Gessler P, Kirchmann N, Kientsch-Engel R, Haas N, Lasch P, Kachel W
Department of Pediatrics, University Hospital of Mannheim, Germany.
Blood. 1993 Nov 15;82(10):3177-82.
The neonate is uniquely susceptible to severe and overwhelming bacterial infections. One of the most important deficits in the neonatal host defense system seems to be a quantitative and qualitative deficiency of the myeloid and the phagocytic system. Future optimal therapy of neonatal sepsis may include the use of adjuvant immunologic therapy. Granulocyte colony-stimulating factor (G-CSF) has been shown to induce neutrophilia and to enhance mature effector neutrophil function. To evaluate the role of G-CSF with respect to infection, we examined serum levels of G-CSF in term and preterm neonates, using an enzyme-linked immunosorbent assay method. G-CSF levels in healthy neonates showed peak levels up to 7 hours after birth, followed by an increase in total neutrophil cell (TNC) counts. Both G-CSF levels determined between 4 and 7 hours after birth and peak TNC counts correlated with the gestational age of the neonates. The state of nutrition, maternal treatment with glucocorticoids, maternal infection and hypertension, and the mode of delivery influenced peak G-CSF levels. Neonates with signs of infection between 4 and 7 hours after birth had higher levels of G-CSF than did healthy neonates (1,312 +/- 396 pg/mL v 176 +/- 19 pg/mL). In conclusion, the presented results of serum concentrations of G-CSF in relation to TNC counts and various diseases suggests an important role of G-CSF in the regulation of granulopoiesis during the neonatal period.
新生儿特别容易受到严重且难以抵御的细菌感染。新生儿宿主防御系统中最重要的缺陷之一似乎是髓系和吞噬系统在数量和质量上的不足。未来新生儿败血症的最佳治疗方法可能包括使用辅助免疫疗法。粒细胞集落刺激因子(G-CSF)已被证明可诱导中性粒细胞增多并增强成熟效应中性粒细胞的功能。为了评估G-CSF在感染方面的作用,我们采用酶联免疫吸附测定法检测了足月儿和早产儿血清中的G-CSF水平。健康新生儿的G-CSF水平在出生后7小时内达到峰值,随后总中性粒细胞计数(TNC)增加。出生后4至7小时测定的G-CSF水平和TNC峰值均与新生儿的胎龄相关。营养状况、母亲使用糖皮质激素治疗、母亲感染和高血压以及分娩方式都会影响G-CSF峰值水平。出生后4至7小时有感染迹象的新生儿的G-CSF水平高于健康新生儿(1312±396 pg/mL对176±19 pg/mL)。总之,所呈现的关于G-CSF血清浓度与TNC计数及各种疾病关系的结果表明,G-CSF在新生儿期粒细胞生成的调节中起着重要作用。