Tunc Turan, Cekmez Ferhat, Cetinkaya Merih, Kalayci Tugce, Fidanci Kursat, Saldir Mehmet, Babacan Oguzhan, Sari Erkan, Erdem Galip, Cayci Tuncer, Kul Mustafa, Kavuncuoglu Sultan
Division of Neonatology, Department of Pediatrics, Gulhane Military School of Medicine , Ankara , Turkey .
J Matern Fetal Neonatal Med. 2015 Feb;28(3):356-61. doi: 10.3109/14767058.2014.916683. Epub 2014 May 22.
Neonatal sepsis remains a major cause of morbidity and mortality in newborns. The chemokine CXCL12 and its receptor CXCR4 are now known to play an important role in inflammatory states. However, it is unclear how chemokines respond to late-onset neonatal sepsis.
Patients were classified into the groups of septic and non-septic ones. Samples of venous blood were obtained from all septic and non-septic newborns at the beginning and within 48-72 h after initiation of treatment. Serum levels of CXCR4 and CXCL12 were measured.
Concentrations of IL-6, CXCR4 and CXCL12 at the time of diagnosis were significantly higher in the septic neonates compared with the non-septic ones. Additionally, there were statistically significant differences in septic neonates between the first and the second levels of IL-6, CXCR4, CXCL12 and I/T ratio. ROC curve analyses revealed that IL-6, CXCR4, CXCL12 and I/T ratio resulted in significant AUC with respect to early identification of septic neonates. Univariate logistic regression analysis showed that increased IL-6, CXCR4 and CXCL12 were strong predictors of neonatal LOS.
Serum CXCR4 and CXCL12 levels increase in septic neonates and that both chemokines decrease within 48-72 h of treatment. Serum concentrations of both chemokines represent promising novel biomarkers for neonatal sepsis.
新生儿败血症仍然是新生儿发病和死亡的主要原因。现已知道趋化因子CXCL12及其受体CXCR4在炎症状态中起重要作用。然而，尚不清楚趋化因子如何应对晚发性新生儿败血症。
将患者分为败血症组和非败血症组。在治疗开始时以及治疗开始后48 - 72小时内，从所有败血症和非败血症新生儿中采集静脉血样本。检测血清中CXCR4和CXCL12的水平。
与非败血症新生儿相比，败血症新生儿诊断时的IL - 6、CXCR4和CXCL12浓度显著更高。此外，败血症新生儿中IL - 6、CXCR4、CXCL12和I/T比值的第一和第二水平之间存在统计学显著差异。ROC曲线分析显示，IL - 6、CXCR4、CXCL12和I/T比值在早期识别败血症新生儿方面具有显著的曲线下面积。单因素逻辑回归分析表明，IL - 6、CXCR4和CXCL12升高是新生儿败血症的有力预测指标。
败血症新生儿血清CXCR4和CXCL12水平升高，且两种趋化因子在治疗48 - 72小时内均下降。两种趋化因子的血清浓度是新生儿败血症有前景的新型生物标志物。
