
Authors: Jillian L LeMaistre; Samuel A Sanders; Michael J Stobart; Lingling Lu; J David Knox; Hope D Anderson; Christopher M Anderson Journal: J Cereb Blood Flow Metab Date: 2011-11-09 Impact factor: 6.200
Authors: Sorina R Simon; Lieke van Zogchel; Maria Pilar Bas-Suárez; Giacomo Cavallaro; Ronald I Clyman; Eduardo Villamor Journal: Neonatology Date: 2015-07-07 Impact factor: 4.035
Authors: Manal El Sayed; Lobna Sherif; Reem N Said; Amany S E El-Wakkad; Amira El-Refay; Hany Aly Journal: Am J Perinatol Date: 2010-08-10 Impact factor: 1.862
Authors: Elisa Fiumana; Helena Parfenova; Jonathan H Jaggar; Charles W Leffler Journal: Am J Physiol Heart Circ Physiol Date: 2003-04 Impact factor: 4.733
Authors: Maaike A Riedijk; Dana-Anne H de Gast-Bakker; Josias L D Wattimena; Johannes B van Goudoever Journal: Pediatr Res Date: 2007-10 Impact factor: 3.756