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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
31

Etudes structurales et biochimiques de la γ-kétol réductase chloroplastique d'Arabidopsis thaliana : caractérisation d’une nouvelle classe de « Medium chain dehydrogenase/reductase » impliquée dans la détoxification. / Structural and biochemical studies of a chloroplast γ-ketol reductase of Arabidopsis thaliana : characterization of a new class of "Medium chain dehydrogenase/reductase " involved in detoxification

Mas y Mas, Sarah 30 October 2015 (has links)
Sous l'effet du stress oxydatif, la production des espèces réactives de l'oxygène (ERO) est accrue. Les ERO peuvent réagir avec différentes molécules biologiques dont les acides gras polyinsaturés libres ou provenant des lipides membranaires engendrant la formation d'hydroperoxydes d'acides gras. Dans le chloroplaste, ces molécules sont sujettes à de nombreuses modifications enzymatiques ou chimiques aboutissant à la formation d'oxylipines. Les oxylipines participent à la signalisation cellulaire (précurseurs de la voie du jasmonate par exemple), à la défense de la plante (activité antimicrobienne par exemple). Certaines de ces molécules très réactives et toxiques doivent être métabolisées en des produits moins réactifs, par des réactions d'oxydoréduction par exemple.La ceQORH (chloroplast envelope Quinone OxydoReductase Homolog) et IEP32 (Inner Envelope Protein 32) d'Arabidopsis thaliana sont des oxydoréductases chloroplastiques impliquées dans la détoxification de la plante. Elles sont transportées au travers de l'enveloppe du chloroplaste sans clivage de leur peptide de transit par une voie d'import alternative à la voie TOC/TIC (Translocon at the Outer envelope membrane of Chloroplasts et Translocon at the Inner envelope membrane of Chloroplasts). Ces particularités ont fait de la ceQORH et d'IEP32 des enzymes intéressantes à étudier.IEP32 a été purifiée et cristallisée. Les structures de la ceQORH sous forme apo, liée au NADPH et liée au NADP+ et à des inhibiteurs ont été déterminées en utilisant la cristallographie aux rayons X. Leur analyse a permis de mettre en évidence que la ceQORH existe sous différents états oligomériques dans les conditions expérimentales utilisées. Ces observations ont été confirmées par des expériences d'ultracentrifugation analytique. La ceQORH est une enzyme monomérique qui lie le NADPH par l'intermédiaire de son domaine de Rossmann . Le site catalytique, large et hydrophobe, permet à la ceQORH d'accommoder et de réduire un grand nombre de substrat dont le motif commun est la présence d'une fonction alcène en α, β d'un groupement carbonyle. Les constantes d'efficacité et d'affinité étant meilleures pour les γ-kétols que pour les quinones, nous proposons que la ceQORH soit renommée « γ-kétol réductase ».Mots clefs : chloroplaste - Medium chain dehydrogenase/reductase - γ-kétol réductase - oxylipines - oligomérisation - inhibition - cristallographie aux rayons X - ultracentrifugation analytique / Under the influence of the oxidative stress, the production of the Reactive Oxygen Species (ROS) is increased. These compounds can react with various biological molecules like free polyunsaturated fatty acids or derived from lipids producting hydroperoxides of fatty acids. In chloroplast, these molecules are subject to numerous enzymatic or chemical modifications resulting in oxylipins. Oxylipins participate in cell signaling (precursors of the way of the jasmonate for example), or in the defense of the plant (antimicrobial activity). However some of them are very reactive and toxic so they are metabolized in less reactive molecules by oxidoreduction reactions.The ceQORH (chloroplast envelope Quinone OxydoReductase Homolog) and IEP32 (Inner Envelope Protein 32) of Arabidopsis thaliana are chloroplast oxidoreductases involved in the plant detoxification. They are transported through the envelope of the chloroplast without cleavage of their transit peptide by an alternative import pathway of TOC/TIC (Translocon at the Outer envelope membrane of Chloroplasts and Translocon at the Inner envelope membrane of Chloroplasts). In order to better understand their roles, we studied their enzymatic properties and structures.IEP32 was purified and crystallized. The structures apo-ceQORH and bound to the NADPH/ NADP + with inhibitors were determined using X-ray crystallography. The analysis allowed us to show that ceQORH exists under different oligomerization states what was confirmed by results of analytical ultracentrifugation. The NADPH binding to the Rossmann fold induces the monomerization. The catalytic site is large and hydrophobic allowing to ceQORH to reduce many α, β-unsaturated carbonyls of various chain lengths. CeQORH was shown to reduce with high efficiency the reactive double bond of γ-ketols that's why we propose to rename ceQORH by “γ- ketol reductase”.Keywords: chloroplast – Medium chain dehydrogenase/reductase – γ-ketol reductase – oxylipins – oligomerization state – inhibition – X-ray crystallography – analytical ultracentrifugation
32

DESENVOLVIMENTO TECNOLÓGICO DE SUSPENSÕES E LIOFILIZADOS DE NANOCÁPSULAS POLIMÉRICAS PARA A VEICULAÇÃO DO NEUROPROTETOR IDEBENONA / TECHNOLOGICAL DEVELOPMENT OF POLYMERIC NANOCAPSULES SUSPENSIONS AND FREEZE-DRIED POWDERS FOR RELEASE OF NEUROPROTECTIVE IDEBENONE

Brendle, Martina Gehrke 30 October 2013 (has links)
Idebenone is an antioxidant, a synthetic derivative of coenzyme Q10, with several applications, such as neuroprotection. However, this drug has low solubility in water, besides is irritant substance and has chemical instability. Hence, idebenone-loaded nano-organized systems have been developed, such as polymeric nanocapsules (NC). Vegetable oils containing antioxidants such as coconut oil and palm oil can be interesting for the composition of these particles. In this way, the aim of this work was to develop NC suspensions containing different oils as core (palm, coconut or medium chain triglycerides) for delivery of neuroprotective agent idebenone in order to compare the behavior of these systems concerning physico-chemical stability, photostability, controlled release, and conversion to redispersible solid dosage forms (lyophilized products). The nanocapsules were prepared by interfacial deposition of preformed polymer. As the results, it was possible to prepare poly(Ɛ-caprolactone) NC suspensions and palm oil (PO/PCL) or Eudragit® RS100 and coconut oil (OC/EUD) containing idebenone (1.0 mg/mL) with appropriate physico-chemical characteristics. Parameters such as the proportion of aqueous phase/organic phase, type of both surfactant (low HLB) and polymer influenced the optimization of these systems. For comparison, corresponding formulations were prepared with medium chain triglycerides (TCM/PCL or TCM/EUD), using the same conditions. The suspensions had an average diameter between 166 and 216nm, low polydispersity index (0.085 to 0.142), positive or negative zeta potential, depending on the characteristics of the polymer, and high encapsulation efficiency. The maintenance of average particle diameter and low polydispersity index have be verified during stability study (room temperature and exposed or not to light) for 75 days. However, the idebenone content significantly decreased in this period, with influence on the type of polymer. Thereafter, photostability study has shown that the suspensions NC OP/PCL (UVC/UVA) and TCM/PCL (UVA) were able to significantly reduce the degradation of idebenone (content: 53,7-76,1%) compared to an aqueous micellar (content: 31,2-63,1%) dispersion containing the drug. In addition, these systems were able to promoting drug controlled release (t1/2 26 h), without burst effect, showing monoexponential profile (t1/2< 3.0 h for free drug). The lyophilization of suspensions, employing trehalose as soluble carbohydrate, resulted in suitable and redispersible products (content of 96-100%, less than 3.6% moisture; 0.8-1.2 index), presenting several spherical structures, including in colloidal range, featuring the presence of NC in these dried products. In the stability study (room temperature/protection from light and moisture), it was observed that the lyophilized products were able to delay or decrease the degradation of idebenone compared to suspensions of origin, regardless of the both type of polymer (PCL/EUD) and oil (OP/OC/TCM). In conclusion, the developed systems are promising for the controlled release of neuroprotective drug idebenone. / A idebenona é um antioxidante, derivado sintético da coenzima Q10, com várias aplicações, como em neuroproteção. No entanto, este fármaco possui baixa solubilidade em água, potencial irritativo e instabilidade química, fato que tem despertado o interesse em sua associação a sistemas nano-organizados. Dentre estes, destacam-se as nanocápsulas poliméricas (NC). Óleos vegetais, contendo compostos antioxidantes, como óleo de coco e de palma, podem ser interessantes para a composição destas partículas. Neste sentido, o objetivo deste trabalho foi desenvolver suspensões de NC contendo diferentes óleos como núcleo (palma, coco ou triglicerídeos de cadeia média), almejando à veiculação do neuroprotetor idebenona, de forma a comparar o comportamento dos sistemas quanto à estabilidade físico-química, fotoestabilidade, controle de liberação, além da conversão em formas farmacêuticas sólidas redispersíveis (liofilizados). As NC foram preparadas pelo método de deposição interfacial de polímero pré-formado. Conforme os resultados, foi possível preparar suspensões de NC de poli(ε-caprolactona) e óleo de palma (OP/PCL) ou de Eudragit® RS100 e óleo de coco (OC/EUD), contendo idebenona (1,0 mg/mL), com características físico-químicas adequadas, sendo que fatores como proporção das fases aquosa/orgânica, tipo de tensoativo de baixo EHL e de polímero influenciaram a otimização dos sistemas. Para fins comparativos, formulações correspondentes foram preparadas com triglicerídeos de cadeia média (TCM/PCL ou TCM/EUD), empregando as mesmas condições. As suspensões apresentaram diâmetros médios entre 166 e 216 nm, baixos índices de polidispersão (0,085-0,142), potencial zeta positivo ou negativo, dependendo das características do polímero e elevada eficiência de encapsulamento. Quando estas suspensões foram submetidas a estudo de estabilidade, à temperatura ambiente e expostas ou não à luz, durante 75 dias, verificou-se manutenção dos diâmetros médios de partículas e baixos índices de polidispersão. Entretanto, o teor de idebenona decaiu significativamente neste período, com influência significativa do tipo de polímero. Após, estudo de fotoestabilidade demonstrou que as suspensões de NC OP/PCL (UVC/UVA) e TCM/PCL (UVA) foram capazes de reduzir significativamente a degradação da idebenona (teor remanescente: 53,7-76,1%) em comparação a uma dispersão micelar aquosa contendo o fármaco (teor remanescente: 31,2-63,1%), além de promoverem liberação controlada da mesma (t1/2 26 h), sem efeito burst, com perfil ajustado ao modelo monoexponencial (t1/2<3,0 h para fármaco livre). A liofilização das suspensões, empregando trealose, um carboidrato solúvel, resultou em produtos adequados (teor entre 96-100 %; umidade inferior a 3,6 %), redispersíveis (índice de ressuspensão entre 0,8-1,2) e com a presença de inúmeras estruturas esféricas, inclusive na faixa coloidal, caracterizando a presença das NC nestes produtos secos. No estudo de estabilidade (temperatura ambiente/proteção da luz e da umidade), observou-se que os produtos liofilizados foram capazes de retardar ou diminuir significativamente a degradação da idebenona em comparação às suspensões de origem, independentemente do tipo de polímero (PCL/EUD) e de óleo (OP/OC/TCM). Sendo assim, os sistemas desenvolvidos são promissores para a liberação controlada do neuroprotetor idebenona.
33

Ações do óleo de peixe e triglicerídeos de cadeia média na esteatose hepática e estresse oxidativo induzidos pela dieta hiperlipídica em ratos / THE EFFECTS OF FISH OIL AND MEDIUM CHAIN TRIGLYCERIDES IN HEPATIC STEATOSIS AND OXIDATIVE STRESS INDUCED BY HIGH FAT DIET IN RATS

Bianca Bellizzi de Almeida 14 October 2011 (has links)
Introdução: A doença hepática gordurosa não alcoólica é caracterizada pelo acúmulo hepático de lipídeos, principalmente na forma de triglicerídeos. Devido à atividade inflamatória progressiva pode evoluir para uma forma mais grave, a esteatohepatite não alcoólica. Os ácidos graxos poli-insaturados ômega-3 são associados a efeitos metabólicos positivos para redução da esteatose hepática, no entanto, são mais susceptíveis a peroxidação lipídica. Os triglicerídeos de cadeia média (TCMs) promovem a prevenção do bloqueio da beta-oxidação de ácidos graxos e redução da peroxidação lipídica, no entanto os efeitos na redução da esteatose ainda são controversos. Objetivo: O objetivo do estudo foi avaliar as implicações da dieta hiperlipídica (HL+) com óleo de peixe ou com óleo de TCM no desenvolvimento da esteatose hepática, no perfil de ácidos graxos hepáticos e no estresse oxidativo em ratos. Metodologia: Cinquenta ratos machos da linhagem wistar foram divididos em 5 grupos. Os animais receberam água e comida a vontade durante 45 dias. A adaptação a dieta HL+ foi realizada nos primeiros 15 dias. A composição da dieta do grupo que recebeu somente a gordura animal (HL+GA) era de 50% de gordura animal, e a dieta dos grupos HL+OS, HL+TCM e HL+OP era composta por 35% de gordura animal e 15% de óleo de soja, óleo de TCM e óleo de peixe, respectivamente. Resultados: Todos os grupos que receberam as dietas hiperlipídicas apresentaram maior acúmulo de gordura total e de triglicerídes hepaticos e somente os grupos HL+GA e HL+TCM apresentaram maior acúmulo de colesterol total hepático em relação ao controle. O grupo HL+TCM apresentou maior acúmulo percentual de gordura e um exacerbado acúmulo de triglicerídeos hepáticos em relação aos grupos alimentados com as dietas HL+. A redução do colesterol total sérico foi observada nos grupos HL+TCM e HL+OP, comparados ao controle. A maior incorporação hepática dos ácidos graxos EPA e DHA no grupo HL+OP contribuiu para o aumento do Índice de Peroxibilidade dos ácidos graxos e das substâncias reativas ao ácido tiobarbitúrico livres e totais e para a depleção da vitamina E no fígado. A maior razão AGS/AGPI hepática observada no grupo HL+TCM contribuiu para a preservação dos antioxidantes hepáticos. A alanina aminotransferase, um marcador de dano hepático, apresentou-se aumentada em todos os grupos que receberam as dietas HL+. Conclusões: A dieta hiperlipídica foi eficiente na indução do acúmulo de gordura hepática. O uso do óleo de TCM foi associado a uma maior concentração de lipídeos e preservação dos antioxidantes hepáticos. A dieta hiperlipídica com óleo de peixe foi associada ao aumento significativo na peroxidação lipídica, apesar do menor acúmulo de colesterol e triglicerídeos hepaticos. / Introduction: The Non-alcoholic Fatty liver disease is characterized by hepatic accumulation of lipids, mainly in the form of triglycerides. The disease may progress to a more severe form, the Non-alcoholic steatohepatitis, due to progressive inflammatory activity. Many authors have shown positive metabolic effects associated with the use of polyunsaturated omega-3 fatty acids and reduction in hepatic steatosis. However, these fatty acids are more susceptible to lipid peroxidation. The medium chain triglycerides (MCTs) are able to block beta-oxidation of fatty acids and reduce lipid peroxidation, but the MCT effects in steatosis are still controversial. Objective: The aim of this study was to assess the implications of high-fat diet (HF+) with fish oil or with MCT oil in the development of hepatic steatosis, liver fatty acid profile and oxidative stress markers in rats. Methodology: Fifty wistar male rats were divided into 5 groups. The animals had free access to food and water for 45 days. The first 15 days was dedicated for adaptation to high-fat diet. The HF+AF group received high-fat diet with 50% of animal fat and the other high-fat diets were made with 35% of animal fat plus 15% of other types of fat: soybean oil (HF+SO), MCT oil (HF+MCT) and fish oil (HF+FO). Results: The high-fat groups had higher hepatic total fat and triglycerides accumulation and only the groups HF+AF and HF+MCT had higher accumulation of hepatic cholesterol compared to control. The HF+MCT group had the highest percentage of hepatic fat accumulation and an exacerbated triglyceride accumulation in the liver among HF+ groups. The serum total cholesterol decreased in groups HF+MCT and HF+FO compared with the control group. The highest incorporation of hepatic fatty acids EPA and DHA in the HF+FO group contributed to the increased fatty acids peroxidizability index and total and free hepatic TBARS and depletion of hepatic vitamin E. The biggest ratio SFA/PUFA of liver fatty acids observed in the HF+MCT group contributed to the preservation of hepatic antioxidants. The alanine aminotransferase is a liver damage marker and was increased in all high-fat groups. Conclusions: The high-fat diet was effective to increase the hepatic fat concentration. The consumption of MCT oil can increase the hepatic lipid concentration and hepatic antioxidants. There was a significant increase in hepatic lipid peroxidation in the HF+FO group, although hepatic cholesterol and triglycerides were decreased.
34

Qualitative Analysis of Chlorinated Paraffins in Recycled Plastics

GAUDIN, Solal January 2023 (has links)
Described in many studies as dangerous for the environment and potentially carcinogenic for humans, Chlorinated Paraffins (CPs) are easily widespread due to their substantial production and use in different products. Previous studies reported the presence of CPs in different plastic polymers. However, the impact of recycled content in plastic materials on the CPs levels hasn’t particularly been considered. Recycling plastics is becoming essential but the accumulative potential of pollutants, such as CPs, need investigations. The presence of CPs in both virgin and mixed recycled and virgin plastics was studied. Plastic pellets and plastic pieces from products made of three polymer types:Poly(methyl 2-methylpropenoate) (PMMA), Thermoplastic Rubber (TPR) and Thermoplastic Polyurethane (TPU) were analysed. A solid-liquid extraction assisted by ultrasonication was performed, followed by cleanup using silica. CPs in plastic extracts were analysed by Gas Chromatography Orbitrap High Resolution Mass Spectroscopy (GC-Orbitrap-HRMS). Because of the high volatility characteristic of long chain Chlorinated Paraffins (LCCPs), only short chain and medium chain Chlorinated Paraffins (SCCPs and MCCPs ) have been studied in this project. Interesting variations in the presence of SCCPs and MCCPs have been observed from one polymer type to another. In the results, we show that MCCPs were less frequently detected compared to SCCPs. A higher detection frequency of CPs was observed for samples containing recycled plastics. The results indicate that CPs are present in plastic polymers (TPU, PMMA and TPR) and that the content of recycled material has a direct impact on the levels of SCCPs and MCCPs.
35

Exploring the beneficial effects of a high-fat diet supplemented with medium chain triglycerides on hepatic steatosis

Mourad, Stéphanie 08 1900 (has links)
La stéatose hépatique est une affection caractérisée par l'accumulation d'un excès de graisse dans le foie d'un individu sans antécédents d'abus d'alcool. La stéatose hépatique est en train de devenir la maladie chronique du foie la plus répandue dans le monde. En l'absence de thérapies approuvées, les modifications du mode de vie, y compris les interventions diététiques, restent la seule stratégie thérapeutique. Dans cette étude, nous avons cherché à déterminer si un régime riche en graisses (HFD) complété par des triglycérides à chaîne moyenne (TCM) atténue la stéatose hépatique chez les souris. Des souris mâles âgées de 7 semaines C57BL/6 ont été nourries avec un régime riche en graisses puis ont été randomisées pour rester sous régime riche en graisses ou passer à un régime riche en graisses complété par des TCM ou à un régime pauvre en graisses (LFD). Comparées aux souris nourries au HFD, les souris nourries au HFD supplémenté en TCM ont présenté une amélioration significative du degré de stéatose et d'inflammation et une amélioration des tests de tolérance au glucose et à l'insuline avec des changements modestes dans les lipides circulants et les teneurs en triacylglycérol et en cholestérol du foie. Notre étude démontre qu’une diète en gras supplémenté en TCM a des effets bénéfiques sur la stéatose hépatique. Les améliorations observées semblent être liées à la réduction de la teneur hépatique en céramides et en diacylglycérols, améliorant la sensibilité à l’insuline, et faisant des TCM une option non-pharmacologique viable à inclure dans la prise en charge de cette maladie débilitante. / Hepatic steatosis is a condition where excess fat accumulates in an individual's liver without a history of alcohol abuse. Hepatic steatosis is becoming the most common chronic liver disease worldwide. In the absence of approved therapies to specifically treat hepatic steatosis, lifestyle modifications, including dietary interventions, remain the only therapeutic strategy. In this study, we sought to determine whether a high-fat diet (HFD) supplemented with medium-chain triglycerides (MCT) attenuates hepatic steatosis in mice. Seven-week-old C57BL/6 male mice were fed HFD for 12 weeks to induce hepatic steatosis, then mice were randomized to remain on HFD or switch to either HFD supplemented with MCT or low-fat diet (LFD) for 6 weeks. Mice switched to LFD were used as another model of dietary interventions. Compared with mice fed HFD, mice fed HFD supplemented with MCT exhibited significant improvement in the degree of steatosis and inflammation as well as improvement in glucose and insulin tolerance tests with modest changes in circulating lipids and liver triacylglycerol and cholesterol contents, the hallmark of hepatic steatosis. Our study demonstrates that HFD supplement with MCT has beneficial effects on hepatic steatosis. The observed improvements seem to be linked to reductions in hepatic ceramide and diacylglycerol content, which ultimately prevents protein kinase C-ε translocation to the plasma membrane and improves insulin sensitivity, making a dietary supplement like MCTs, a viable non-pharmacological option in the management of this debilitating disease.
36

Characteristics Associated with Neonatal Carnitine Levels: A Systematic Review & Clinical Database Analysis

Sutherland, Sarah C. 28 January 2013 (has links)
Newborn screening programs measure analyte levels in neonatal blood spots to identify individuals at high risk of disease. Carnitine and acylcarnitine levels are primary markers used in the detection of fatty acid oxidation disorders. These analytes may be influenced by certain pre/perinatal or newborn screening related factors. The primary objective of this study was to explore the association between these characteristics and levels of blood carnitines and acylcarnitines in the newborn population. The study was composed of two parts: a systematic review and a clinical database analysis of existing newborn screening data. The systematic review results suggested considerable variability across studies in the presence and directionality of associations between analyte levels and birth weight, gestational age, age at time of blood spot collection, type of sample, and storage time. Sex was not significantly associated with carnitine or acylcarnitine levels in neonatal blood. We identified a need to more fully investigate a potential interaction between gestational age and birth weight in regard to analyte levels. The secondary data analyses indicated a statistically significant relationship between analyte levels and all perinatal / infant and newborn screening related factors of interest, but effect sizes were generally small. The interaction between gestational age and birth weight was significant in all models; when further explored through graphical analysis with conditional means, extremely premature neonates stood out as having distinct analyte patterns in relation to birth weight. Variation in the ratio of total acylcarnitine to free carnitine was better accounted for by the perinatal and newborn factors than was variation in any individual carnitine or acylcarnitine, indicating that proportions of carnitine and acylcarnitines may be more important in understanding an individual’s metabolic functioning than individual analyte levels. A low proportion of variation was explained in all multivariate models, supporting the use of universal algorithms in newborn screening and suggesting the need for further large scale empirical research targeted at previously unaccounted for perinatal factors such as birth stress.
37

Characteristics Associated with Neonatal Carnitine Levels: A Systematic Review & Clinical Database Analysis

Sutherland, Sarah C. 28 January 2013 (has links)
Newborn screening programs measure analyte levels in neonatal blood spots to identify individuals at high risk of disease. Carnitine and acylcarnitine levels are primary markers used in the detection of fatty acid oxidation disorders. These analytes may be influenced by certain pre/perinatal or newborn screening related factors. The primary objective of this study was to explore the association between these characteristics and levels of blood carnitines and acylcarnitines in the newborn population. The study was composed of two parts: a systematic review and a clinical database analysis of existing newborn screening data. The systematic review results suggested considerable variability across studies in the presence and directionality of associations between analyte levels and birth weight, gestational age, age at time of blood spot collection, type of sample, and storage time. Sex was not significantly associated with carnitine or acylcarnitine levels in neonatal blood. We identified a need to more fully investigate a potential interaction between gestational age and birth weight in regard to analyte levels. The secondary data analyses indicated a statistically significant relationship between analyte levels and all perinatal / infant and newborn screening related factors of interest, but effect sizes were generally small. The interaction between gestational age and birth weight was significant in all models; when further explored through graphical analysis with conditional means, extremely premature neonates stood out as having distinct analyte patterns in relation to birth weight. Variation in the ratio of total acylcarnitine to free carnitine was better accounted for by the perinatal and newborn factors than was variation in any individual carnitine or acylcarnitine, indicating that proportions of carnitine and acylcarnitines may be more important in understanding an individual’s metabolic functioning than individual analyte levels. A low proportion of variation was explained in all multivariate models, supporting the use of universal algorithms in newborn screening and suggesting the need for further large scale empirical research targeted at previously unaccounted for perinatal factors such as birth stress.
38

Characteristics Associated with Neonatal Carnitine Levels: A Systematic Review & Clinical Database Analysis

Sutherland, Sarah C. January 2013 (has links)
Newborn screening programs measure analyte levels in neonatal blood spots to identify individuals at high risk of disease. Carnitine and acylcarnitine levels are primary markers used in the detection of fatty acid oxidation disorders. These analytes may be influenced by certain pre/perinatal or newborn screening related factors. The primary objective of this study was to explore the association between these characteristics and levels of blood carnitines and acylcarnitines in the newborn population. The study was composed of two parts: a systematic review and a clinical database analysis of existing newborn screening data. The systematic review results suggested considerable variability across studies in the presence and directionality of associations between analyte levels and birth weight, gestational age, age at time of blood spot collection, type of sample, and storage time. Sex was not significantly associated with carnitine or acylcarnitine levels in neonatal blood. We identified a need to more fully investigate a potential interaction between gestational age and birth weight in regard to analyte levels. The secondary data analyses indicated a statistically significant relationship between analyte levels and all perinatal / infant and newborn screening related factors of interest, but effect sizes were generally small. The interaction between gestational age and birth weight was significant in all models; when further explored through graphical analysis with conditional means, extremely premature neonates stood out as having distinct analyte patterns in relation to birth weight. Variation in the ratio of total acylcarnitine to free carnitine was better accounted for by the perinatal and newborn factors than was variation in any individual carnitine or acylcarnitine, indicating that proportions of carnitine and acylcarnitines may be more important in understanding an individual’s metabolic functioning than individual analyte levels. A low proportion of variation was explained in all multivariate models, supporting the use of universal algorithms in newborn screening and suggesting the need for further large scale empirical research targeted at previously unaccounted for perinatal factors such as birth stress.

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