Lipopolysaccharide-binding protein in noninfected neonates and those with suspected early-onset bacterial infection

Orlikowsky, Thorsten; Trüg, C; Neunhoeffer, Felix; Deperschmidt, M; Eichner, Martin; Poets, Christian F.

doi:10.1038/sj.jp.7211422

Cited by 24 publications

(18 citation statements)

References 29 publications

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“…Physiologic increase in serum LBP concentration in healthy term neonates during the first 3 days of life has been reported [15]. Our results are consistent with this as neonates without FIRS/funisitis had higher LBP on day 1 than at delivery.…”

Section: Discussionsupporting

confidence: 82%

“…Although increased LBP serum concentrations have been reported in preterm and term neonates with early- and late-onset sepsis [14,15,16], no data are available on the diagnostic accuracy of cord blood concentrations of LBP for detecting FIRS. We therefore performed a prospective study in preterm neonates (<32 weeks' gestation) born after PPROM in order to evaluate whether LBP differentiates between neonates with and without FIRS and with and without funisitis.…”

Section: Introductionmentioning

confidence: 99%

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Lipopolysaccharide-Binding Protein as Marker of Fetal Inflammatory Response Syndrome after Preterm Premature Rupture of Membranes

Pavcnik-Arnol

Lučovnik²,

Kornhauser‐Cerar³

et al. 2013

Neonatology

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Background: Intra-amniotic inflammation with preterm premature rupture of membranes (PPROM) is a risk factor for fetal inflammatory response syndrome (FIRS) and adverse neonatal outcome. Objectives: To evaluate the diagnostic accuracy of lipopolysaccharide-binding protein (LBP) for detecting FIRS in preterm neonates born after PPROM. Methods: This was a prospective study in the level III neonatal intensive care unit (42 neonates; 23 + 6 to 31 + 6 weeks' gestation) of mothers with PPROM. Umbilical cord blood concentrations of LBP, C-reactive protein (CRP), interleukin (IL)-6 and white blood cell count with differential were measured at delivery and 24 h after birth. Neonates were classified into FIRS (n = 22) and no FIRS (n = 20) groups according to clinical criteria and IL-6 level (≥17.5 pg/ml). Histological examination of the placenta and umbilical cord was performed. Neurological examination at 12 months' corrected age was performed. Results: Umbilical cord blood concentration of LBP was significantly higher in the FIRS group than in the no FIRS group at delivery (median 21.6 mg/l vs. median 2.3 mg/l; p < 0.0001) and 24 h after birth (median 17.2 mg/l vs. median 20.0 mg/l; p < 0.001). The area under the ROC curve for FIRS at delivery was 0.98 (95% CI 0.88-1.0) for LBP, 0.92 (95% CI 0.80-0.99) for CRP and 0.82 (95% CI 0.64-0.94) for immature to total neutrophil ratio. Similar results were obtained if FIRS was defined by funisitis. Umbilical cord blood concentration of LBP at delivery was significantly higher in neonates with abnormal neurological exam at 12 months than in those with normal exam (median 19.5 mg/l vs. median 3.75 mg/l; p < 0.015). Conclusions: In preterm neonates born to asymptomatic women with PPROM, LBP in cord blood at delivery is an excellent diagnostic biomarker of FIRS/funisitis with prognostic potential.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Lipopolysaccharide-Binding Protein as Marker of Fetal Inflammatory Response Syndrome after Preterm Premature Rupture of Membranes

Pavcnik-Arnol

Lučovnik²,

Kornhauser‐Cerar³

et al. 2013

Neonatology

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“…-Since even uncomplicated labor (from a reductionistic immunological view) is an inflammatory event, most serologic parameters, e.g. chemokines, cytokines or acute phase proteins, are elevated non-specifically in the first hours of life or they follow specific postnatal time kinetics [18]. -Although soluble factors are promising diagnostic markers for the detection of infection, their measurement with enzyme-linked immunosorbent assay (ELISA) is usually performed in batches which may translate to delays in the reporting.…”

Section: Role Of Flow Cytometry In the Detection Of Infectionmentioning

confidence: 99%

Flow Cytometric Methods in the Detection of Neonatal Infection

Gille

Orlikowsky²

2007

Transfus Med Hemother

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Bacterial infection remains the main cause of neonatal morbidity and mortality. With clinical signs unspecific and little, its course is fulminant, and only early antibiotic therapy protects from death or major adverse sequelae. Methods: Conventional diagnostic tests have shortcomings and are only partly suitable to identify infected vs. non-infected newborns. There is a fast increasing demand for standardized flow cytometric techniques in the detection of neonatal infection which require minimal amounts of blood. Target cells are monocytes/ macrophages, granulocytes and NK cells. Results: The choice of receptors and interpretation of results need to be done carefully: A variety of receptors are expressed differently, basally or upon cytokine-mediated regulation, in full- or preterm neonates than in adults, and their expression is influenced by perinatal confounders. Examples are HLA-DR, CD80, CD86, CD16, CD32 receptors on monocytes/macrophages. Flow cytometric measurement of CD11b and CD64 expression on phagocytes combined with cytokine (IL-6 or IL-8) or C-reactive protein measurement in plasma or whole blood have turned out to be most sensitive and specific markers for detecting early- and late-onset bacterial infection. Conclusion: To date, no flow cytometric marker or set of markers is sensitive and specific enough to allow neonatologists to withhold antibiotic treatment of a sick neonate who is suspected to be infected.

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“…Although the clinical work-up was mostly performed by experienced neonatologists, we are aware of intrinsic restrictions related to heterogeneity of patients, limited comparability to other studies or dependence on physicians' experience. The CRP cut-off applied in our study (10 mg/l) is arbitrary but has been used by other investigators [31].…”

Section: Discussionmentioning

confidence: 99%

Influence of Gestational Age, Cesarean Section and Hematocrit on IL-8 Concentrations in Plasma and Detergent-Lysed Whole Blood of Noninfected Newborns

Neunhoeffer

Lipponer

Eichner

et al. 2011

Transfus Med Hemother

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SummaryBackground: Sensitivity of interleukin-8 (IL-8) in detecting early-onset bacterial infection (EOBI) is high. A high percentage is bound to nonspecific receptors on erythrocytes which can be determined via cell lysis. We have shown detergent-lysed whole blood (DLWB) IL-8 to be superior to plasma IL-8 in detecting EOBI. Methods: To evaluate influence of pre-and perinatal factors on plasma and DLWB IL-8 concentrations, IL-8 was determined via ELISA (Immulite) in 146 noninfected newborns with risk factors for EOBI at two different time periods: 0-6 (group I) and 24-30 h (group II) after birth. The influence of gender, mode of delivery, gestational age and hematocrit was evaluated. Results: While we found no influence of gender or gestational age, hematocrit was positively correlated with IL-8 plasma concentration (group I: r = 0.33, p < 0.001; group II: r = 0.30, p <0.01). IL-8 plasma concentrations after primary versus secondary cesarean section were lower (p < 0.05). Gestational age was correlated with DLWB IL-8 concentrations (group I: r = 0.46, p < 0.001; group II: r = 0.28, p < 0.001). Conclusion: Plasma IL-8 concentrations were positively correlated with hematocrit, whereas DLWB IL-8 concentrations increased with gestational age. This may be relevant to the interpretation of IL-8 in preterm infants and infants with anemia, polyglobulia or hematolytic diseases. SchlüsselwörterInterleukin-8 · IL-8 · Lysiertes Vollblut · Hämatokrit · Gestationsalter · Geburtsgewicht Zusammenfassung Hintergrund: Die Sensitivität von Interleukin-8 (IL-8) bei der Diagnose der frühen Form der neonatalen bakteriellen Infektion (early-onset bacterial infection; EOBI) ist hoch. Ein hoher Prozentsatz wird an nichtspezifische Rezeptoren auf Erythrozyten gebunden, welcher nach Zell-Lyse bestimmt werden kann. Wir haben gezeigt, dass Lysat-IL-8 (DLWB) bei der Diagnose der EOBI gegenüber Plasma-IL-8 überlegen ist. Methoden: Um den Einfluss von prä-und perinatalen Faktoren auf Plasma-und Lysat-IL-8 zu untersuchen, wurde bei 146 nichtinfizierten Neugeborenen mit Risikofaktoren für EOBI IL-8 mittels ELISA (Immulite) zu zwei unterschiedlichen Zeitpunkten bestimmt: 0-6 (Gruppe I) und 24-30 h (Gruppe II) nach Geburt. Der Einfluss von Geschlecht, Geburtsmodus, Gestationsalter und Hämatokrit wurde untersucht. Ergebnisse: Wir fanden keinen Einfluss von Geschlecht oder Gestationsalter auf Plasma-IL-8, der Hämato-krit korrelierte positiv mit Plasma-IL-8-Konzentrationen (Gruppe I: r = 0,33, p < 0,001; Gruppe II: r = 0,30, p < 0,01). IL-8-Konzentrationen in Plasma waren primärer niedriger als nach sekundärer Sectio caesarea (p < 0,05). Das Gestationsalter korrelierte positiv mit IL-8-Werten in Lysat: (Gruppe I: r = 0,46, p < 0,001; Gruppe II: r = 0,28. p < 0,001). Schlussfolgerung: Plasma-, jedoch nicht DLWB-IL-8-Konzentrationen, korrelierten positiv mit dem Hämatokrit, wohingegen IL-8 in Lysat mit dem Gestationsalter positiv korrelierte. Dieser Sachverhalt kann bei der Interpretation von IL-8-Werten von Frühgeborenen und von Kindern mit Polyglobul...

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Lipopolysaccharide-binding protein in noninfected neonates and those with suspected early-onset bacterial infection

Cited by 24 publications

References 29 publications

Lipopolysaccharide-Binding Protein as Marker of Fetal Inflammatory Response Syndrome after Preterm Premature Rupture of Membranes

Lipopolysaccharide-Binding Protein as Marker of Fetal Inflammatory Response Syndrome after Preterm Premature Rupture of Membranes

Flow Cytometric Methods in the Detection of Neonatal Infection

Influence of Gestational Age, Cesarean Section and Hematocrit on IL-8 Concentrations in Plasma and Detergent-Lysed Whole Blood of Noninfected Newborns

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