Neonatal infections in Saudi Arabia: association with C-reactive protein, CRP -286 (C>T>A) gene polymorphism and IgG antibodies

Abstract

BackgroundC-reactive protein (CRP) is a nonspecific, acute-phase protein that rises in response to infectious and non-infectious inflammatory processes. Infections are the single largest cause of neonatal deaths globally.The primary aim of this study is to examine the association between CRP gene polymorphism and serum levels of CRP in correlation with early onset sepsis (EOS) infection in newborns living in Taif city, Saudi Arabia. The second aim is to examine the relationship between specific IgG/IgG subclasses and early onset sepsis (EOS) infection among these newborns.MethodsStaphylococcus aureus (S. aureus) is one of the most common organisms related to sepsis infection in the newborn at King Abdel Aziz Specialist Hospital (KAASH). This study was conducted in Taif city, at KAASH’s neonatal intensive care unit between March and August 2012. Neonates were consecutively enrolled onto the study having met our inclusion criteria (as per our research protocol).The CRP concentration level was analysed using NycoCard® CRP Single Test. CRP -286 (C>T>A) A polymorphisms were analyzed using Pyrosequencing technology for CRP genotyping. IgG subclasses were analysed in the study population using ELISA.ResultLogistic regression analyses showed that the AA and AC genotypes were negatively associated amongst EOS neonates compared to suspected neonates. The frequency of CC and CT were significantly associated with the EOS neonates compared to the suspected group. The levels of specific IgG1, IgG2 and IgG3 antibodies were significantly lower amongst EOS compared to the suspected group.ConclusionsTaken together, the CRP-286 (C>T>A) A genotype polymorphism and specific IgG antibodies isotype levels can contribute to a reduced risk of EOS. Furthermore, CRP has a potential use in detecting EOS in neonates, which may mean earlier detection and management of EOS and subsequently better clinical outcome.

Clinical immunology Neonatal infections in Saudi Arabia: Association with cytokine gene polymorphisms

“…The subjects were classified into three different groups according to Nasr et al . [ 39 ]. Group I is the control group, in which babies have no symptoms or signs of sepsis and a negative blood culture.…”

“…25 µl from peripheral blood or discs of the same size from filter paper were incubated overnight in 1 ml of 0.5% saponin in PBS at 4°C, and they were then washed for 15-30 minutes in 1 ml PBS at 4°C. The discs or the pellets, were boiled in 200 µl of 5% Chelex-100 in water for 15 minutes, and the DNA was collected in supernatants after centrifugation at 250 × g for 10 minutes [ 39 ].…”

“…Patients were enrolled if they met the following inclusion criteria for participation in the study: 40 ±2 weeks gestation, an admission to the NICU at KAASH for at least 24 hours, fever (≥ 38.0°C measured consecutively on two occasions at least six hours apart), and symptoms or signs of sepsis as described previously [41,42]. The subjects were classified into three different groups according to Nasr et al [39]. Group I is the control group, in which babies have no symptoms or signs of sepsis and a negative blood culture.…”

“…Consequently, genetic variability in the regulatory and coding regions of inflammatory cytokine genes may influence the susceptibility and/or outcome of sepsis. We reported in a previous study that a high level of C-reactive protein (CRP) was associated with early onset sepsis (EOS) infection in neonates living in Saudi Arabia, and those babies carrying the A-allele were associated with high levels of circulating CRP [39]. Because IL-1β, IL-6, and TNF-α appear before CRP in EOS infection [16][17][18][19], such cytokine gene polymorphisms may provide useful biomarkers for the screening of patients at risk, as well as in the identification of those most likely to benefit from specific therapeutic choices [40].…”

Association of C-reactive protein and Interleukin-6 single nucleotide polymorphisms with preterm labour: results of a pilot study

“…Meanwhile, CRP polymorphisms have been associated with various kinds of inflammatory diseases, such as bacterial infections [3,4], heart disorders [5][6][7][8][9][10], and malignant tumours [11][12][13][14]. Specific SNPs have previously been linked to preterm birth and labour [15,16].…”