Antioxidants as therapy in the newborn: Some words of caution

Reactive oxygen and nitrogen species are considered to play a major role in the pathogenesis of a wide range of human disorders. This may be a particu larly important pathogenetic mechanism in the newborn nursery. The phrase " oxygen radical disease of prematurity" has been coined to collectively desc ribe a wide range of neonatal disorders based on the belief that premature newborns are deficient in antioxidant defenses at a time when they are subj ected to acute and chronic oxidant stresses. This belief has led to a numbe r of clinical trials of antioxidant therapies being undertaken in neonatal patients. The realization that reactive oxygen species play a critical role in neonatal illnesses has only recently been paralleled by an increased un derstanding of their physiologic roles. A major concern is that effective s cavenging of reactive oxygen species, to attenuate their toxic effects, wil l also inhibit essential cellular functions such as growth in potential tar get organs such as lung, brain, intestine, and retina.