Oxidative Stress-Mediated Damage in Newborns with Necrotizing Enterocolitis: A Possible Role of Melatonin.
BACKGROUND
Necrotizing enterocolitis is a gastrointestinal surgical emergency in premature neonates. Free radicals have been linked to the development of the disease in infants. Ischemia, hypoxia-reperfusion, infection, and inflammation produce elevated levels of reactive oxygen species, impairing the redox balance and shifting cells into a state of oxidative stress. Melatonin, an effective direct free-radical scavenger and indirect antioxidant agent, exerts pleiotropic action on the human body. Several studies have tested the efficacy of melatonin in counteracting oxidative injury in diseases of newborns. Melatonin has been widely used in newborns including cases of asphyxia, respiratory distress syndrome, and sepsis, and no significant toxicity or treatment-related side effects with long-term melatonin therapy have been reported.


CONCLUSIONS
Therefore, melatonin, besides standard therapies, could be considered as a potentially safe approach to prevent and treat necrotizing enterocolitis in premature infants. This review summarizes what is known about the role of oxidative stress, and potentially beneficial effects of antioxidants, such as melatonin, in necrotizing enterocolitis.
Neonatal and Pediatric Intensive Care Unit, Department of Pediatrics, University of Messina, Messina, Italy.
Lucia
L
Marseglia
Neonatal and Pediatric Intensive Care Unit, Department of Pediatrics, University of Messina, Messina, Italy.
Gabriella
G
D'Angelo
Neonatal and Pediatric Intensive Care Unit, Department of Pediatrics, University of Messina, Messina, Italy.
Sara
S
Manti
Neonatal and Pediatric Intensive Care Unit, Department of Pediatrics, University of Messina, Messina, Italy.
Salvatore
S
Aversa
Department of Cellular and Structural Biology, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
Russel J
RJ
Reiter
Unit of Pediatric Surgery, Department of Pediatrics, University of Messina, Messina, Italy.
Pietro
P
Antonuccio
Unit of Pediatric Surgery, Department of Pediatrics, University of Messina, Messina, Italy.
Antonio
A
Centorrino
Unit of Pediatric Surgery, Department of Pediatrics, University of Messina, Messina, Italy.
Carmelo
C
Romeo
Unit of Pediatric Surgery, Department of Pediatrics, University of Messina, Messina, Italy.
Pietro
P
Impellizzeri
Neonatal and Pediatric Intensive Care Unit, Department of Pediatrics, University of Messina, Messina, Italy.
Eloisa
E
Gitto
D000975:Antioxidants / Q000627:therapeutic use*; D020345:Enterocolitis, Necrotizing / Q000188:drug therapy / Q000378:metabolism / Q000517:prevention & control*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008550:Melatonin / Q000627:therapeutic use*; D018384:Oxidative Stress
D000975:Antioxidants; D008550:Melatonin