Department of Paediatrics, University Hospital Schleswig–Holstein, University of Lübeck Medical School, Ratzeburger Allee 160, Campus Lübeck, 23538 Lübeck, Germany.
Inflamm Res. 2011 Mar;60(3):227-32. doi: 10.1007/s00011-010-0258-5.
Parenteral nutrition is an important risk factor for late onset sepsis in neonates. This may be caused by the long-term need of central venous access but also through a potentially modulating effect of lipids and glucose on the immune function.
It was the aim of this study to characterize the effect of lipids and glucose on the neonatal immune response in an in vitro Staphylococcus epidermidis sepsis model using whole cord blood of healthy term infants and preterm infants.
At the single cell level, IL-6, IL-8 and TNF-α expression of CD14+ cells was significantly increased upon addition of 1% lipids, while the addition of clinically meaningful lipid concentrations had no remarkable effect. When glucose was added to whole cord blood cultures, a dose-dependent effect was demonstrated for IL-8 expression but not for other cytokines.
These in vitro data suggest that the proinflammatory cytokine response to S. epidermidis may be modulated by lipids and glucose. Further studies are needed to investigate whether these findings are applicable to clinical settings and to evaluate the role of cytokine monitoring in infants receiving long-term parenteral nutrition.
肠外营养是新生儿晚发性败血症的一个重要危险因素。这可能是由于长期需要中心静脉通路引起的，但也可能是由于脂质和葡萄糖对免疫功能的潜在调节作用。
本研究旨在使用健康足月和早产儿的脐带血全血，在体外表皮葡萄球菌败血症模型中，研究脂质和葡萄糖对新生儿免疫反应的影响。
在单细胞水平上，添加 1%脂质可显著增加 CD14+细胞中 IL-6、IL-8 和 TNF-α 的表达，而添加临床相关浓度的脂质则无明显作用。当葡萄糖加入脐带血培养物中时，IL-8 的表达呈剂量依赖性，但其他细胞因子则没有。
这些体外数据表明，表皮葡萄球菌引起的促炎细胞因子反应可能受到脂质和葡萄糖的调节。需要进一步的研究来调查这些发现是否适用于临床环境，并评估细胞因子监测在接受长期肠外营养的婴儿中的作用。
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