Asymmetric dimethylarginine and l-arginine levels in neonatal sepsis and septic shock. (May 2015)

• Record Type: Journal Article
• Authors: Aydemir, Ozge; Ozcan, Beyza; Yucel, Husniye; Yagmur Bas, Ahmet; Demirel, Nihal
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 28:Number 8(2015)
• Page Start: 977
• Page End: 982
• Publication Date: 2015-05
• Subjects: Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.3109/14767058.2014.939950
• Languages: English
• ISSNs: 1476-7058

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objective</italic>: Nitric oxide (NO) formed by the enzyme NO synthase (NOS) from <sc>l</sc>-arginine, is an important mediator for pathogen elimination. Being a potent vasodilator NO is implicated in hypotension and decreased organ perfusion in sepsis. Asymmetric dimethylarginine (ADMA) is an endogenous NOS inhibitor. We investigated ADMA and <sc>l</sc>-arginine levels in neonatal sepsis and their relation to disease severity.</p> <p> <italic>Methods</italic>: A prospective controlled study was conducted including 31 neonates with sepsis and 20 controls. Serum ADMA and <sc>l</sc>-arginine levels were measured within 24 h of sepsis diagnosis. Clinical and laboratory data including clinical risk index for babies (CRIB) score, presence of septic shock, organ dysfunction and death were recorded.</p> <p> <italic>Results</italic>: <sc>l</sc>-Arginine and ADMA levels were higher in neonates with sepsis compared to controls (<italic>p</italic> = 0.029 and <italic>p</italic> = 0.001, respectively). Neonates with septic shock had higher ADMA levels compared to septic neonates without shock (<italic>p</italic> = 0.026) and controls (<italic>p</italic> < 0.001). <sc>l</sc>-Arginine levels were higher in neonates with septic shock compared to septic neonates without shock (<italic>p</italic> = 0.012) and controls (<italic>p</italic> < 0.001). Survivors and non-survivors had similar <sc>l</sc>-arginine and ADMA levels. ADMA levels were correlated with CRIB score (rho = 0.320, <italic>p</italic> = 0.025).</p> <p> <italic>Conclusion</italic>: <sc>l</sc>-arginine and ADMA levels are elevated in neonatal sepsis and even higher levels are observed in septic shock.</p> </abstract>