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Tracking Changes of Lymphocyte Subsets and Pre‐inflammatory Mediators in Full‐term Neonates with Suspected or Documented Infection
Author(s) -
Hotoura E.,
Giapros V.,
Kostoula A.,
Spirou P.,
Andronikou S.
Publication year - 2011
Publication title -
scandinavian journal of immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.934
H-Index - 88
eISSN - 1365-3083
pISSN - 0300-9475
DOI - 10.1111/j.1365-3083.2010.02499.x
Subject(s) - cd8 , sepsis , immunology , tumor necrosis factor alpha , cd3 , immune system , antibody , medicine , lymphocyte , cytokine
Investigation was made of changes in immune system parameters during the course of neonatal infection. The study population consisted of 95 full‐term neonates matched for chronological age and sex, divided into three groups: suspected infection ( n = 20), sepsis ( n = 25), infection‐free control subjects ( n = 50). Serial measurements were made of the cytokines interleukin‐6 (IL‐6), interleukin‐1b (IL‐1b) and tumour necrosis factor‐α (TNF‐α), lymphocyte subsets [CD3+, CD4+, CD8+, natural killer (NK) cells and B cells], the immunoglobulins (Ig) (IgG, IgM and IgA), C‐reactive protein (CRP), and the total blood count, before, 2 days after initiation of treatment and after stopping treatment (time periods first, second and third, respectively). IL6, TNF‐α, IL1‐b and CRP were higher at the first time period in the sepsis group, and IL6 and TNF‐α continued to be higher in this group at the second period. IL‐6 and TNF‐α were precise sepsis predictors with sensitivity and specificity of 0.92, 0.98 and 0.91, 0.92, respectively. NK cells, B cells, CD3+, CD4+, CD8+ were higher in the sepsis and suspected infection groups, but the ratios CD3+/CD4+, CD3+/CD8+, CD4+/CD8+ showed no difference from the controls. IgG was lower and IgM higher in the sepsis group. In the control subjects CD3+, CD4+, CD8+ lymphocytes increased with increasing age. It is concluded that IL‐6 and TNF are good diagnostic markers of sepsis in full‐term neonates. Lymphocyte subsets were affected by both the clinical condition and the chronological age. NK and B cells may be elevated in suspected and documented sepsis, and further studies are needed to determine their clinical significance.