ABSTRACT. Newborn infants are more susceptible to bacterial infections than adults. This susceptibility has been attributed to defects in humoral and cellular activity. Host cellular activity can be modified by factors produced by bacteria or the host in response to infection. We assessed the effect of two factors associated with gramnegative bacterial infection, lipopolysaccharide (LPS) and TNF-a, on polymorphonuclear neutrophilic granulocytes (PMN) obtained from adult or newborns (umbilical cord blood). PILIN were primed in vitro with L P S (10 pg/L) or TNF-a (lo-' ILI) for 45 min and then assessed, using a chemiluminescence (CL) assay a s a n indicator of oxidative radical production with formyl-methionyl-leucyl-phenylalanine as the trigger for C L initiation. C L activity of unprimed P h I N was similar for adults and newborns (13.3 and 13.7 C L units, respectively). After priming with LPS, C L activity was increased to 43.4 C L units for P b I N from adults but to only 17.6 C L units for P b I N from newborns ( p < 0.001, adults versus newborn increment). Priming of P h I N with L P S was most effective when autologous plasma was present. Using FITC-conjugated L P S and a flow cytometry assay, we could demonstrate no difference between the binding affinity of L P S for adult and newborn PMN. IIowever, formyl-methionyl-leucyl-phenylalanine binding studies indicated that adult P h I N had a higher number of binding sites. TNF-a priming of newborn PILIN was also ineffective. Adult P M N increased CL activity by 3.9-fold when primed with TNF-a, whereas newborn PILIN increased by only 1.75-fold ( p < 0.005). This priming deficiency was not attributable to TNF-a receptors because phycoerythrin-conjugated TNF-a was associated with P h I N from adults and newborns equally. Thus, P h I N from newborns are not primed effectively in vitro with L P S or TNF-a. This defect may contribute to neonatal susceptibility to bacterial infection. (Pediatr Res 34: 243-248, 1993) Abbreviations PhIN, polymorphonuclear neutrophilic granulocyte IFN-y, interferon-y TNF-a, tumor necrosis factor-a