Layseca-Espinosa Esther, Pérez-González Luis F, Torres-Montes Abraham, Baranda Lourdes, de la Fuente Hortensia, Rosenstein Yvonne, González-Amaro Roberto
Department of Immunology, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, México.
Pediatr Allergy Immunol. 2002 Oct;13(5):319-27. doi: 10.1034/j.1399-3038.2002.01064.x.
The aim of this study was to identify a novel immunological indicator useful for the early diagnosis (through a rapid and single determination) of neonatal sepsis (NS). Peripheral blood samples were taken from 63 neonates, who were classified into four groups: proven NS (n = 17); clinical NS (n = 14); disease without infection (n = 17); and healthy newborns (n = 15). Neutrophil expression of CD64, CD43, CD44, CD50, CD62L and Mac-1, and plasma levels of interleukin (IL)-1beta, IL-6, tumor necrosis factor-alpha (TNF-alpha) and soluble L-selectin (sCD62L), were determined. Expression of CD64 was significantly enhanced in the group with proven sepsis and clinical NS compared to newborns without infection (p < 0.05). Eight newborns with proven or clinical sepsis, but only one with disease without infection, showed an increased percentage of CD64+ cells (diagnostic specificity = 96.8%). No significant differences were found in the expression of the other leucocyte differentiation antigens studied. As previously described, TNF-alpha and IL-6 levels were significantly elevated in newborns with proven or clinical sepsis compared to neonates without infection (p < 0.05). Our results suggest that, through a single determination, the enhanced expression of CD64 is a highly specific indicator of NS, although its diagnostic sensitivity is low (25.8%). In contrast, we found that plasma levels of IL-1beta and sCD62L, as well as the expression of Mac-1, CD43, CD44, CD50, and CD62L, do not appear to be useful for the diagnosis of NS.
本研究的目的是确定一种新型免疫指标，用于新生儿败血症（NS）的早期诊断（通过快速单次检测）。采集了63例新生儿的外周血样本，这些新生儿被分为四组：确诊NS组（n = 17）；临床NS组（n = 14）；无感染疾病组（n = 17）；健康新生儿组（n = 15）。测定了中性粒细胞CD64、CD43、CD44、CD50、CD62L和Mac-1的表达，以及白细胞介素（IL）-1β、IL-6、肿瘤坏死因子-α（TNF-α）和可溶性L-选择素（sCD62L）的血浆水平。与无感染的新生儿相比，确诊败血症组和临床NS组中CD64的表达显著增强（p < 0.05）。8例确诊或临床败血症的新生儿，但只有1例无感染疾病的新生儿，CD64+细胞百分比增加（诊断特异性 = 96.8%）。在所研究的其他白细胞分化抗原的表达上未发现显著差异。如前所述，与无感染的新生儿相比，确诊或临床败血症的新生儿中TNF-α和IL-6水平显著升高（p < 0.05）。我们的结果表明，通过单次检测，CD64表达增强是NS的高度特异性指标，尽管其诊断敏感性较低（25.8%）。相比之下，我们发现IL-1β和sCD62L的血浆水平以及Mac-1、CD43、CD44、CD50和CD62L的表达似乎对NS的诊断无用。
