[Prognostic value of serum TNF-alpha, IL-10, leptin and CRP levels in newborns with septicemia]

Abstract

This study was aimed to investigate the prognostic value of tumor necrosis factor-alpha (TNF-alpha), interleukin-10 (IL-10), leptin and C-reactive protein (CRP) levels in newborn sepsis. A total of 57 newborns with nosocomial sepsis and 30 healthy newborns were included to the study. Serum TNF-alpha, IL-10, leptin (Biosource, Belgium) and CRP (Dade Behring, Germany) levels were investigated by ELISA methodology before the initiation of the therapy (day 0) and on the third and fifth days of therapy. Initial leptin levels were found to be high in the control group (p = 0.00) and CRP levels were found to be high in the patient group (p = 0.00). No significant difference was detected for IL-10 and TNF-alpha levels (p > 0.05). CRP levels were significantly higher in the patient group than the controls on the third day of the therapy (p = 0.001), however, no significant difference was detected for the other parameters (p > 0.05). On the fifth day of the therapy CRP (p = 0.023) and leptin (p = 0.00) levels were significantly high in the patient group and TNF-alpha in the control group (p = 0.00) while no significant difference was observed for IL-10 levels (p > 0.05). Mortality rate was 24.5%. When the mean TNF-alpha, IL-10, leptin and CRP levels on the 0th, 3rd and 5th days were analysed for alive (n = 43) and dead (n = 14) newborns with sepsis, it was observed that TNF-alpha, IL-10 and CRP levels were related with poor prognosis (p < 0.05). The ROC analysis performed for the determination of the prognostic performance of TNF-alpha and IL-10 revealed that these parameters had predictive value about mortality when their levels were above certain cut-off values (on the 5th day of therapy for IL-10 > 1.8 ng/ml and for TNF-alpha > 21.1 ng/ml). It can be concluded that besides routine laboratory parameters, serum TNF-alpha and IL-10 levels at the initiation of therapy and afterwards may help to predict prognosis and guide treatment in newborns with sepsis.