Neonatal Intensive Care Unit, University Hospital of Ioannina, Ioannina, Leoforos Stavrou Niarchou, Greece.
Scand J Immunol. 2011 Mar;73(3):250-5. doi: 10.1111/j.1365-3083.2010.02499.x.
Investigation was made of changes in immune system parameters during the course of neonatal infection. The study population consisted of 95 full-term neonates matched for chronological age and sex, divided into three groups: suspected infection (n=20), sepsis (n=25), infection-free control subjects (n=50). Serial measurements were made of the cytokines interleukin-6 (IL-6), interleukin-1b (IL-1b) and tumour necrosis factor-α (TNF-α), lymphocyte subsets [CD3+, CD4+, CD8+, natural killer (NK) cells and B cells], the immunoglobulins (Ig) (IgG, IgM and IgA), C-reactive protein (CRP), and the total blood count, before, 2 days after initiation of treatment and after stopping treatment (time periods first, second and third, respectively). IL6, TNF-α, IL1-b and CRP were higher at the first time period in the sepsis group, and IL6 and TNF-α continued to be higher in this group at the second period. IL-6 and TNF-α were precise sepsis predictors with sensitivity and specificity of 0.92, 0.98 and 0.91, 0.92, respectively. NK cells, B cells, CD3+, CD4+, CD8+ were higher in the sepsis and suspected infection groups, but the ratios CD3+/CD4+, CD3+/CD8+, CD4+/CD8+ showed no difference from the controls. IgG was lower and IgM higher in the sepsis group. In the control subjects CD3+, CD4+, CD8+ lymphocytes increased with increasing age. It is concluded that IL-6 and TNF are good diagnostic markers of sepsis in full-term neonates. Lymphocyte subsets were affected by both the clinical condition and the chronological age. NK and B cells may be elevated in suspected and documented sepsis, and further studies are needed to determine their clinical significance.
研究了新生儿感染过程中免疫系统参数的变化。研究人群由 95 名按时间顺序年龄和性别匹配的足月新生儿组成，分为三组：疑似感染（n=20）、败血症（n=25）和无感染对照（n=50）。在开始治疗前、治疗后 2 天和停止治疗后（分别为第一、第二和第三时间段），连续测量细胞因子白细胞介素-6（IL-6）、白细胞介素-1b（IL-1b）和肿瘤坏死因子-α（TNF-α）、淋巴细胞亚群[CD3+、CD4+、CD8+、自然杀伤（NK）细胞和 B 细胞]、免疫球蛋白（Ig）（IgG、IgM 和 IgA）、C 反应蛋白（CRP）和全血细胞计数。在败血症组，第一个时间段的 IL6、TNF-α、IL1-b 和 CRP 较高，在第二个时间段，IL6 和 TNF-α 继续在该组中升高。IL-6 和 TNF-α 是精确的败血症预测因子，其敏感性和特异性分别为 0.92、0.98 和 0.91、0.92。在败血症和疑似感染组中，NK 细胞、B 细胞、CD3+、CD4+、CD8+较高，但 CD3+/CD4+、CD3+/CD8+、CD4+/CD8+的比值与对照组无差异。败血症组 IgG 较低，IgM 较高。在对照组中，CD3+、CD4+、CD8+淋巴细胞随年龄增长而增加。结论：IL-6 和 TNF 是足月新生儿败血症的良好诊断标志物。淋巴细胞亚群受临床状况和时间顺序年龄的影响。NK 和 B 细胞可能在疑似和确诊败血症中升高，需要进一步研究以确定其临床意义。
