Effect of Neonatal Phototherapy on Serum Levels of Interleukin 1, 6, 8, TNFa and White Blood Cell Count

Abstract
Background: Recent progress in medical sciences approved Phototherapy (PT) as a standard method of treatment and care for hyperbilirubinemia in the neonatal period. Some investi-gations have expressed concern about potential toxic effects of phototherapy, one possible harmful is affection of cytokines production, which can affect the function of neonatal immune system.
Aim of the Study: This work aimed to investigate the effect of PT on serum levels of interleukin 1, 6, 8, TNFa  and WBCs count in neonates with hyperbilirubinemia and in normally healthy neonates.
Material and Methods: The present study was carried out at Al-Azhar University Hospital (Damietta) during the period from January 2017 to March 2018, the study included 90 Egyptian term neonates with neonatal jaundice who had total bilirubin levels higher than 15mg /dl, and 30 normal healthy neonates were selected as control group. Venous blood samples were obtained from newborn with jaundice before exposure and at 72h after exposure to PT and from controls at the time of examination for estimation of interleukins 1, 6, 8, TNFa  and WBCs count.
Results: The mean level of IL-1 before PT was (1.84±0.89) and decreased slightly after PT (1.75±0.63) with no statistically significant difference, (p-value=0.43). The mean value of IL-6 before PT was (38.7±19) and decreased slightly after PT (34.6±16.8) with no statistically significant difference (p-value=0.13). The mean level of IL-8 before PT was (376.4± 84.7) and decreased slightly after PT (353.7±94.6) with no statistically significant difference, (p-value=0.09). The mean level of TNFa  before PT was (8.63±4.6) and increased after PT (17.6±3.2), with statistically significant difference, p-value (<0.0001). The mean level of WBCs count before PT was (11300±1987) and increased after PT (12500±2281) with statistically significant difference, (p-value=0.0002).
Conclusion: Our findings demonstrate that an increased levels of serum TNFa  and WBCs count in healthy term neonates after PT could be considered as complications. Therefore, it seems that PT can alter the function of the immune system. Otherwise, the levels of interleukins 1, 6, 8 were very slightly decreased after PT.