Badr Hassan S, El-Gendy Fady M, Helwa Mohamed A
a Department of Pediatrics , Menoufia University , Shibin El Kom , Egypt.
b Clinical Pathology, Faculty of Medicine , Menoufia University , Shibin El Kom , Egypt.
J Matern Fetal Neonatal Med. 2018 Aug;31(16):2209-2215. doi: 10.1080/14767058.2017.1336760. Epub 2017 Jun 14.
Neonatal sepsis remains one of the leading causes of morbidity and mortality both among term and preterm infants. Advances in neonatal care improved survival and reduced complications in preterm infants. Chemokines are chemotactic cytokines that give directional guidance for leukocyte migration during inflammatory process. The chemokine CXCL12 and its receptor CXCR4 are now known to play an important role in inflammatory states. However, its value as a biomarker in neonatal sepsis is unclear.
To assess the value of measuring the serum levels of alpha-chemokine receptor type 4 (CXCR-4) and stromal-derived-factor-1 (CXCL12) in diagnosis of late onset neonatal sepsis.
Serum levels of CXCL12 and CXCR4 were determined in 38 full term neonates, 23 cases of late onset sepsis (13 males and 10 female), and 15 healthy neonates as control (six males and nine females) by ELISA technique and flow-cytometry.
Serum levels of CXCR4 and CXCL12 were significantly higher in neonates with late onset sepsis compared with the non-septic ones. The sensitivity, the specificity, and the overall accuracy of CXCL12 were 100%. The sensitivity of CXCR4 was 87%; the specificity was 80% and the overall accuracy was 84%.
Serum CXCR4 and CXCL12 levels increase significantly in septic neonates and they are valuable marker in diagnosis of neonatal sepsis. Serum concentrations of both chemokines represent promising novel biomarkers for neonatal sepsis.
新生儿败血症仍然是足月儿和早产儿发病及死亡的主要原因之一。新生儿护理的进步提高了早产儿的存活率并减少了并发症。趋化因子是趋化性细胞因子，在炎症过程中为白细胞迁移提供定向引导。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，其作为新生儿败血症生物标志物的价值尚不清楚。
评估检测血清α趋化因子受体4（CXCR-4）和基质细胞衍生因子-1（CXCL12）水平在诊断晚发性新生儿败血症中的价值。
采用酶联免疫吸附测定（ELISA）技术和流式细胞术，测定38例足月儿、23例晚发性败血症患儿（男13例，女10例）和15例健康新生儿（男6例，女9例）作为对照的血清CXCL12和CXCR4水平。
晚发性败血症新生儿的血清CXCR4和CXCL12水平显著高于非败血症新生儿。CXCL12的敏感性、特异性和总体准确率均为100%。CXCR4的敏感性为87%；特异性为80%，总体准确率为84%。
败血症新生儿的血清CXCR4和CXCL12水平显著升高，它们是诊断新生儿败血症的有价值标志物。两种趋化因子的血清浓度均代表了新生儿败血症有前景的新型生物标志物。
