Decembrino Lidia, DeAmici Mara, De Silvestri Annalisa, Manzoni Paolo, Paolillo Piermichele, Stronati Mauro
a Fondazione IRCCS Policlinico San Matteo , Neonatal Intesive Care Unit , Pavia , Italy.
b Fondazione IRCCS Policlinico San Matteo, Pediatric Clinic, IRCCS San Matteo Foundation , Pavia , Italy.
J Matern Fetal Neonatal Med. 2017 Dec;30(23):2890-2893. doi: 10.1080/14767058.2016.1266479. Epub 2016 Dec 20.
Lactoferrin (Lf) is one of the major proteins of all exocrine secretions with a role in the antinfective process. Our aim was to evaluate how plasma Fl levels may change in response to infection in newborn preterm infants.
A total of 15 (8 females, 7 males) newborn preterm infants with a postnatal age >72 h of life, underwent to blood culture and others markers of infection, for suspected sepsis, were enrolled in the study.
We found that Lf serum concentration was significantly lowest in four neonates (26.7%) with confirmed sepsis than in 11 (73.3%) with clinical sepsis. The AUC was 0.90 (95%CI: 0.63-0.99). The optimal cutoff for Lf was <1.2 μg/ml with a sensibility of 100% and a specificity of 81.8%. Lf serum concentration was positively correlated with WBC or neutrophil (Spearman rho = 0.69 and 0.49, respectively).
Serum Lf could prove a promising, sensitive and specific marker in the diagnostic approach to infants with suspected sepsis, thanks to its role in defense mechanisms and physiological functions of the immune system. Low levels of Lf in sepsis may suggest an immature response due to suboptimal leukocites activity in newborn preterm infants.
乳铁蛋白（Lf）是所有外分泌分泌物中的主要蛋白质之一，在抗感染过程中发挥作用。我们的目的是评估新生儿早产儿感染时血浆Lf水平如何变化。
本研究纳入了15例（8例女性，7例男性）出生后年龄>72小时的新生儿早产儿，因疑似败血症接受血培养及其他感染标志物检查。
我们发现，4例（26.7%）确诊败血症的新生儿的Lf血清浓度显著低于11例（73.3%）临床败血症患儿。曲线下面积（AUC）为0.90（95%置信区间：0.63 - 0.99）。Lf的最佳截断值为<1.2μg/ml，敏感性为100%，特异性为81.8%。Lf血清浓度与白细胞或中性粒细胞呈正相关（斯皮尔曼相关系数分别为0.69和0.49）。
由于血清Lf在免疫系统的防御机制和生理功能中发挥作用，它可能是诊断疑似败血症婴儿的一种有前景、敏感且特异的标志物。败血症时Lf水平低可能表明新生儿早产儿白细胞活性欠佳导致免疫反应不成熟。
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