Oxidative Stress in Children on Long-Term Parenteral Nutrition

Background: The immaturity of glutathione metabolism is believed to explain the oxidative stress observed in premature neonates on total parenteral nutrition [TPN]. Animal studies report that peroxides contaminating TPN induce the low glutathione levels as a consequence of the inhibition of the generation of substrates for its synthesis. We hypothesize that older children receiving long-term TPN have low levels of glutathione with the consequence to have an increased oxidative stress. Methods: Total glutathione and oxidative stress markers [hydroperoxides and isoprostane-F2α] were measured in urine, plasma or erythrocytes from 6 children aged 77 ± 24 months treated with TPN for a mean duration of 28 ± 7 months and from 7 control children aged of 87 ± 21 months. Results: In the TPN group, glutathione was lower [p<0.01] whereas hydroperoxide and isoprostane-F2α were higher [p<0.01] than in control group. Plasma isoprostane-F2α was negatively correlated with erythrocytes glutathione [r2 = 0.60, p<0.01]. Ascorbate levels were similar in erythrocyte, but higher [p<0.05] in urine of the TPN group. Conclusion: Similar to premature infants, oxidative stress is increased in children on long-term TPN. The oxidative stress is associated with low glutathione.