CLINICAL AND MORPHOLOGICAL CORRELATES OF PINEAL GLAND FUNCTION IN INFANTS WITH EXTREMELY LOW BODY WEIGHT

Abstract

Introduction. The functional activity of the pineal gland plays a dramatic important role in the adaptation to postnatal life and in the pathogenesis of the most common perinatal pathology of premature infants. The aim of the study. To determine the morphofunctional features of the pineal gland in premature infants with extremely low body weight. Material and methods. In 46 preterm infants with extremely low birth weight, the level of melatonin metabolite in urine 6-sulfoxymelatonin was determined at first day of life. The 20 dead infants underwent macro- and microscopic examination of the pineal gland using the immunohistochemical method. Results. All preterm infants with extremely low birth weight had perinatal pathology, which led to death in 20 of them. Urinary excretion of the metabolite melatonin 6-sulfoximelatonin in preterm infants with extremely low birth weight in the first day of life, which had fatal consequences, significantly reduced compared with surviving children, indicating depletion of functional activity of the pineal gland and may be as a marker of adverse course of the neonatal period. Morphologically, in the pineal gland of premature infants with extremely low body weight there is an increase in morphofunctional activity of pineal cells. This is confirmed by morphometric data and increased expression of MelanA and S100 in immunohistochemical studies. Macro- and microscopic data suggest that extrauterine existence in distress conditions accelerates the differentiation of the pineal gland (depletion) and indicates the presence of damage to glandular tissue, which in turn reduces the synthesis of melatonin and its mediated metabolite 6 – sulfoxymelatonin in urine. Conclusions. Decreased urinary excretion of 6-sulfoximelatonin in preterm infants with extremely low birth weight in the first day of life and mophological changes in the pineal gland of deceased children indicate depletion of functional activity of the pineal gland in conditions of perinatal pathology

Keywords

• Melatonin; Prematurity; Pineal Gland.