Rationale and Potential Use of Cytokines in the Prevention and Treatment of Neonatal Sepsis

Goldman, Stanton; Ellis, Robin; Dhar, Vijay; Cairo, Mitchell S.

doi:10.1016/s0095-5108(18)30106-4

Cited by 22 publications

(15 citation statements)

References 27 publications

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“…Another finding of this study is the significant enhancement of superoxide release by priming neonatal and adult neutrophils with G-CSF and GM-CSF. This positive effect of CSF on the neutrophil superoxide release is in accordance with studies done in newborn infants in vivo (34,35) and in vitro (21,34). In contrast in adults, although the in vitro studies showed a consistent significant enhancement of fMLP-superoxide generation following G/GM-CSF priming (16,40,41,48,56,57), the in vivo superoxide production showed controversial results.…”

Section: Discussionsupporting

confidence: 82%

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Effect of Granulocyte and Granulocyte Macrophage Colony Stimulating Factors (G-CSF and GM-CSF) on Neonatal Neutrophil Functions

2000

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Section: Discussionsupporting

confidence: 82%

“…Further, a significant reduction (61%) in the incidence of nosocomial infections in VLBW was reported (34). Exceptionally, Schibler et al (60) reported no effect of G-CSF administration on neutrophil counts and maturation and in the outcome of preterm and full-term septic babies.…”

Section: Discussionmentioning

confidence: 98%

Effect of Granulocyte and Granulocyte Macrophage Colony Stimulating Factors (G-CSF and GM-CSF) on Neonatal Neutrophil Functions

2000

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“…Neonatal sepsis is a major problem for physicians taking care of newborns for it is still a significant cause of mortality and morbidity in newborn nurseries. The incidence of sepsis in the neonate ranges from 1 to 10 per 1,000 livebirths; however the incidence can be as high as 50-70% in newborns with a birth weight between 500 and 1,500 g [2]. Standard treatment of sepsis in newborns is not much different from that in other age groups, except that early diagnosis is a must to avoid the high mortality which can go up to 75%, if treatment is not started immediately [2].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of sepsis in the neonate ranges from 1 to 10 per 1,000 livebirths; however the incidence can be as high as 50-70% in newborns with a birth weight between 500 and 1,500 g [2]. Standard treatment of sepsis in newborns is not much different from that in other age groups, except that early diagnosis is a must to avoid the high mortality which can go up to 75%, if treatment is not started immediately [2]. Therefore, early diagnostic measurements for sepsis have been studied extensively in neonates including complete blood cell count, C-reactive protein, fibronectin, tumor necrosis factor (TNF), interleukin 6, interleukin 1, procalcitonin, most of which still remain experimental [3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Urinary Nitric Oxide in Newborns with Infections

Ergenekon¹,

Gücüyener

Erbaş

et al. 2000

Neonatology

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Background: Neonatal sepsis is a major problem in newborn nurseries because of the difficulty in early diagnosis and because of the high morbidity and mortality. The objective of the present study was to investigate whether urinary nitric oxide (NO) levels could be useful for the diagnosis of infected newborns. Methods: Newborns with suspected infection according to previously defined criteria between ages of 1–7 days and 8–30 days were included as the study groups (p) to be compared with age-matched healthy controls (c). Urine NO levels were assayed by Sievers NOA based on chemiluminescence and expressed as corrected for urine creatinine. Results: 20 newborns with suspected infection at 1–7 days of age (group 1p) were compared with 45 healthy age-matched newborns (group 1c). 16 newborns with suspected infection at 8–30 days of age (group 2p) were compared with 15 healthy age-matched newborns (group 2c). The groups were similar with regard to birth weight and gestational age; however, the urinary NO levels in newborns with suspected infection at 1–7 days of age (80.25 ± 60.68 μmol/mg creatinine) were higher than in healthy newborns (25.45 ± 19.35 μmol/mg creatinine). Similarly, newborns with suspected infection at 8–30 days of age had higher urinary NO levels (81.78 ± 40.43 μmol/mg creatinine) than age-matched controls (36.99 ± 24.58 μmol/mg creatinine; p < 0.05). The sensitivity of urinary NO levels to detect infection was 50% in both age groups, and the specificity was 95% for 1–7 days of age and 93% for 8–30 days of age. Groups 1p and 2p were similar with regard to NO production. Altogether 12 patients had culture-proven sepsis, 11 patients had clinical sepsis, and 13 patients had other infections. The NO levels were similar in patients with culture-proven and clinical sepsis and higher than in patients with other infections. No difference was observed among NO levels of patients with gram-positive and gram-negative sepsis. Conclusions: Urinary NO levels which are quick and easy to measure are higher in infected newborns as compared with controls, and although the specificity is good, the sensitivity of the test is low, necessitating the use of another marker in addition to NO.

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“…A cohort of 152 neutropenic patients with AIDS was studied retrospectively and the group receiving G-CSF was noted to have a statistically significant reduction of gram-negative rod bacteremia [44•] Pediatrics In a phase II randomized multicenter study, very low birth weight neonates given GM-CSF had reduced incidence of nosocomial infections [45]. In a study of infants with prolonged preeclampsia-associated neutropenia, infants given recombinant human G-CSF showed reduction in the incidence of sepsis from 54% to 13% [46].…”

Section: Aidsmentioning

confidence: 99%

Colony-stimulating factors in the therapeutic approach to sepsis

Alcid

Mathew

1999

Curr Infect Dis Rep

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Sepsis and its complications continue to be a leading cause of death in the United States despite availability of potent broad-spectrum antimicrobial agents. Current in vitro, ex vivo, animal, and human data are reviewed. Present data shows that colony-stimulating factors (CSFs), granulocyte CSFs, and granulocyte-macrophage CSFs are very effective in raising the leukocyte count and shortening the number of neutropenic days. CSFs in some studies improved outcome of neutropenic septic patients especially when given very early. However, there are studies that do not show any benefit. CSFs appear to be safe and should be limited to septic, neutropenic patients whose duration of neutropenia is anticipated to be prolonged, or to patients who are seriously ill.

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Rationale and Potential Use of Cytokines in the Prevention and Treatment of Neonatal Sepsis

Cited by 22 publications

References 27 publications

Effect of Granulocyte and Granulocyte Macrophage Colony Stimulating Factors (G-CSF and GM-CSF) on Neonatal Neutrophil Functions

Effect of Granulocyte and Granulocyte Macrophage Colony Stimulating Factors (G-CSF and GM-CSF) on Neonatal Neutrophil Functions

Urinary Nitric Oxide in Newborns with Infections

Colony-stimulating factors in the therapeutic approach to sepsis

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