Serum acute phase reactants in pediatric patients; Especially in neonates

Ito, Hiroshi; Kishikawa, Teruaki; Yamakawa, Y; Toda, Takashi; Tsunooka, Hidehiko; Masaoka, Akira; Ando, Shigemitsu

doi:10.1007/bf02469494

Cited by 4 publications

(2 citation statements)

References 9 publications

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“…This is mainly based on clinical experience with adults, who respond to surgical trauma first with a significant increase of circulating endotoxin followed by a cascade of inflammatory mediators such as IL-6 and CRP. Our results differ from those of other authors, who found increased cytokine levels and acute-phase reaction in neonates after abdominal surgery (15)(16)(17). Although the inflammatory response in newborns is still not fully characterized, our data clearly demonstrate that newborns respond to surgical trauma only with a mild increase of leukocytes and no increase of endotoxin, IL-6, and CRP levels in plasma.…”

Section: Discussioncontrasting

confidence: 99%

Different Acute-Phase Response in Newborns and Infants Undergoing Surgery

et al. 2002

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In a prospective clinical study, we investigated the inflammatory response in 88 neonatal subjects (43 boys and 45 girls) who underwent major abdominal surgery owing to congenital malformation involving the gastrointestinal tract and compared it with the response in 20 infants (8 boys, 12 girls; mean age, 4 mo) who underwent elective surgery for resolution of an existing temporary stoma. In both groups, plasma levels of endotoxin, IL-6, and C-reactive protein as well as leukocyte counts were determined during and after surgery. Endotoxin was measured by the Limulus amebocyte test, IL-6 by ELISA, and C-reactive protein by nephelometry. Statistical analyses were performed using the Wilcoxon signed-rank test. A significant increase in circulating endotoxin and a leukocyte shift was observed in the infant group only. Postoperatively, IL-6 levels peaked between 2 and 6 h and C-reactive protein after 24 h in the infant group. In contrast, no significant increase in the levels of endotoxin, IL-6, and C-reactive protein in plasma were observed during and after surgery in the neonatal subjects, except those with gastroschisis. Newborns with gastroschisis developed an inflammatory response after surgery that was less pronounced than the response of infants older than 4 mo. The finding that endotoxemia in newborns does not follow surgical trauma is most likely because of the absence of bacterial colonization of the gastrointestinal tract.

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Section: Discussioncontrasting

confidence: 99%

Different Acute-Phase Response in Newborns and Infants Undergoing Surgery

et al. 2002

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“…AAT is an acute phase reactant 27. Merritt et al 8 showed that the AAT concentration almost doubled in lung lavages from infants developing classical CLD.…”

Section: Discussionmentioning

confidence: 99%

Relationship of proteinases and proteinase inhibitors with microbial presence in chronic lung disease of prematurity

Davies

Spiller

Beeton

et al. 2010

Thorax

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BackgroundA proteolytic imbalance has been implicated in the development of “classical” chronic lung disease of prematurity (CLD). However, in “new” CLD this pattern has changed. This study examines the longitudinal relationship between neutrophil proteinases and their inhibitors in ventilated preterm infants and their relationship to microbial colonisation.MethodsSerial bronchoalveolar lavage fluid was obtained from ventilated newborn preterm infants. Neutrophil elastase (NE) activity, cell counts, metalloproteinase (MMP)-9, MMP-9/TIMP-1 complex, SerpinB1 concentration and percentage of SerpinB1 and α1-antitrypsin (AAT) in complex with elastase were measured. The presence of microbial genes was examined using PCR for 16S rRNA genes.ResultsStatistically more infants who developed CLD had NE activity in at least one sample (10/20) compared with infants with resolved respiratory distress syndrome (RDS) (2/17). However, NE activity was present in a minority of samples, occurring as episodic peaks. Peak levels of MMP-9, MMP-9/TIMP-1 complex, percentage of AAT and SerpinB1 in complex and cell counts were all statistically greater in infants developing CLD than in infants with resolved RDS. Peak values frequently occurred as episodic spikes and strong temporal relationships were noted between all markers. The peak values for all variables were significantly correlated to each other. The presence of bacterial 16S rRNA genes was associated with the development of CLD and with elevated elastase and MMP-9.ConclusionNE activity and MMP-9 appear to be important in the development of “new” CLD with both proteinase and inhibitor concentrations increasing episodically, possibly in response to postnatal infection.

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