D-PENICILLAMINE AS A NEONATAL NEUROPROTECTANT II: EFFECTS ON GASOTRANSMITTERS AND ENDOGENOUS NEUROMODULATORS

*Lajos Lakatos and György Balla

ABSTRACT

Objective – the aim of this article was to demonstrate a new concept in the etiology of bilirubin-induced neurologic dysfunction (BIND) and highlight the role of D-Penicillamine (D-PA). Study Design – The authors conducted a review searching the literature of gasotransmitters and of neuroprotective effects of D-PA in the neonatal period. Results – nitric oxide (NO), carbon monoxide (CO) and hydrogen sulfide (H2S) are regarded as gasotransmitters and endogenous neuromodulators playing multiple roles in CNS under physiological and pathological states. D-PA by its ability to modulate both oxidative stress and NO pathway may have significant neuroprotective effects in cases jeopardized by BIND or retinopathy of prematurity (ROP). Other endogenously generated small-molecule species, such as CO and H2S have also been shown to possess important signaling properties. Interpretation –The present research article address the medical necessity of the use of D-PA as a neonatal neuroprotective drug.

Keywords: Bilirubin-induced neurologic dysfunction; Reactive oxygen species; nitric oxide; carbon monoxide; hydrogen sulfide; D-Penicillamine in the neonatal period.