Shaw C K, Thapalial A, Shaw P, Malla K
Department of Paediatrics, Manipal College of Medical Sciences (MCOMS), Pokhara, Nepal.
Int J Clin Pract. 2007 Mar;61(3):482-7. doi: 10.1111/j.1742-1241.2006.01162.x.
Neonatal sepsis is a significant cause of morbidity and mortality in the neonatal intensive care unit. The epidemiology of neonatal infections is complex; however, they are in large part secondary to developmentally immature host defence mechanisms. These immunodeficiencies, which are exaggerated in premature and sick neonates, include quantitative and qualitative deficits in phagocytes, complement components, cytokines and immunoglobulins. Therapies that modulate or augment host defences may attenuate the virulence of neonatal infections. In this paper, we have reviewed immunotherapies that modulate the immune system of the neonate, including intravenous immunoglobulins and myeloid haematopoietic growth factors. Future studies should focus on investigating other abnormalities of neonatal host defence and/or combined immunotherapy approaches in an attempt to circumvent the immaturity of host defence and potentially reduce both the incidence and severity of neonatal sepsis.
新生儿败血症是新生儿重症监护病房发病和死亡的重要原因。新生儿感染的流行病学情况复杂；然而，在很大程度上，它们继发于发育不成熟的宿主防御机制。这些免疫缺陷在早产儿和患病新生儿中更为突出，包括吞噬细胞、补体成分、细胞因子和免疫球蛋白的数量和质量缺陷。调节或增强宿主防御的疗法可能会减弱新生儿感染的毒力。在本文中，我们综述了调节新生儿免疫系统的免疫疗法，包括静脉注射免疫球蛋白和髓系造血生长因子。未来的研究应集中于调查新生儿宿主防御的其他异常情况和/或联合免疫疗法，以试图克服宿主防御的不成熟，并有可能降低新生儿败血症的发病率和严重程度。
