Abstract
Not fully maturated immune system in preterm neonates may contribute to the increased susceptibility to infection. The levels of some cytokines can be useful in the prediction and diagnosis of sepsis in premature neonates. In the present study, we evaluated the potential predictive role of IFN-γ and IL-5 in cord and venous blood, together with the determination of C-reactive protein and procalcitonin (PCT) for sepsis development in premature neonates. A total of 80 participants were included. The laboratory results and clinical histories showed that 21 participants had sepsis. Early onset sepsis was detected in 3 patients while late onset sepsis was observed in 18 participants. The venous plasma levels of IFN-γ and PCT was markedly increased in sepsis groups when compared to the participants without sepsis. On the other hand, levels of IL-5 did not significantly change in the evaluated groups of sepsis and in the control group of participants. Simultaneously, plasma venous levels were not altered in any of the evaluated groups. Obtained findings suggest that venous plasma levels of IFN-γ, rather than levels of IFN-γ in cord blood plasma, and PCT may have predictive potential for sepsis development in preterm neonates. Further studies are necessary to get more comprehension of the complex function of cytokines for sepsis development in preterm neonates.
Highlights
Neonatal sepsis represents public health problem with high rate of morbidity and mortality
We tried to evaluate the role of representative cytokines of Th1 (IFN-γ) and Th2 (IL-5) immune response for sepsis prediction in premature neonates who are younger or older than 32 weeks of gestational age (GA), mainly because named groups exhibit different levels of immune system maturity due to fetal development [2]
Taking into account that the difference in immune system maturity could be the origin of the heterogeneity of the immune response during sepsis [13], we determined specific immune mediators (CRP and PCT) to have more elements for better prediction of sepsis development in preterm neonates [14]
Summary
Neonatal sepsis represents public health problem with high rate of morbidity and mortality. The most harmful effect is especially addressed to preterm neonates [1]. The health of preterm neonates deteriorates rapidly, causing septic shock, and neonates may die even before antimicrobial tests are ready [2]. Onset sepsis (EOS) occurs in the first 72 h of life and it is usually caused by organisms transmitted vertically, from the mother to the infant before or at the time of birth. Pro- and anti-inflammatory cytokines have key roles and regulate the inflammation process and host response to infection. The immune system develops throughout the fetal period, it has been proved that different microbial antigens evoke innate and adaptive mechanisms of the host and release cytokines, resulting in clinical signs and outcomes [4]
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