Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi University, Tıp Fakültesi, Turkey
Approval Date: 2015
Thesis Language: Turkish
Student: HAKAN ÖZTÜRK
Supervisor: Esin Koç
Open Archive Collection: AVESIS Open Access Collection
Abstract:Nitric oxide (NO) plays a preventive role in the development of necrotizing enterocolitis (NEC) by providing an increase in mucosal blood flow, mucus secretion and showing antioxidant, antiinflammatory and antimicrobial activity. Oral nitrite and nitrate intake has gained importance with the discovery of the conversion of nitrite to NO in acidic medium out of the synthesis of NO from L-arginine. Objective of this study was to examine in breast milk the concentrations of NO and asymmetric dimethylarginine (ADMA) which is a a competitive inhibitor of NO and to compare these concentrations in terms of gestational age and maturity of breast milk. Twenty-six women having no chronical disease were included in the study. Breasts of the mothers of newborns who were divided into 3 groups as term, late pretem and pretem were milked with a pump on the days 3, 7 and 28. Griess method was used for the measurement of nitrite/nitrate and HPLC was used for the measurement of ADMA. When breast milk concentrations of NO were compared according to the postnatal day of the milk independently from gestational age; NO concentration was higher in the colostrum than in the transition milk and mature milk (p=0,035; p=0,001; respectively). NO concentration in the transition milk was higher compared to the mature milk, although the difference was not statistically significant (p=0,110). Again on comparison of ADMA concentrations among these group and days; no statistically significant difference was observed in terms of gestational age and maturity of the milk (p=0.865, p=0.115; respectively). When NO concentrations in breast milks were examined; the highest level was found in the colostrum, suggesting that colostrum is a valuable food for newborns. Given the role which NO plays in the pathogenesis of NEC and newborns often diagnosed with NEC after the first week of life, suggests that although insufficient NO intake is not the only reason, it may contribute to the development of NEC. In previous studies, plasma levels of ADMA were negatively correlated with NO and did not show a correlation with breast milk, suggesting that ADMA doesn't make NO inhibition in breast milk.