Value of Resistin in Early Onset Neonatal Sepsis

Abstract

The diagnosis of neonatal sepsis is usually difficult because the sign and symptoms are nonspecific. Although C-reactive protein (CRP) and procalcitonin (PCT) are the most commonly used auxiliary tests, they are not reliable enough markers to be used for diagnosis of neonatal sepsis. This study aimed to evaluate the efficacy of resistin in diagnosing early onset neonatal sepsis and to compare its effectiveness to CRP and PCT. This prospective study was performed in the neonatal intensive care unit of Medicine Hospital between June and September 2016. Twenty-nine infants in the sepsis group and 33 infants in the control group were recruited. The Töllner scoring system was used for clinical signs. The hematologic parameters were evaluated using the Manroe and Rodwell scoring systems. The blood samples for CRP, PCT, and resistin were collected at admission (T0), and at 72 hours (T3). Mean plasma resistin level at T0 was 54.20 ± 39.3 ng/mL in the sepsis group and 34.92 ± 6.9 ng/mL in the control group. The sensitivity at T0 for resistin was 76%, and the specificity was 67%. The values of area under the curve (AUC) for CRP, PCT, and resistin were 0.84, 0.66, and 0.72, respectively. We found the diagnostic value of resistin to be lower than CRP, although its plasma levels were elevated. Therefore, we propose that resistin has limited value in diagnosis and follow-up of early-onset neonatal sepsis.

Relevance of Biomarkers Currently in Use or Research for Practical Diagnosis Approach of Neonatal Early-Onset Sepsis

“…Some studies on adult and neonatal patients have reported elevated serum levels during inflammation and infection. The few studies conducted on newborns have suggested that this marker could be an indicator of EOS, but its diagnostic value proved to be less than that of CRP and the cut-off value could not be established with accuracy due to several factors such as control group and number of days since the first sign of sepsis [ 125 , 126 ]. Some biomarkers such as sTREM-1 (human triggering receptor expressed on myeloid cells-1), pentraxin-3 and pro-adrenomedullin, which were found to have high values in infected adults and children, failed to prove their role in neonatal EOS [ 127 ].…”

Multiple organ dysfunction syndrome prediction in newborn children

“…При активации эндотелиальных клеток цитокинами наблюдается быстрое повышение (в течение 1-6 ч) уровня sICAM-1 в сыворотке крови, что делает его маркером системного воспаления. В нас тоящее время существуют разногласия относительно полезности этого маркера для диагностики EOS, поскольку некоторые авторы предложили sICAM-1 в качестве ценного маркера только в первые 4 дня жизни, а другие отметили аналогичные или даже более высокие уровни у здоровых новорожденных в первые 5 дней [40,41]; 5) програнулин -аутокринный фактор роста из 593 аминокислот, который регулирует сигнальную систему TNF/TNFR, может предсказывать сепсис и СПОН у новорожденных > 34 недель беременности [42]; 6) неоптерин -биохимический маркер иммунной активности, повышение которого определяется при клеточно-опосредованном иммунном ответе; 7) резистин (FIZZ3) -белок, богатый цистеином, который играет спорную физиологическую роль в ожирении и инсулинорезистентности и повышается при системном воспалительном ответе у новорожденных, детей и взрослых, однако его диагностическую ценность еще предстоит узнать [43,44]; 8) пресепсин (ПСП) -это белок, являющийся N-концевым фрагментом рецептора макрофагов CD14 [45]. Механизм образования ПСП связан с бактериальным фагоцитозом и расщеплением CD14 лизосомальными ферментами.…”