Almanzar Giovanni, Schönlaub Jörn, Hammerer-Lercher Angelika, Koppelstaetter Christian, Bernhard David, Prelog Martina
University Children's Hospital, University of Wuerzburg, Josef-Schneider-Str. 2, Wuerzburg, Germany.
Central Laboratory, University Hospital Innsbruck, Anichstr. 35, Innsbruck, Austria.
Early Hum Dev. 2015 Dec;91(12):663-70. doi: 10.1016/j.earlhumdev.2015.09.010. Epub 2015 Oct 26.
Several studies reported that the mode of delivery may induce changes to the immune system. Our hypothesis was that the delivery mode may influence mainly the naive T cell subpopulation.
Particular focus was set on the proportions and peripheral replicative history of naive T cells and cord blood serum concentrations of IL-7, a cytokine involved in peripheral naive T cell homeostasis.
STUDY DESIGN, SUBJECTS AND OUTCOME MEASURES: In a prospective cohort study, proportions of lymphocyte populations were measured in mothers and newborns delivered by spontaneous vaginal delivery (SD), vacuum extraction (VE), primary (PCS) and secondary Cesarean sections (SCS) by flow cytometry. T-cell-receptor-excision-circles (TRECs) and relative telomere lengths (RTLs) were used to estimate the replicative history of peripheral naive T cells. The cytokine profile was assessed by ELISA.
The study demonstrated that leukocytes, neutrophils and NK cells were increased in spontaneously delivered newborns compared to PCS, whereas circulating T cells were relatively lower. TRECs and RTLs were not significantly influenced by the delivery mode. IL-2, IL-8 and IFN-γ were increased in VD. IL-7 production tends to be increased in more stress-associated delivery modes, such as VE and SCS.
Our results demonstrate proportional changes in newborns delivered by PCS and diminished cytokine production. It has to be proven whether these alterations may be of disadvantage regarding early defense of infectious diseases. Understanding the physiological role of these changes may help to find preventive strategies for neonatal infectious risks and the development of atopy or other immune diseases.
多项研究报告称，分娩方式可能会引起免疫系统的变化。我们的假设是，分娩方式可能主要影响初始T细胞亚群。
特别关注初始T细胞的比例和外周复制史，以及白细胞介素-7（IL-7，一种参与外周初始T细胞稳态的细胞因子）的脐血血清浓度。
研究设计、研究对象和观察指标：在一项前瞻性队列研究中，通过流式细胞术测量了经自然阴道分娩（SD）、真空吸引分娩（VE）、初次剖宫产（PCS）和二次剖宫产（SCS）的母亲及新生儿的淋巴细胞群体比例。采用T细胞受体切除环（TREC）和相对端粒长度（RTL）来估计外周初始T细胞的复制史。通过酶联免疫吸附测定（ELISA）评估细胞因子谱。
研究表明，与初次剖宫产的新生儿相比，自然分娩的新生儿的白细胞、中性粒细胞和自然杀伤细胞增多，而循环T细胞相对较少。TREC和RTL不受分娩方式的显著影响。自然阴道分娩的新生儿中白细胞介素-2、白细胞介素-8和干扰素-γ水平升高。在与压力相关的分娩方式（如真空吸引分娩和二次剖宫产）中，白细胞介素-7的产生往往增加。
我们的结果表明，初次剖宫产分娩的新生儿存在比例变化，且细胞因子产生减少。这些改变是否对早期抵御传染病不利还有待证实。了解这些变化的生理作用可能有助于找到预防新生儿感染风险以及预防特应性疾病或其他免疫疾病发展的策略。
