Cholinergic and oxidative stress mechanisms in sudden infant death syndrome.
OBJECTIVE
To determine whether biochemical parameters of cholinergic and oxidative stress function including red cell acetylcholinesterase (AChE), serum/plasma thyroglobulin, selenium, iron, ferritin, vitamins C, E, and A affect risk in apparent life-threatening event (ALTE), sudden infant death syndrome (SIDS), and sudden unexpected death in infancy (SUDI). To assess these biochemical parameters as a function of age; and for influence of pharmacology and epidemiology, including infant health, care, and feeding practices.


METHODS
A multicentre, case-control study with blood samples from 34 ALTE and 67 non-ALTE (control) infants matched for age, and 30 SIDS/SUDI and four non-SIDS/non-SUDI (post-mortem control) infants.


RESULTS
Levels/activity of the biochemical parameters were not significantly different in ALTE vs. control infants, with the exception of higher vitamin C levels in the ALTE group (p = 0.009). In ALTE and control groups, AChE and thyroglobulin levels increased and decreased respectively from birth to attain normal adult levels from 6 months. Levels of iron and ferritin were higher in the first 6 month period for all infant groups studied, intersecting with vitamin C levels peaking around 4 months of age.


CONCLUSIONS
Lower AChE levels and higher combined levels of iron and vitamin C in the first 6 months of life may augment cholinergic and oxidative stress effect, particularly at the age when SIDS is most prevalent. This may contribute to risk of ALTE and SIDS/SUDI events during infancy.
Dick
Anne
A
Canterbury Cot Death Fellow, Community Paediatric Unit, Christchurch, New Zealand. anne@ccst.co.nz
Ford
Rodney
R
D000110:Acetylcholinesterase / Q000097:blood*; D000367:Age Factors; D000704:Analysis of Variance; D016022:Case-Control Studies; D018678:Cholinergic Agents / Q000378:metabolism*; D005293:Ferritins / Q000097:blood; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007501:Iron / Q000097:blood; D009520:New Zealand / Q000453:epidemiology; D018384:Oxidative Stress / Q000502:physiology*; D012016:Reference Values; D012307:Risk Factors; D012643:Selenium / Q000097:blood; D013398:Sudden Infant Death / Q000209:etiology*; D011795:Surveys and Questionnaires; D013954:Thyroglobulin / Q000097:blood; D014815:Vitamins / Q000097:blood
D018678:Cholinergic Agents; D014815:Vitamins; D005293:Ferritins; D013954:Thyroglobulin; D007501:Iron; D000110:Acetylcholinesterase; D012643:Selenium
Am J Clin Nutr. 2003 Apr;77(4):924-30
12663293
Biochem Biophys Res Commun. 1994 Feb 15;198(3):915-22
8117296
Eur J Endocrinol. 1998 Apr;138(4):379-82
9578503
Pediatrics. 1994 Jan;93(1):44-9
8265322
Arch Pediatr Adolesc Med. 2003 Mar;157(3):286-90
12622679
J Pharmacol Exp Ther. 1997 Sep;282(3):1547-56
9316871
J Am Coll Nutr. 1999 Oct;18(5):426-33
10511324
Mol Pharmacol. 1980 Jan;17(1):24-30
7383017
Neuropeptides. 1992 Jan;21(1):35-48
1371183
Clin Chest Med. 1985 Dec;6(4):595-601
3853478
Arch Dis Child Fetal Neonatal Ed. 2005 Mar;90(2):F117-22
15724034
Neuroscience. 1983 Dec;10(4):1369-77
6664495
Pediatrics. 1987 Feb;79(2):292-9
3808807
Science. 1995 Sep 8;269(5229):1446-50
7660131
Am Rev Respir Dis. 1987 Dec;136(6 Pt 2):S65-72
3318605
Biol Neonate. 1994;65(3-4):194-7
8038282
J Toxicol Clin Toxicol. 1991;29(1):81-90
2005669
Am J Med. 1991 Sep 30;91(3C):2S-13S
1928207
Laryngoscope. 1993 Jun;103(6):623-30
8502096
J Clin Pathol. 1995 Aug;48(8):763-7
7560206
Acta Paediatr Suppl. 1993 Jun;82 Suppl 389:53-6
8374194
J Neurochem. 1985 Aug;45(2):427-33
4009168
Am J Med. 1991 Sep 30;91(3C):14S-22S
1928205
Endocrinology. 2000 Jul;141(7):2518-25
10875253
Acta Paediatr. 2003;92(2):162-4
12710640
Am J Clin Nutr. 1981 Sep;34(9):1706-11
7282597
Acta Paediatr Suppl. 1993 Jun;82 Suppl 389:107-10
8374176
Br Med Bull. 1993 Jul;49(3):588-603
8221025