Cord blood levels of cytokines as predictors of early neonatal sepsis

Abstract

Aim: To investigate whether cord blood levels of C‐reactive protein, interleukin‐1β, interleukin‐6, interleukin‐8, tumour necrosis factor‐α and the soluble receptor of interleukin‐2, are useful markers in the diagnosis of early neonatal sepsis. Design: Umbilical cord blood samples were obtained at birth from 261 neonates, but 5 of these newborns were excluded from the study. Group I included 10 newborns that developed early neonatal sepsis with a positive blood culture; Group II included 11 newborns with non‐infectious perinatal diseases; Group III, which served as the control group, included 10 randomly selected patients, matched for gestational age, among the 235 healthy newborn babies. Results: There were no differences among the three study groups in levels of C‐reactive protein, interleukin‐1 β, tumour necrosis factor‐α and the soluble receptor of interleukin‐2. Interleukin‐6 was significantly elevated in Group I (360.4 ± 157.8 pg/ml) and Group II (158.8 ± 122.3 pg/ml), when compared with Group III (8.6 ± 3.12 pg/ml) (p < 0.01), whereas interleukin‐8 was significantly elevated in Group I (389.3 ± 115.9 pg/ml) compared with Groups II (30.2 ± 5.1 pg/ml) (p < 0.05) and III (33.9 ± 8.6 pg/ml) (p < 0.05). A cut‐off of 100.8 pg/ml for interleukin‐6 obtained by the ROC (receiver operating characteristic) method gave a sensitivity of 50% and a specificity of 87%, and a cut‐off of 111.7 pg/ml for interleukin‐8 showed a sensitivity of 78% and a specificity of 91%. Conclusion: While cord blood levels of interleukin‐6 appear to be related to pathological conditions in the perinatal period (infectious and non‐infectious), interleukin‐8 seems to be a good predictor of early bacterial neonatal infection.

Human Cytomegalovirus UL144 Is Associated with Viremia and Infant Development Sequelae in Congenital Infection

“…Circulating IL-8 and IL-10 were significantly increased following cCMV infection with respect to healthy adult control levels (P Ͻ 0.015 and P Ͻ 0.0001, respectively; Mann-Whitney U test). The healthy adult control cytokine levels were compared with published neonatal and pediatric cytokine control levels and were within the ranges given (14,17,22,23). cCMV cytokine levels were also compared to the levels detected in pCMV-infected infants and an adult immunodeficient HCMV-positive population.…”

“…No serum samples from healthy neonates were used as controls for ethical reasons. Neonatal cytokine and chemokine control levels were determined using HCMV-negative healthy adult serum specimens and from published neonatal and pediatric cytokine "control" values (14,17,22,23). In addition, cCMV cytokine and chemokine levels were compared to those of other, noncongenital HCMV infections identified during the same period.…”

‘Haptoglobin concentrations in preterm and term newborns’

“…The HPT increase in bacteremic newborns is likely related to IL-6, a multifunctional cytokine that induces HPT synthesis, and that has been evaluated in the diagnosis of neonatal sepsis. [18][19][20][21][22] Circulating HPT is internalized by CD163, a receptor present mainly on monocytes and macrophages. CD163 binds toxic HPT-hemoglobin complexes, and it acts also as an immunomodulator.…”

Interleucina 6 e proteína c reativa no diagnóstico de sepse tardia no recém-nascido

“…Trabalhos da literatura 6,7 realizados com RN que apresentavam fatores de risco para sepse precoce e tardia comprovaram o valor desta proteína no diagnóstico das infecções bacterianas. Na última década, vários trabalhos da literatura utilizaram as interleucinas (IL) para o diagnóstico de sepse de início precoce no RN 9,10,11,12 . Estas proteínas são produzidas por vários tipos de células, principalmente monócitos e macrófagos, e são classificadas como pró-inflamatórias e antiinflamatórias.…”