TY - JOUR
T1 - T cell cytokines and the risk of blood stream infection in extremely low birth weight infants
AU - Schelonka, Robert L.
AU - Maheshwari, Akhil
AU - Carlo, Waldemar A.
AU - Taylor, Sarah
AU - Hansen, Nellie I.
AU - Schendel, Diana E.
AU - Thorsen, Poul
AU - Skogstrand, Kristin
AU - Hougaard, David M.
AU - Higgins, Rosemary D.
N1 - Funding Information:
Research support: The National Institutes of Health (General Clinical Research Center Grants M01 RR30, M01 RR32, M01 RR39, M01 RR70, M01 RR80, M01 RR633, M01 RR750, M01 RR997, M01 RR6022, M01 RR7122, M01 RR8084, M01 RR16587), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grants U01 HD36790, U10 HD21364, U10 HD21373, U10 HD21385, U10 HD21397, U10 HD21415, U10 HD27851, U10 HD27853, U10 HD27856, U10 HD27871, U10 HD27880, U10 HD27881, U10 HD27904, U10 HD34216, U10 HD40461, U10 HD40492, U10 HD40498, U10 HD40689), and the Centers for Disease Control and Prevention (Interagency Agreement Y1-HD-5000-01) provided grant support for recruitment during 1999–2001 and data analysis for the Neonatal Research Network’s Cytokines Study. The funding agencies provided overall oversight for study conduct, but all data analyses and interpretation were independent of the funding agencies.
Funding Information:
The National Institutes of Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the Centers for Disease Control and Prevention (via an Interagency Agreement Y1-HD-5000-01) provided grant support for recruitment during 1999–2001 and data analysis for the Neonatal Research Network’s Cytokines Study. The funding agencies provided overall oversight for study conduct, but all data analyses and interpretation were independent of the funding agencies. We are indebted to our medical and nursing colleagues and the infants and their parents who agreed to take part in this study.
PY - 2011/2
Y1 - 2011/2
N2 - 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.
AB - 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.
KW - Cytokine
KW - Infection
KW - Neonate
KW - Sepsis
UR - http://www.scopus.com/inward/record.url?scp=78651065638&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78651065638&partnerID=8YFLogxK
U2 - 10.1016/j.cyto.2010.11.003
DO - 10.1016/j.cyto.2010.11.003
M3 - Article
C2 - 21145756
AN - SCOPUS:78651065638
SN - 1043-4666
VL - 53
SP - 249
EP - 255
JO - Cytokine
JF - Cytokine
IS - 2
ER -