Centre for Neonatal Research and Education and Division of Paediatrics, Medical School, University of Western Australia, Perth, Western Australia, Australia.
Telethon Kids Institute, Perth, Western Australia, Australia.
PLoS One. 2020 May 14;15(5):e0232933. doi: 10.1371/journal.pone.0232933. eCollection 2020.
Deficiencies in innate immune responses may contribute to the increased susceptibility to infection in preterm infants. In vivo cytokine profiles in response to sepsis in very preterm infants are not fully understood.
To characterise plasma pro- and anti-inflammatory cytokine concentrations and pre-defined ratios in very preterm infants with late-onset sepsis (LOS).
In this observational study, peripheral blood samples were collected at the time of evaluation for suspected LOS from 31 preterm infants (<30 weeks gestational age). Plasma cytokine concentrations were determined by 12-plex immunoassay.
IL-10, IFN-γ, IL-12p70, IP-10, IL-6 and CCL2 were elevated in the majority infants with LOS (n = 12) compared to those without LOS (n = 19). There was no difference in TNF-α, IL-1β, IL-17AF, IL-8 and IL-15 concentrations between groups. IL-10/TNF-α ratios were increased, while CCL2/IL-10 and IL-12p70/IL-10 ratios were decreased in infants with LOS compared to those without.
Very preterm infants have a marked innate inflammatory response at the time of LOS. The increase in IL-10/TNF-α ratio may indicate early immune hypo-responsiveness. Longitudinal studies with a larger number of participants are required to understand immune responses and clinical outcomes following LOS in preterm infants.
先天免疫反应缺陷可能导致早产儿易感染。尚未充分了解极早产儿对败血症的体内细胞因子反应谱。
描述晚发型败血症（LOS）早产儿的促炎和抗炎细胞因子浓度及预定义比值。
本观察性研究中，从 31 名（<30 周胎龄）疑似 LOS 的早产儿中采集外周血样本。通过 12 重免疫分析测定血浆细胞因子浓度。
与无 LOS 的早产儿（n=19）相比，大多数 LOS 早产儿（n=12）的 IL-10、IFN-γ、IL-12p70、IP-10、IL-6 和 CCL2 升高。两组间 TNF-α、IL-1β、IL-17AF、IL-8 和 IL-15 浓度无差异。与无 LOS 者相比，LOS 患儿的 IL-10/TNF-α 比值升高，CCL2/IL-10 和 IL-12p70/IL-10 比值降低。
LOS 时极早产儿存在明显的先天炎症反应。IL-10/TNF-α 比值升高可能表明早期免疫反应低下。需要更多参与者的纵向研究来了解早产儿 LOS 后的免疫反应和临床结局。
