Immune changes in neonates with hyperbilirubinemia on different phototherapies

Abstract

Objective To investigate the changes of bilirubin, serum soluble interleukin-2 receptor (SIL-2R), and granulocyte-macrophage colony stimulating factor (GM-CSF) levels in neonates with hyperbilirubinemia on different phototherapies and their clinical significance. Methods Sixty newborns with hyperbilirubinemia who were hospitalized from January 2016 to December 2016 at the Third Affiliated Hospital of Inner Mongolia Medical College were randomly selected. According to the treatment methods used, the patients were equally divided into two groups: those receiving persistent blue light treatment for 12 h per day (group 1) and those receiving intermittent blue light treatment for 6-8 h per day (group 2). Thirty age-matched healthy newborns were included as a control group (no jaundice or serum bilirubin levels≤ 205.2 μmol/ L). SIL-2R and GM-CSF levels in peripheral venous blood samples from these neonates were measured, compared, and analyzed. Analysis of variance was used to compare the differences in serum bilirubin, SIL-2R, and GM-CSF levels in the three groups, and pairwise comparisons were performed between groups. Pearson correlation analysis was used to analyze the correlation of high bilirubin in groups 1 and 2 with SIL-2R and GM-CSF. Results Before treatment, both SIL-2R [(42.99±7.02) pg/ml vs (45.02±7.93) pg/ml vs (25.92±6.98) pg/ml, P<0.001] and GM-CSF [(23.49±3.29) ng/L vs (25.34±2.58) ng/L vs (8.85±2.21) ng/L, P<0.001] levels in groups 1 and 2 were significantly higher than those in the control group. After treatment, SIL-2R [(40.65±8.03) pg/ml vs (32.97±7.05) pg/ml vs (25.92±6.98) pg/ml] and GM-CSF [(22.45±3.64) ng/L vs (15.38±3.19) ng/L vs (8.85±2.21) ng/L] levels in groups 1 and 2 were still both significantly higher than those in the control group (P<0.001); SIL-2R and GM-CSF levels were significantly lower in group 2 after treatment than pre-treatment (t=63.264 and 10.917, respectively, P<0.001). Serum total bilirubin levels were positively correlated with SIL-2R (r=0.523 and 0.578, respectively, P<0.01) and GM-CSF (r=0.545 and 0.548, respectively, P<0.01) levels in the hyperbilirubin group before treatment. Conclusion There is a disturbance of cellular immunity and cytokine secretion in neonates with hyperbilirubinemia. Intermittent phototherapy is helpful to the recovery of immune function of neonates while reducing high indirect bilirubin. Key words: Hyperbilirubinemia, neonate; Soluble interleukin-2 receptor; Granulocyte-macrophage colony stimulating factor