NEONATAL TUMOR-NECROSIS-FACTOR, INTERLEUKIN-1-ALPHA, INTERLEUKIN-1-BETA, AND INTERLEUKIN-6 RESPONSE TO INFECTION

Various studies have shown that in vitro production of cytokines by le ukocytes from the newborn are normal, decreased, or increased. We inve stigated the blood levels of tumor necrosis factor-alpha (TNF-alpha) i nterleukin-1 alpha, interleukin-1 beta (IL-1 beta), and interleukin-6 (IL-6) simultaneously to assess the cytokine response to systemic infe ction during the neonatal period. One or more cytokine levels were ele vated in all of the newborns with sepsis. Serum TNF levels in the newb orns with sepsis were significantly higher than the two control groups (P<0.002). Serum IL-6 levels in the study group were also found to be significantly higher than the control groups (P<0.0004 for sepsis vs adult controls and P<0.03 for sepsis vs newborn controls). We could no t find statistically significant correlation between any of the cytoki ne levels, C-reactive protein, white blood cells, and platelet counts and the outcome. Gram-negative bacteria were the main causative agents in these patients, although one of them was infected with gram-positi ve bacteria, besides one premature infant (29 weeks) with Candida seps is also had significantly elevated TNF, IL-1 beta, and IL-6 levels. Ou r data show that both mature and premature neonates were able to produ ce and significantly increase the blood levels of the cytokines in res ponse to sepsis. Because the biologic relevance of cytokine levels is not known, further prospective and sequential studies on cytokine leve ls simultaneously and correlation with clinical parameters are needed to clarify the biological role of this important component of the host defense system.