The role of nitric oxide in apoptosis modulation in newborns with pneumonia

Introduction. Nitric oxide (NO) is an im-portant diagnostic marker and mediator in the inflammatory process, which plays a key role in the mechanism of programmed cell death, thus, forming the basis of many pathological diseases.

Methods. The study involved 73 newborns with pneumonia (moderate severity in 44 neonates (group 1), severe pneumonia in 29 (group 2)). The intensity of neutrophil apoptosis and necrosis was determined by flow cytometry, whereas nitric oxide me-tabolites were measured by spectropho-tometry. 

Results. The level of nitric oxide metabo-lites (NO2+NO3) in newborns with pneu-monia was higher than in healthy children (16.93 (15.82; 17.79) μmol/ml) and cor-related with disease severity (in group 1 – 22.65 (21.42; 23.40) μmol/ml in group 2 – 26.82 (25.81; 27.91) μmol/ml). The level of NO3 increased moderately, while NO2 generation was more intense, exceed-ing control indexes in both groups (рc-1<0.001; рc-2<0.001; р1-2<0.001).

The occurrence of intensive neutrophil apoptosis was revealed in newborns with pneumonia of moderate severity (рc-1<0.001), while necrosis prevailed in se-vere pneumonia (рc-2<0.001).

Inverse correlation (R=-0.63; р<0.05) was found between the level of nitric oxide metabolites and neutrophil apoptosis; and direct correlation (R=0.68; р<0.05) was re-vealed between NO metabolites and neu-trophil necrosis indices.

Conclusions. Increased generation of nitric oxide metabolites, that directly correlated with disease severity in newborns with pneumonia, was found. NO2 has multidi-rectional effects on neutrophil apoptosis and necrosis, leading to toxic accumula-tion of neutrophils in the organism, thus enhancing the inflammatory and intoxica-tion process that impact disease severity.

nitric oxide, apoptosis, necrosis, neutrophils, pneumonia, newborn

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