INFLAMMATORY AND IMMUNOLOGICAL MARKERS IN PRETERM INFANTS - CORRELATION WITH DISEASE

Newborn infants often suffer from bacterial and viral infections witho ut presenting typical symptoms. Therefore, reliable methods for detect ing and monitoring sepsis in the newborn would be beneficial. In older patients C-reactive protein (CRP) and neopterin have proved useful se rum markers of infection and inflammation. Both of these markers are r egulated by cytokines, and it has been proposed that cytokines themsel ves could be used to monitor immune activation and infection. This stu dy has examined the levels of CRP, neopterin, soluble IL-2R, tumour ne crosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma) in co rd blood samples from both premature and term neonates. Having establi shed reference ranges for these analytes, serial measurements were mad e in babies requiring intensive care support. The results suggest that in preterm infants the simultaneous measurement of CRP and neopterin, and possibly soluble IL-2R, may provide an accurate early diagnosis o f sepsis and may be of use in differentiating between bacterial and vi ral etiologies. In addition, serial measurement of these markers may h elp in the early diagnosis of necrotizing enterocolitis (NEC).