Pre-inflammatory Mediators and Lymphocyte Subpopulations in Preterm Neonates with Sepsis

Abstract

The aim of this study is to investigate prospectively specific immune system factors in preterm neonates with late-onset sepsis and infection-free controls. Matched preterm neonates (n = 82) were divided into three groups: suspected infection (n = 25), sepsis (n = 17), and infection-free controls (n = 40). Serial measurements were made of interleukin-6 (IL-6), IL-1β, tumor necrosis factor-α (TNF-α), lymphocyte subsets [CD3+, CD4+, CD8+, natural killer (NK) cells, and B cells], the immunoglobulins (IgG, IgM, and IgA), C-reactive protein (CRP), and the total blood count, before, 2 days after initiation of treatment, and after stopping treatment. The percentages of NK and B cells were higher in the sepsis group, but those of CD3+, CD4+, and CD8+ showed no differences. IgG was lower in the sepsis group. IL-6 >30 pg/ml and TNF-α >30 pg/ml were sensitive sepsis predictors with sensitivity 1 (0.78-1) and 1 (0.79-1), respectively, but their specificity was poor. CRP was a specific [0.90 (0.80-0.96)] but not sensitive index [0.68 (0.48-0.85)], and its combination with IL-6 or TNF-α could enhance their diagnostic accuracy. It is concluded that NK and B cells may be elevated in late neonatal sepsis. IL-6 or TNF-α combined with CRP is a good diagnostic marker for late-onset sepsis in preterm neonates.

Diagnostic utility of biomarkers in diagnosis of early stages of neonatal sepsis in neonatal intensive care unit in Egypt

“…We demonstrated that septic neonates and neonates with clinically suspected sepsis had significantly elevated levels of CRP. This was in line with the previous studies, 3,11 and this means that this parameter can differentiate healthy infants from those with proven or suspected sepsis.…”

Tumor Necrosis Factor-αas a Diagnostic Marker for Neonatal Sepsis: A Meta-Analysis

“…LONS was defined as the clinical sepsis 72 h after birth, met the inclusion criteria in [1, 14, 24, 28–30]. …”

“…Eight trials were included to estimate the use of the TNF- α test in the northern hemisphere at the diagnosis of proven late-onset neonatal sepsis [1, 14, 29, 30]. In these trials, sensitivity ranged from 61.4% to 100% and pooled sensitivity is 84.0% (95% CI 78.8%–88.4%), specificity ranged from 68.8% to 96.6% and pooled specificity is 83.3% (95% CI 79.6%–86.6%), and the detailed forest maps are shown in Figure 8.…”

“…Neonatal sepsis (NS), as one of the major causes, leads to neonatal mortality and morbidity, especially in neonates born preterm [1]. Early diagnosis and management of the newborn infant with NS play key roles in preventing severe and life-threatening complications [2].…”

Bifidobacterium bifidum OLB6378 Simultaneously Enhances Systemic and Mucosal Humoral Immunity in Low Birth Weight Infants: A Non-Randomized Study

“…Their high risk of early infantile infectious disease can be partially attributed to the insufficient production of serum immunoglobulin G (IgG) and intestinal secretory immunoglobulin A (SIgA) antibodies, both of which are the main components of systemic and mucosal humoral immunity. Infants with a low serum IgG level are at a high risk of developing sepsis and the levels of SIgA in the gastrointestinal system have been shown to affect the incidence of infectious diseases [2,3,4,5]. Thus, enhancing humoral immunity within an appropriate range during the early stages could be an effective strategy to ensure infants’ healthy growth and development without contracting serious infections.…”