84 HYPOXIA PPRECEDES DEATH IN SIDS. POSSIBLE TRIGGER MECHANISMS

Abstract

Hypoxanthine (Hx) is formed from hypoxic degradation of AMP and is thus a marker of hypoxia. Results of Hx measurements in vitreous humor in 112 SIDS cases and in 21 infants and children suffering sudden violent death, were corrected according to the expected postmortem Hx increase. The corrected median Hx level of the SIDS group was 232 μmol/l, (range 0-668 μmol/l), which is significantly higher than the control group; 0 μmol/l, (range 0-91 umol/l), (p<0.01). The finding confirms that death in SIDS is preceded by a period of hypoxia in most cases. Increased numbers of IgM-cells in the tracheal wall, IgA-cells in the duodenal mucosa and IgA-, IgM- and IgG-cells in the salivary gland in SIDS-victims, suggest an overstimulation of the mucosal immune system in SIDS - perhaps caused by microbial factors. Such peripheral immune stimulation leads to release of cytokines which can induce immunostimulation in vital brain centres creating a vicious circle inducing hypoxia and death in infants at risk. Retrograde axonal transport might be a link to centres of the brain.