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. 2011 Feb;53(2):249-55.
doi: 10.1016/j.cyto.2010.11.003. Epub 2010 Dec 9.

T cell cytokines and the risk of blood stream infection in extremely low birth weight infants

Robert L Schelonka  1 , Akhil Maheshwari, Waldemar A Carlo, Sarah Taylor, Nellie I Hansen, Diana E Schendel, Poul Thorsen, Kristin Skogstrand, David M Hougaard, Rosemary D Higgins; NICHD Neonatal Research Network
Collaborators, Affiliations

T cell cytokines and the risk of blood stream infection in extremely low birth weight infants

Robert L Schelonka et al. Cytokine. 2011 Feb.

Abstract

Cytokines mediate the host immune response to infectious micro-organisms. The objective of this study was to determine whether immune regulatory interleukins (IL-4, IL-5, IL-6, and IL-10) and inflammatory cytokines (Interferon-γ [INF-γ], tumor necrosis factor-β [TNF-β], IL-2, and IL-17) are associated with an increased risk of developing blood stream bacterial/fungal infection (BSI) in extremely low birth weight (ELBW) infants. ELBW infants from 17 NICHD Neonatal Research Network centers without early onset sepsis were studied. Cytokines were measured from blood on days 1, 3, 7, 14, and 21 after birth. 996 ELBW infants contributed a minimum of 4080 unique measurements for each cytokine during the five sampling periods. Infants with BSI had lower levels of the inflammatory cytokines IL-17 (p=0.01), and higher levels of the regulatory cytokines, IL-6 (p=0.01) and IL-10 (p<0.001). Higher levels of regulatory cytokines relative to pro-inflammatory cytokines were associated with increased risk of BSI even after adjusting for confounding variables. In ELBW infants, the ratio of immune regulatory cytokines to inflammatory cytokines was associated with development of BSI. Altered maturation of regulatory and inflammatory cytokines may increase the risk of serious infection in this population.

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Conflict of interest statement

Conflicts of interest: None

Figures

Figure 1
Figure 1
Temporal cytokine values for the five sampling periods. A. Shows values for the Th1/Th17 cytokines. B shows values for the Th2 regulatory cytokine group. Gray line-open circles are median values for the no BSI group. Black line and closed boxes are median values for the group of infants with BSI. * P <0.05 and † P <0.01 for unadjusted values. After adjusting for study center and gestational age, significant differences were no longer found at the indicated sample days for IL-17 and IL-5. Differences remained as indicated for IL-6 and IL-10.
Figure 2
Figure 2
Ratios of Th2/regulatory to Th1/Th17 cytokine values for the five sampling periods after adjustment for center and gestational age. Gray line-open circles are median values for the no BSI group. Black line and closed boxes are median values for the group of infants with BSI. * P <0.05 and † P <0.01.
See this image and copyright information in PMC

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