Red blood cell transfusions can induce proinflammatory cytokines in preterm infants
Red blood cell transfusions can induce proinflammatory cytokines in preterm infants
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DOI：
10.1111/trf.14080
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发表时间：
2017-05-01
期刊：
影响因子：
2.9
通讯作者：
Gori, Anna Maria
中科院分区：
文献类型：
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作者：
Dani, Carlo;Poggi, Chiara;Gori, Anna Maria
背景：早产儿发生红细胞（RBC）输血相关坏死性小肠结肠炎（TANEC）的风险最近被强调。我们的目的是评估红细胞输注后极早产儿血清细胞因子水平的变化，以评估其可能的促炎作用。研究设计和方法：我们进行了一项前瞻性观察性研究。我们研究了一例输血事件，发生在妊娠少于32周、出生超过7天（n=20）的新生儿重症监护室。在输血前120分钟（T-0）及输血后120分钟（T-1）、12 +/- 3小时（T-2）、24 +/- 6小时（T-3）分别检测白细胞介素(IL) -1 β、IL-6、IL-8、肿瘤坏死因子- α、干扰素- γ (ifn - γ)、IL-17、单核细胞趋化蛋白-1 （MCP-1）、干扰素诱导蛋白10 （IP-10）、细胞内粘附分子-1 （ICAM-1）和血管细胞粘附分子血清水平。输血结束后48 +/- 6小时（T-4）。结果：婴儿接受19.8 +/- 3.0 mL红细胞，平均年龄为50 +/- 18天。他们的红细胞压积水平从24.1 +/- 1.2%上升到39.4 +/- 2.9%。红细胞输注后，IL-1 β、IL-8、ifn - γ、IL-17、MCP-1、IP-10和ICAM-1显著升高。结论：红细胞输注后促炎细胞因子升高。这些发现可能有助于解释TANEC的发病机制，并建议采用明智的输血指南，这将有助于避免输血相关免疫调节和输血不足的有害风险。
BACKGROUND: The risk of developing red blood cell (RBC) transfusion-associated necrotizing enterocolitis (TANEC) in preterm infants has recently been emphasized. Our aim was to assess changes in cytokine serum levels after RBC transfusions in a cohort of very preterm infants to evaluate their possible proinflammatory effect.STUDY DESIGN AND METHODS: We carried out a prospective observational study. One transfusion event was studied in infants less than 32 weeks' gestation and more than 7 days old (n=20) admitted to a tertiary neonatal intensive care unit. Interleukin (IL) -1 beta, IL-6, IL-8, tumor necrosis factor-alpha, interferon-gamma (IFN-gamma), IL-17, monocyte chemoattractant protein-1 (MCP-1), interferonc-induced protein 10 (IP-10), intracellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule serum levels were measured in enrolled patients within 120 minutes before (T-0) the RBC transfusion and then within 120 minutes (T-1), 12 +/- 3 hours (T-2), 24 +/- 6 hours (T-3), and 48 +/- 6 hours (T-4) after the end of RBC transfusion.RESULTS: Infants received 19.8 +/- 3.0 mL of RBCs at the mean age of 50 +/- 18 days. Their hematocrit level increased from 24.1 +/- 1.2% to 39.4 +/- 2.9%. IL-1 beta, IL-8, IFN-gamma, IL-17, MCP-1, IP-10, and ICAM-1 increased significantly after RBC transfusions.CONCLUSION: Proinflammatory cytokines are increased after RBC transfusion. These findings may contribute to explaining the pathogenesis of TANEC and suggest the opportunity of adopting wise transfusion guidelines that would help to avoid detrimental risks of transfusion-related immunomodulation and of undertransfusion.