Plasma levels and gene expression of granulocyte colony-stimulating factor, tumor necrosis factor-α, interleukin (IL)-1β, IL-6, IL-8, and soluble intercellular adhesion molecule-1 in neonatal early onset sepsis
Plasma levels and gene expression of granulocyte colony-stimulating factor, tumor necrosis factor-α, interleukin (IL)-1β, IL-6, IL-8, and soluble intercellular adhesion molecule-1 in neonatal early onset sepsis
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DOI：
10.1203/00006450-199810000-00002
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发表时间：
1998-10-01
影响因子：
3.6
通讯作者：
Brandis, M
中科院分区：
文献类型：
--
作者：
Berner, R;Niemeyer, CM;Brandis, M
细菌性败血症仍然是新生儿发病和死亡的主要原因。特别是早发性脓毒症，其临床病程不同，并且在以后的生活中涉及除脓毒症以外的其他病原体。在这项研究中，评估了早发败血症新生儿的脐带血和出生后第一天的粒细胞集落刺激因子（G-CSF）、肿瘤坏死因子-α（TNF-α）、IL-1β、IL-6、IL-8和可溶性细胞间粘附分子-1（sICAM-1）的血浆浓度和mRNA表达。无论是否早产，与健康婴儿和临床怀疑但未确诊脓毒症的婴儿相比，脓毒症新生儿的血浆 G-CSF、TNF-α、IL-1β、IL-6 和 IL-8（但不包括 sICAM-1）水平过度升高。与相应的母体水平相比，新生儿细胞因子索血浆水平同样高度升高，表明新生儿产生内源性细胞因子。然而，除了 TNF-α 之外，脓毒症婴儿血细胞中 mRNA 表达的检测频率并不比非脓毒症患者血细胞中的高。细胞因子水平在出生后最初几天内显着下降，而 sICAM-1 和 C 反应蛋白水平在同一时期内增加。总之，与 C 反应蛋白和 sICAM-1 相比，脐带血血浆中 G-CSF、TNF-α、IL-1β、IL-6 和 IL-8 的水平（而不是 mRNA 的存在）可以预测新生儿早发败血症，具有高敏感性和特异性。血细胞以外的细胞类型可能对脓毒症新生儿细胞因子的高产生有很大影响。
Bacterial sepsis is still a leading cause of neonatal morbidity and mortality. Early onset sepsis in particular, presents with a different clinical course and involves other pathogens than sepsis later in life. In this study, plasma concentrations and mRNA expression of granulocyte colony-stimulating factor (G-CSF), tumor necrosis factor-alpha (TNF-alpha), IL-1 beta, IL-6, IL-8, and soluble intercellular adhesion molecule-1 (sICAM-1) of neonates with early onset sepsis were evaluated in cord blood and during the first days of life. Irrespective of prematurity, plasma levels of G-CSF, TNF-alpha, IL-1 beta, IL-6, and IL-8, but not sICAM-1, were excessively elevated in septic neonates when compared with both healthy infants and infants with clinically suspected but not confirmed sepsis. Compared with the corresponding maternal levels, neonatal cytokine cord plasma levels were likewise highly elevated, indicating the endogenous cytokine production by the neonate. With the exception of TNF-alpha, mRNA expression in blood cells from septic infants was, however, not more frequently detectable than in those from nonseptic patients. Cytokine levels decreased significantly within the first days of life, whereas levels of sICAM-1 and C-reactive protein increased during the same time period. In summary, in contrast to C-reactive protein and sICAM-1, cord blood plasma levels, but not the presence of mRNA, of G-CSF, TNF-alpha, IL-1 beta, IL-6, and IL-8 can predict neonatal early onset sepsis with a high sensitivity and specificity. Cell types other than blood cells are likely to contribute considerably to the high cytokine production in septic newborns.