Abstract
Aim: It is difficult to identify neonatal sepsis early due to the lack of specific markers. The aim of the present study was to explore whether miR-26a expression in peripheral blood mononuclear cells (PBMCs) could be used as a diagnostic marker of the disease and whether phosphatase and tensin homolog (PTEN) was involved in suppressing miR-26a expression.Methods: A total of 51 early-onset septic newborns and 102 healthy newborns were included. Blood specimens were collected from septic newborns at the time of clinical diagnosis (baseline) and again between 72 and 96 h after birth. Blood specimens were collected from healthy newborns on admission. The expressions of miR-26a and PTEN in PBMCs were measured using real-time quantitative PCR (RT-qPCR). Other data, including hemoculture, were collected from medical records.Results: In septic newborns with and without a positive hemoculture, a lower baseline level of miR-26a in PBMCs was associated with a higher risk of disease. Additionally, at baseline, there was a certain linear relationship between the levels of miR-26a and two serological inflammatory markers (i.e., white blood cell count and C-reactive protein level) in septic newborns. In addition, the baseline expressions of miR-26a and PTEN showed a reverse linear relationship. Compared with those at baseline, the expression of miR-26a was higher and the expression of PTEN was lower in septic newborns starting at 72 h after birth.Conclusion: A lower baseline miR-26a expression in PBMCs indicated the occurrence of early-onset neonatal sepsis, and a reduced miR-26a expression might be partly related to the inflammatory process and PTEN upregulation.
Highlights
Due to their immature immune system, newborns are affected by infectious diseases
The temperature, heart rate, respiratory rate, white blood cell count, C-reactive protein, and premature delivery rate were miR-26a and Neonatal Sepsis significantly higher in the total early-onset sepsis (EOS) group than those in the control group (P = 0.003, P = 0.011, P < 0.001, P < 0.001, P < 0.001, and P < 0.001, respectively), and the body weight was lower in the total EOS group compared with the control group (P < 0.001)
Multivariate hazard ratios (HRs) (95%CI)a,b a“Total EOS”, “Newborns with clinical features of sepsis”; “EOS_POS”, “Newborns with positive haemoculture”; “EOS_NEG”, “Newborns with negative haemoculture”; Odds ratios (ORs), Odds ratio; HR, Hazard ratio; 95% confidence intervals (95% CIs), 95% Confidence interval. bAssociation of miR-26a with neonatal sepsis was detected using univariate and multivariate logistic regression analysis
Summary
Due to their immature immune system, newborns are affected by infectious diseases. Neonatal sepsis is usually divided into two clinical types: early-onset sepsis (EOS) and late-onset sepsis (LOS). The former refers to a disease that occurs during the first 72 h of life; the latter indicates a process that develops after the first 72 h [1, 2]. The disease is confirmed by microbiological blood culture, which takes days and probably has a high rate of false-positive results In this context, doctors are usually dependent on the clinical manifestations, white blood cell count, and other inflammatory markers (such as C-reactive protein) to establish an initial diagnosis and provide empirical antibiotic therapy [1, 2]. A novel biochemical marker is urgently needed to compensate for the deficiencies in the current diagnostic process
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