Neonatal immunology

The neonate, whether premature or of normal gestational age, is a unique host from an immunologic perspective. Many components of the immune system function less well in neonates compared with adults, giving rise to the concept of an 'immunodeficiency of immaturity.' The adaptive significance of these alterations for neonatal survival remains obscure. This review highlights some of the most prominent quantitative and qualitative differences between neonatal and adult immune systems. From a clinical standpoint, the most important differences appear to be (1) reduction in the available bone marrow reserve of granulocyte precursors, (2) reduction in serum complement activity, (3) decreased ability to produce antibodies against bacterial polysaccharide antigens, and (4) increased percentage of T lymphocytes bearing an antigenically 'naive' cell surface phenotype and a correspondingly naive functional program.