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早产婴儿胎粪中的炎症标志物升高。

Premature Birth Infants Present Elevated Inflammatory Markers in the Meconium.

作者信息

Rodríguez-Benítez María Victoria, Gámez-Belmonte Reyes, Gil-Campos Mercedes, Hernández-Chirlaque Cristina, Bouzas Paula R, Sánchez de Medina Fermín, Martínez-Augustin Olga

机构信息

Unit of Neonatology, Reina Sofía University Hospital, IMIBIC, Córdoba, Spain.

Department of Pharmacology, CIBERehd, School of Pharmacy, Instituto de Investigación Biosanitaria ibs.GRANADA, University of Granada, Granada, Spain.

出版信息

Front Pediatr. 2021 Jan 18;8:627475. doi: 10.3389/fped.2020.627475. eCollection 2020.

Abstract

Prematurity, a well-established risk factor for various intestinal diseases in newborns, results in increased morbidity and mortality. However, the intestinal inflammatory status of preterm (PT) infants has been poorly characterized. Here we have broadly described the intestinal and systemic inflammatory status of PT children. Meconium and plasma from 39 PT and 32 full term (T) newborns were studied. Fecal calprotectin, polymorphonuclear leukocyte elastase (PMN-E), TNF, IL-17A, IL-8, IP-10, MCP-1, MIP-1, IL-1β, IL-1α, and E-selectin and the enzymatic activities of myeloperoxidase (MPO) and alkaline phosphatase (AP) in meconium were measured. Plasma levels of AP, hepatocyte growth factor, nerve growth factor (NGF), proinflammatory cytokines, leptin, adiponectin, PAI-1, and resistin were also determined. Correlations with gestational age (GA) and birth weight (BW) were studied. Neutrophil derived PMN-E, MPO and calprotectin were increased in the meconium of PT compared to T newborns, while AP was decreased. No significant differences were found in other inflammatory parameters. Considering data from all children, GA and BW showed inverse correlation with neutrophil markers, while AP directly correlated with BW. Plasma levels of IL-1β and NGF were enhanced in PT infants, and were also negatively correlated with BW. PT children additionally showed neutropenia and decreased adiponectin, leptin, haematocrit, and haemoglobin. These parameters (neutrophils, adiponectin, and so forth) were positively correlated with GA and BW, while IL-8, MCP-1, PAI-1, and plasma AP were negatively correlated. PT children showing postnatal morbidity exhibited increased meconium MPO and MIP-1α. PT neonates present a significant elevation of intestinal inflammatory parameters, characterized by the presence of neutrophil markers, associated with mild systemic inflammation.

摘要

早产是新生儿各种肠道疾病公认的危险因素,会导致发病率和死亡率增加。然而,早产儿(PT)的肠道炎症状态一直未得到充分描述。在此,我们广泛描述了PT儿童的肠道和全身炎症状态。研究了39例PT新生儿和32例足月儿(T)的胎粪和血浆。测量了胎粪中粪便钙卫蛋白、多形核白细胞弹性蛋白酶(PMN-E)、肿瘤坏死因子、白细胞介素-17A、白细胞介素-8、干扰素诱导蛋白10(IP-10)、单核细胞趋化蛋白-1(MCP-1)、巨噬细胞炎性蛋白-1(MIP-1)、白细胞介素-1β、白细胞介素-1α和E-选择素以及髓过氧化物酶(MPO)和碱性磷酸酶(AP)的酶活性。还测定了血浆中AP、肝细胞生长因子、神经生长因子(NGF)、促炎细胞因子、瘦素、脂联素、纤溶酶原激活物抑制剂-1(PAI-1)和抵抗素的水平。研究了与胎龄(GA)和出生体重(BW)的相关性。与T新生儿相比,PT新生儿胎粪中源自中性粒细胞的PMN-E、MPO和钙卫蛋白增加,而AP减少。在其他炎症参数方面未发现显著差异。综合所有儿童的数据,GA和BW与中性粒细胞标志物呈负相关,而AP与BW呈正相关。PT婴儿血浆中白细胞介素-1β和NGF水平升高,且也与BW呈负相关。PT儿童还表现出中性粒细胞减少以及脂联素、瘦素、血细胞比容和血红蛋白降低。这些参数(中性粒细胞、脂联素等)与GA和BW呈正相关,而白细胞介素-8、MCP-1、PAI-1和血浆AP呈负相关。出现产后发病的PT儿童胎粪MPO和MIP-1α增加。PT新生儿肠道炎症参数显著升高,其特征为存在中性粒细胞标志物,并伴有轻度全身炎症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f850/7848191/bcb9975a7e9e/fped-08-627475-g0001.jpg

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