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Studies on Pediatric Disorders pp 371–386Cite as

Infectious and Inflammatory Disorders

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Abstract

In cases of severe infectious and inflammatory disorders, pathological manifestations are the result of complex biological phenomena including a surge of cytokines/chemokines and overproduction of nitric oxide and other reactive oxygen species. High levels of these reactive species can attack various substrates in the body and can contribute to the development of acute and chronic disorders. The use of specific biomarkers for measurement of oxidative damage affecting tissues and organs has been introduced into the field of pediatric medicine. This chapter presents a review of the medical literature, including the authors’ clinical experiences, describing the use of these biomarkers in infectious and inflammatory disorders of children. The findings suggest that oxidative stress is likely to contribute to the progression and amplification of the inflammatory response related to the disorders. The use of these biomarkers in cerebrospinal fluid samples is expected to be especially important for the evaluation and management of purulent meningitis and acute encephalopathy. In children with purulent meningitis, markers of oxidative injury increase in relation with disease severity and occurrence of neurological complications. Dexamethasone is beneficial in the early treatment of purulent meningitis, probably through its potent antioxidative and anti-inflammatory effects. In children with influenza encephalopathy, the mortality rate decreased from about 30 to 7 % in Japan, along with the wide spread of multidisciplinary treatments including pulse steroid therapy, high-dose immunoglobulin, an antioxidative agent (edaravone), and plasma exchange. Combinations of antioxidants with antimicrobial drugs might present promising treatment options to ameliorate severe forms of infectious and inflammatory disorders in children.

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Abbreviations

BOM:

Bilirubin oxidative metabolites

CNS:

Central nervous system

CSF:

Cerebrospinal fluid

ELISA:

Enzyme-linked immunosorbent assay

GPX:

Glutathione peroxidase

HIV:

Human immunodeficiency virus

HO:

Heme oxygenase

IAE:

Influenza-associated acute encephalopathy

MDA:

Malonaldehyde

MPO:

Myeloperoxidase

NO:

Nitric oxide

NOS:

Nitric oxide synthase

8-OHdG:

8-hydroxy-2′-deoxyguanosine

ROS:

Reactive oxygen species

RSV:

Respiratory syncytial virus

SOD:

Superoxide dismutase

TAC:

Total antioxidant capacity

TH:

Total hydroperoxides

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Authors and Affiliations

  1. Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, 700-8558, Japan

    Hirokazu Tsukahara M.D., Ph.D., Masato Yashiro M.D., Ph.D., Yoshiharu Nagaoka M.D. & Tsuneo Morishima M.D., Ph.D.

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  1. Hirokazu Tsukahara M.D., Ph.D.
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  2. Masato Yashiro M.D., Ph.D.
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  3. Yoshiharu Nagaoka M.D.
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Correspondence to Hirokazu Tsukahara M.D., Ph.D. .

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Editors and Affiliations

  1. Dentistry and Pharmaceutical Sciences Department of Pediatrics, Okayama University Graduate School of Medicine, Okayama, Japan

    Hirokazu Tsukahara

  2. Department of Pediatrics, Kansai Medical University, Osaka, Japan

    Kazunari Kaneko

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Tsukahara, H., Yashiro, M., Nagaoka, Y., Morishima, T. (2014). Infectious and Inflammatory Disorders. In: Tsukahara, H., Kaneko, K. (eds) Studies on Pediatric Disorders. Oxidative Stress in Applied Basic Research and Clinical Practice. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0679-6_22

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