Zonneveld Rens, Jongman Rianne M, Juliana Amadu, Molema Grietje, van Meurs Matijs, Plötz Frans B
Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Academic Pediatric Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname.
BMJ Paediatr Open. 2018 Oct 9;2(1):e000312. doi: 10.1136/bmjpo-2018-000312. eCollection 2018.
Early onset sepsis (EOS) is defined as onset of sepsis within 72 hours after birth. Leucocyte-endothelial interactions play a pivotal part in EOS pathophysiology. Endothelial cell adhesion molecules (CAMs) orchestrate these interactions and their soluble isoforms (sCAMs) are released into the vasculature by enzymes called sheddases.
This study was undertaken to explore further the pathophysiology of EOS and to investigate the potential of sCAM and their sheddases as potential biomarkers for EOS.
Stored serum aliquots were used from 71 Surinamese newborns suspected of EOS and 20 healthy newborns from an earlier study. Serum had been collected within 72 hours after birth and six (8.6%) newborns had a positive blood culture with gram-negative pathogens. Concentrations of sCAMs sP-selectin, sE-selectin, soluble vascular cell adhesion molecule-1, intercellular adhesion molecule-1 and platelet and endothelial cell adhesion molecule-1, sheddases matrix metalloproteinase-9 (MMP-9) and neutrophil elastase (NE) and sheddase antagonist tissue-inhibitor of metalloproteinases-1 (TIMP-1) were measured simultaneously with Luminex and ELISA.
MMP-9 and TIMP-1 levels were measured in serum of n=91 newborns and sCAMs and NE levels in serum of n=80 newborns, respectively. We found no differences in median concentrations of sCAMs, MMP-9 and TIMP-1 or NE between blood culture positive EOS, blood culture negative EOS and control groups at start of antibiotic treatment.
Our data indicate that serum concentrations of sCAMs and their sheddases have no clinical utility as biomarkers for EOS.
NCT02486783. Results.
早发型败血症（EOS）定义为出生后72小时内出现的败血症。白细胞与内皮细胞的相互作用在EOS的病理生理学中起关键作用。内皮细胞粘附分子（CAMs）协调这些相互作用，其可溶性亚型（sCAMs）通过称为脱落酶的酶释放到血管系统中。
本研究旨在进一步探索EOS的病理生理学，并研究sCAM及其脱落酶作为EOS潜在生物标志物的可能性。
使用来自71名疑似EOS的苏里南新生儿和早期研究中的20名健康新生儿的储存血清样本。出生后72小时内采集血清，6名（8.6%）新生儿血培养革兰氏阴性病原体呈阳性。使用Luminex和ELISA同时测量sCAMs（可溶性P选择素、可溶性E选择素、可溶性血管细胞粘附分子-1、细胞间粘附分子-1和血小板内皮细胞粘附分子-1）、脱落酶基质金属蛋白酶-9（MMP-9）和中性粒细胞弹性蛋白酶（NE）以及脱落酶拮抗剂金属蛋白酶组织抑制剂-1（TIMP-1）的浓度。
分别在n = 91名新生儿的血清中测量了MMP-9和TIMP-1水平，在n = 80名新生儿的血清中测量了sCAMs和NE水平。我们发现在抗生素治疗开始时，血培养阳性EOS、血培养阴性EOS和对照组之间sCAMs、MMP-9和TIMP-1或NE的中位数浓度没有差异。
我们的数据表明，sCAMs及其脱落酶的血清浓度作为EOS的生物标志物没有临床应用价值。
NCT02486783。结果。
