Effects of melatonin treatment in septic newborns

Free radicals have been implicated in the pathogenesis of neonatal sepsis a nd its complications. This study was conducted to determine the changes in the clinical status and the serum levels of lipid peroxidation products [ma londialdehyde (MDA) and 4-hydroxylalkenals (4-HDA)] in 10 septic newborns t reated with the antioxidant melatonin given within the first 12 h after dia gnosis. Ten other septic newborns in a comparable state were used as "septi c" controls, while 10 healthy newborns served as normal controls. A total o f 20 mg melatonin was administered oral-ly in two doses of 10 mg each, with a 1 -h interval. One blood sample was collected before melatonin administr ation and two additional blood samples (at 1 and 4 h) were collected after melatonin administration to assess serum levels of lipid peroxidation produ cts. Serum MDA + 4-HDA concentrations in newborns with sepsis were signific antly higher than those in healthy infants without sepsis; in contrast, in septic newborns treated with melatonin there was a significant reduction (p < 0.05) of MDA + 4-HDA to the levels in the normal controls at both I and 4 h (p < 0.05). Melatonin also improved the clinical outcome of the septic newborns as judged by measurement of sepsis-related serum parameters after 24 and 48 h. Three of 10 septic children who were not treated with melatoni n died within 72 h after diagnosis of sepsis; none of the 10 septic newborn s treated with melatonin died. To our knowledge, this is the first study wh ere melatonin was given to human newborns.