O'Hare Fiona M, Watson R William G, O'Neill Amanda, Segurado Ricardo, Sweetman Deirdre, Downey Paul, Mooney Eoghan, Murphy John, Donoghue Veronica, Molloy Eleanor J
Paediatrics, National Maternity Hospital, Dublin, Ireland.
UCD School of Medicine & Medical Sciences & Conway Institute of Biomolecular and Biomedical Sciences, University College Dublin, Dublin, Ireland.
Acta Paediatr. 2017 Apr;106(4):561-567. doi: 10.1111/apa.13745. Epub 2017 Feb 16.
Inflammatory cytokines may play a role in the final common pathway in the pathogenesis of hypoxic-ischaemic injury in experimental models. We aimed to profile the systemic pro-and anti-inflammatory response over the first week of life in term infants at risk of neonatal encephalopathy.
In a tertiary referral university neonatal intensive care unit, serial blood samples were analysed from 41 term infants (requiring resuscitation at birth) in this prospective observational pilot study. Serum levels of 10 pro-and anti-inflammatory cytokines were evaluated including interleukin(IL)-1α, IL-1β, IL-6, IL-8, IL-10, tumour necrosis factor(TNF)-α, interferon (IFN)-γ, vascular endothelial growth factor (VEGF), granulocyte/colony-stimulating factor (G-CSF) and granulocyte macrophage/colony-stimulating factor (GM-CSF).
Infants with neonatal encephalopathy and abnormal neuroimaging (n = 15) had significantly elevated granulocyte macrophage/colony-stimulating factor at 0-24 h and interleukin-8, interleukin-6 and interleukin-10 at 24-48 hour. Tumour necrosis factor-α and vascular endothelial growth factor levels were lower at 72-96 hour (p < 0.05). Significantly elevated levels of interleukin-10 were associated with mortality.
Serum cytokine changes and innate immune dysregulation in the first week of life may be indicators of outcome in neonatal encephalopathy but require validation in larger studies.
在实验模型中，炎性细胞因子可能在缺氧缺血性损伤发病机制的最终共同途径中发挥作用。我们旨在剖析有新生儿脑病风险的足月儿出生后第一周内全身性促炎和抗炎反应情况。
在一家三级转诊大学新生儿重症监护病房，对41名足月儿（出生时需要复苏）进行了前瞻性观察性初步研究，分析其系列血样。评估了10种促炎和抗炎细胞因子的血清水平，包括白细胞介素（IL）-1α、IL-1β、IL-6、IL-8、IL-10、肿瘤坏死因子（TNF）-α、干扰素（IFN）-γ、血管内皮生长因子（VEGF）、粒细胞/集落刺激因子（G-CSF）和粒细胞巨噬细胞/集落刺激因子（GM-CSF）。
患有新生儿脑病且神经影像学异常的婴儿（n = 15）在0 - 24小时时粒细胞巨噬细胞/集落刺激因子显著升高，在24 - 48小时时白细胞介素-8、白细胞介素-6和白细胞介素-10显著升高。在72 - 96小时时肿瘤坏死因子-α和血管内皮生长因子水平较低（p < 0.05）。白细胞介素-10水平显著升高与死亡率相关。
出生后第一周血清细胞因子变化和先天免疫失调可能是新生儿脑病预后的指标，但需要在更大规模研究中进行验证。
