Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
Cytokine. 2011 Feb;53(2):249-55. doi: 10.1016/j.cyto.2010.11.003. Epub 2010 Dec 9.
Cytokines mediate the host immune response to infectious micro-organisms. The objective of this study was to determine whether immune regulatory interleukins (IL-4, IL-5, IL-6, and IL-10) and inflammatory cytokines (Interferon-γ [INF-γ], tumor necrosis factor-β [TNF-β], IL-2, and IL-17) are associated with an increased risk of developing blood stream bacterial/fungal infection (BSI) in extremely low birth weight (ELBW) infants. ELBW infants from 17 NICHD Neonatal Research Network centers without early onset sepsis were studied. Cytokines were measured from blood on days 1, 3, 7, 14, and 21 after birth. 996 ELBW infants contributed a minimum of 4080 unique measurements for each cytokine during the five sampling periods. Infants with BSI had lower levels of the inflammatory cytokines IL-17 (p=0.01), and higher levels of the regulatory cytokines, IL-6 (p=0.01) and IL-10 (p<0.001). Higher levels of regulatory cytokines relative to pro-inflammatory cytokines were associated with increased risk of BSI even after adjusting for confounding variables. In ELBW infants, the ratio of immune regulatory cytokines to inflammatory cytokines was associated with development of BSI. Altered maturation of regulatory and inflammatory cytokines may increase the risk of serious infection in this population.
细胞因子介导宿主对感染微生物的免疫反应。本研究的目的是确定免疫调节白细胞介素（IL-4、IL-5、IL-6 和 IL-10）和炎症细胞因子（干扰素-γ[INF-γ]、肿瘤坏死因子-β[TNF-β]、IL-2 和 IL-17）是否与极低出生体重（ELBW）婴儿发生血流细菌/真菌感染（BSI）的风险增加有关。本研究纳入了来自 17 个 NICHD 新生儿研究网络中心且无早发性败血症的 ELBW 婴儿。在出生后第 1、3、7、14 和 21 天，从血液中测量细胞因子。996 名 ELBW 婴儿在五个采样期间至少提供了 4080 个独特的细胞因子测量值。BSI 婴儿的炎症细胞因子 IL-17 水平较低（p=0.01），而调节细胞因子 IL-6（p=0.01）和 IL-10（p<0.001）水平较高。即使在调整混杂变量后，调节性细胞因子相对于促炎细胞因子的较高水平与 BSI 的风险增加相关。在 ELBW 婴儿中，免疫调节细胞因子与炎症细胞因子的比值与 BSI 的发生有关。调节和炎症细胞因子成熟的改变可能会增加该人群严重感染的风险。
