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Marsubrin PMT, Ibrahim NAA, Dilmy MAF, Ariani Y, Wiweko B, Irwinda R, Harzif AK, Hegar B, Basrowi RW. Determinants of prematurity in urban Indonesia: a meta-analysis. J Perinat Med 2024; 52:270-282. [PMID: 38146621 DOI: 10.1515/jpm-2023-0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/26/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVES Indonesia is the fifth country with the highest number of preterm births worldwide. More than a third of neonatal deaths in Indonesia were attributed to preterm birth. Residential areas affected the occurrence of preterm birth due to differing socioeconomic and environmental conditions. Many studies have investigated the determinants of prematurity in Indonesia, however, most of them were performed in rural areas. This study is the first meta-analysis describing the determinants of preterm birth in urban Indonesia, which aimed to become the foundation upon implementing the most suitable preventative measure and policy to reduce the rate of preterm birth. METHODS We collected all published papers investigating the determinants of preterm birth in urban Indonesia from PubMed MEDLINE and EMBASE, using keywords developed from the following key concepts: "preterm birth", "determinants", "risk factors", "Indonesia" and the risk factors, such as "high-risk pregnancy", "anemia", "pre-eclampsia", and "infections". Exclusion criteria were multicenter studies that did not perform a specific analysis on the Indonesian population or did not separate urban and rural populations in their analysis, and articles not available in English or Indonesian. The Newcastle Ottawa Scale was used to assess the risk of bias. This systematic review was registered in PROSPERO. RESULTS Sixteen articles were included in the analysis and classified into five categories: genetic factors, nutrition, smoking, pregnancy characteristics or complications, and disease-related characteristics. CONCLUSIONS Our meta-analysis revealed adolescent pregnancy, smoking, eclampsia, bacterial vaginosis, LC-PUFA, placental vitamin D, and several minerals as the significant determinants of preterm birth in urban Indonesia.
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Affiliation(s)
| | | | - Mohammad Adya Firmansha Dilmy
- Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Yulia Ariani
- Faculty of Medicine, Indonesian Medical Education and Research Institute, Universitas Indonesia, Jakarta, Indonesia
| | - Budi Wiweko
- Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Rima Irwinda
- Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Achmad Kemal Harzif
- Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Badriul Hegar
- Faculty of Medicine, Indonesian Medical Education and Research Institute, Universitas Indonesia, Jakarta, Indonesia
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Benincasa BC, Rieck LGB, Procianoy RS, Silveira RC. Cytokine Levels in Neonates: Unveiling the Impact of Perinatal Inflammation on Prematurity. Am J Perinatol 2023. [PMID: 37989207 DOI: 10.1055/s-0043-1776903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
OBJECTIVE This study aimed to investigate the association between variations in cytokine levels in the first 72 hours of life and prematurity. STUDY DESIGN In this prospective study, we examined the cytokine levels of 110 newborns in the first 72 hours of life. The participants were divided into two groups based on gestational age (66 very preterm and 44 term newborns), and cytokine levels (interleukin [IL]-6, IL-8, and IL-10, tumor necrosis factor-α [TNF-α], and transforming growth factor-β [TGF-β]) were evaluated. RESULTS Premature newborns exhibited higher levels of IL-6, IL-8, and IL-10, while TNF-α and TGF-β levels were lower comparing to term newborns. Even after adjusting for maternal and peripartum factors, the significant differences persisted. CONCLUSION Our study underscores significant cytokine profile differences between full-term and very preterm newborns in early life. Elevated IL-6 and IL-8 levels in preterm infants suggest potential perinatal inflammation links to prematurity. KEY POINTS · There is a direct association between cytokine levels and prematurity.. · Knowledge of the variation of cytokines in newborns enhances personalized interventions.. · Cytokine levels are early associated with gestational age.
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Affiliation(s)
- Bianca C Benincasa
- Department of Neonatology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Laura G B Rieck
- Department of Neonatology, Hospital Materno-Infantil Presidente Vargas, Porto Alegre, Brazil
| | - Renato S Procianoy
- Department of Pediatrics, Neonatal Section, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rita C Silveira
- Department of Pediatrics, Neonatal Section, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Hou L, Li Y, Kang L, Li X, Li H, Xue F. The long-term mediation role of cytokines on the causal pathway from maternal gestational age to offspring eye diseases: Lifecourse-Network Mendelian randomization. Int Immunopharmacol 2023; 122:110667. [PMID: 37487263 DOI: 10.1016/j.intimp.2023.110667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/28/2023] [Accepted: 07/16/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Gestational duration has a significant impact on eye diseases. A large number of evidences suggest that cytokines are associated with gestational duration and eye diseases. However, the causal relationships among cytokines, maternal gestational impairment and offspring eye diseases remain unclear. METHODS We performed lifecourse-network Mendelian randomization (MR) to explore the causal relationships between maternal gestational duration (from the Early Growth Genetics (EGG) Consortium and the Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) study, N = 84,689), neonatal/adult cytokines (from the NHGRI-EBI Catalog, N = 764/4,618), and adult eye diseases (from FinnGen consotium, N = 309,154) using summary-level data from large genome-wide association studies. Multiplicative random effects inverse variance weighted (IVW) and multivariable-IVW methods were the main analysis methods, and the other 15 pleiotropy-robust methods, weak IV-robust methods, and outliers-robust methods were used as auxiliary methods. RESULTS Maternal gestational age (early preterm birth, preterm birth, gestational duration, and post-term birth) had a causal relationship with 42 eye diseases. Four neonatal cytokines, Tumor Necrosis Factor-α(TNF-α), IL10, GROA, and CTACK, as well as four adult cytokines, CTACK, IL10, IL12p70 and IL6 are mediators in the causal relationships between early preterm birth and preterm birth in eight eye diseases. However, after adjusting for these mediators, a null direct causal effect of early preterm birth and preterm birth on eight eye diseases was found. In addition, there was no mediator in the causal relationship between gestational duration and post-term birth to eye diseases. CONCLUSION The effects of maternal gestational duration on offspring eye diseases through cytokines are long-term and life-course effects.
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Affiliation(s)
- Lei Hou
- Beijing International Center for Mathematical Research, Peking University, Beijing 100871, China
| | - Yunxia Li
- Department of Neonatology, Jinan Children's Hospital, Jinan, Shandong 250022, China; Department of Neonatology, Children's Hospital Affiliated to Shandong University, Jinan, Shandong 250022, China
| | - Lili Kang
- Department of Neonatology, Jinan Children's Hospital, Jinan, Shandong 250022, China; Department of Neonatology, Children's Hospital Affiliated to Shandong University, Jinan, Shandong 250022, China
| | - Xiaoying Li
- Department of Neonatology, Jinan Children's Hospital, Jinan, Shandong 250022, China; Department of Neonatology, Children's Hospital Affiliated to Shandong University, Jinan, Shandong 250022, China.
| | - Hongkai Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250000, China; Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250000, China.
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250000, China; Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250000, China.
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4
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BIYIK I, ALBAYRAK M. Biomarkers for Preterm Delivery. Biomark Med 2022. [DOI: 10.2174/9789815040463122010025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Preterm birth occurring before the thirty-seventh gestational week
complicates 4.5%-18% of pregnancies worldwide. The pathogenesis of spontaneous
preterm delivery is not fully understood. Among the factors held to be responsible for
its pathogenesis, the most emphasized is the inflammatory process. Studies in terms of
the prediction of preterm delivery are basically divided into 3 categories: 1) Prediction
in pregnant women who are asymptomatic and without risk factors, 2) Prediction in
pregnant women who are asymptomatic and have risk factors, 3) Prediction in
symptomatic pregnant women who have threatened preterm labour. In this chapter, the
topic of biomarkers in relation to preterm delivery is discussed. The most commonly
used markers in published studies are fetal fibronectin, cervical pIGFBP-1 and cervical
length measurement by transvaginal ultrasound. For prediction in symptomatic
pregnant women applying to the hospital with threatened preterm labour, the markers
used are fetal fibronection, insulin-like growth factors (IGFs) and inflammatory
markers. Preterm labour prediction with markers checked in the first and second
trimesters are fetal fibronection, insulin-like growth factors (IGFs), micro RNAs,
progesterone, circulating microparticles (CMPs), inflammatory markers, matrix
metalloproteinases, aneuploidy syndrome screening test parameters and other
hormones.
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Affiliation(s)
- Ismail BIYIK
- Department of Obstetrics and Gynecology, Kutahya Health Sciences University, Kutahya, Turkey
| | - Mustafa ALBAYRAK
- Department of Gynecologic Oncology, Istanbul Faculty of Medicine, Istanbul University,
Istanbul, Turkey
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Concentrations of fat-soluble nutrients and blood inflammatory compounds in mother-infant dyads at birth. Pediatr Res 2021; 90:436-443. [PMID: 33293682 DOI: 10.1038/s41390-020-01302-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/02/2020] [Accepted: 10/18/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Perinatal inflammation adversely affects health. Therefore, aims of this IRB-approved study are: (1) compare inflammatory compounds within and between maternal and umbilical cord blood samples at the time of delivery, (2) assess relationships between inflammatory compounds in maternal and cord blood with birth characteristics/outcomes, and (3) assess relationships between blood and placental fat-soluble nutrients with blood levels of individual inflammatory compounds. METHODS Mother-infant dyads were enrolled (n = 152) for collection of birth data and biological samples of maternal blood, umbilical cord blood, and placental tissue. Nutrient levels included: lutein + zeaxanthin; lycopene; α-, β-carotene; β-cryptoxanthin; retinol; α-, γ-, δ-tocopherol. Inflammatory compounds included: tumor necrosis factor-α, superoxide dismutase, interleukins (IL) 1β, 2, 6, 8, 10. RESULTS Median inflammatory compound levels were 1.2-2.3 times higher in cord vs. maternal blood, except IL2 (1.3 times lower). Multiple significant correlations existed between maternal vs. infant inflammatory compounds (range of r = 0.22-0.48). While relationships existed with blood nutrient levels, the most significant were identified in placenta where all nutrients (except δ-tocopherol) exhibited relationships with inflammatory compounds. Relationships between anti-inflammatory nutrients and proinflammatory compounds were primarily inverse. CONCLUSION Inflammation is strongly correlated between mother-infant dyads. Fat-soluble nutrients have relationships with inflammatory compounds, suggesting nutrition is a modifiable factor. IMPACT Mother and newborn inflammation status are strongly interrelated. Levels of fat-soluble nutrients in blood, but especially placenta, are associated with blood levels of proinflammatory and anti-inflammatory compounds in both mother and newborn infant. As fat-soluble nutrient levels are associated with blood inflammatory compounds, nutrition is a modifiable factor to modulate inflammation and improve perinatal outcomes.
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Ehrhart J, Sanberg PR, Garbuzova-Davis S. Plasma derived from human umbilical cord blood: Potential cell-additive or cell-substitute therapeutic for neurodegenerative diseases. J Cell Mol Med 2018; 22:6157-6166. [PMID: 30334335 PMCID: PMC6237605 DOI: 10.1111/jcmm.13898] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 08/14/2018] [Indexed: 12/12/2022] Open
Abstract
Limited efficacy of current therapeutic approaches for neurodegenerative disease has led to increased interest in alternative therapies. Cord blood plasma (CBP) derived from human umbilical cord blood (hUCB) may be a potential therapeutic. Benefits of CBP injection into rodent models of aging or ischaemic stroke have been demonstrated, though how benefits are elicited is still unclear. The present study evaluated various factors within the same samples of CBP and human adult blood plasma/sera (ABP/S). Also, autologous CBP effects vs. ABP/S or foetal bovine serum supplements on mononuclear cells from hUCB (MNC hUCB) in vitro were determined. Results showed significantly low concentrations of pro-inflammatory cytokines (IL-2, IL-6, IFN-γ, and TNF-α) and elevated chemokine IL-8 in CBP. Significantly higher levels of VEGF, G-CSF, EGF and FGF-basic growth factors were determined in CBP vs. ABP/S. Autologous CBP media supplements significantly increased MNC hUCB viability and decreased apoptotic cell activity. We are first to demonstrate the unique CBP composition of cytokines and growth factors within the same CBP samples derived from hUCB. Also, our novel finding that autologous CBP promoted MNC hUCB viability and reduced apoptotic cell death in vitro supports CBP's potential as a sole therapeutic or cell-additive agent in developing therapies for various neurodegenerative diseases.
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Affiliation(s)
| | - Paul R Sanberg
- Center of Excellence for Aging and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa, Florida.,Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa, Florida.,Department of Pathology and Cell Biology, Morsani College of Medicine, University of South Florida, Tampa, Florida.,Department of Psychiatry, Morsani College of Medicine, University of South Florida, Tampa, Florida
| | - Svitlana Garbuzova-Davis
- Center of Excellence for Aging and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa, Florida.,Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa, Florida.,Department of Pathology and Cell Biology, Morsani College of Medicine, University of South Florida, Tampa, Florida.,Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida
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Bellos I, Karageorgiou V, Kapnias D, Karamanli KE, Siristatidis C. The role of interleukins in preeclampsia: A comprehensive review. Am J Reprod Immunol 2018; 80:e13055. [PMID: 30265415 DOI: 10.1111/aji.13055] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 09/04/2018] [Accepted: 09/05/2018] [Indexed: 12/13/2022] Open
Abstract
Preeclampsia is a multi-system hypertensive disorder of pregnancy, with significant rates of maternal and neonatal morbidity. It represents a major cause of preterm birth, as definitive treatment demands fetal delivery. Although its pathophysiology is complicated, placental hypoxia and endothelial dysfunction constitute established pathogenetic steps of the disease. Inflammation is considered to be a crucial mediator of preeclampsia process, as an imbalance between TH 1, TH 2, and TH 17 immune responses is observed. The present review accumulates current knowledge about the contribution of interleukins in preeclampsia, summarizing the pathways through which each interleukin exerts its function in the disease. Also, the role of genetic polymorphisms is explored and the predictive efficacy of maternal serum interleukin levels is evaluated. Finally, recommendations about the safe interpretation of the outcomes, as well as guidance for future research, are provided.
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Affiliation(s)
- Ioannis Bellos
- National and Kapodistrian University of Athens, Athens, Greece
| | | | | | | | - Charalampos Siristatidis
- Assisted Reproduction Unit, Third Department of Obstetrics and Gynecology, "Attikon Hospital", Medical School, National and Kapodistrian University of Athens, Athens, Greece
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De Andrés J, Manzano S, García C, Rodríguez JM, Espinosa-Martos I, Jiménez E. Modulatory effect of three probiotic strains on infants' gut microbial composition and immunological parameters on a placebo-controlled, double-blind, randomised study. Benef Microbes 2018; 9:573-584. [PMID: 29726280 DOI: 10.3920/bm2017.0132] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The gut microbiota plays a crucial role in gastrointestinal health. Current use of probiotics is aimed at modulating the bacterial gut composition to alleviate specific diseases. The safety and tolerance of three probiotic strains (Bifidobacterium longum subsp. infantis R0033, Lactobacillus helveticus R0052 and Bifidobacterium bifidum R0071) has recently been described. The objective of the present study was to analyse the microbiological composition and immunological parameters of faecal samples obtained from healthy infants from 3 to 12 months of age after receiving either one of the three probiotic strains or placebo for 8 weeks. 16S ribosomal RNA gene sequencing and multiplexing technology was used for analysis. Faecal sample analysis showed that the most abundant genus in all four groups of infants pre- and post-intervention was Bifidobacterium, representing approximately 50% of the sequences. After the intervention period the microbial composition of faecal samples in the probiotic groups did not display notable changes. In contrast, a decrease in different Bifidobacterium species, such as B. bifidum and Bifidobacterium breve and an increase in Bacteroides, Blautia, Clostridium, Coprococcus and Faecalibacterium genera was observed in the placebo group. The analysis of a wide range of immune factors in faecal samples suggests a modulatory effect by these three probiotic strains during the intervention period. The anti-inflammatory ratio interleukin (IL)-10/IL-12 increased at the end of the intervention period in the B. infantis R0033 group while the TNF-α/IL-10 ratio increased in the L. helveticus R0052 group. The decrease of the IL-10/IL-12 ratio together with the increase of the tumour necrosis factor alpha (TNF-α)/IL-10 ratio demonstrated a pro-inflammatory profile in the placebo group. In conclusion, the species profile of the microbiome observed in all three probiotic groups resembled that of a younger infant, similar to an unweaned infant, when compared to the placebo group which may also be related with an anti-inflammatory effect.
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Affiliation(s)
- J De Andrés
- 1 Dpto. Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Av. Puerta de hierro s/n, 28040Madrid, Spain
| | - S Manzano
- 1 Dpto. Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Av. Puerta de hierro s/n, 28040Madrid, Spain.,2 Probisearch S.L.U., C/Santiago Grisolía, 2, 28760 Tres Cantos, Spain
| | - C García
- 2 Probisearch S.L.U., C/Santiago Grisolía, 2, 28760 Tres Cantos, Spain
| | - J M Rodríguez
- 1 Dpto. Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Av. Puerta de hierro s/n, 28040Madrid, Spain
| | - I Espinosa-Martos
- 2 Probisearch S.L.U., C/Santiago Grisolía, 2, 28760 Tres Cantos, Spain
| | - E Jiménez
- 1 Dpto. Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Av. Puerta de hierro s/n, 28040Madrid, Spain.,2 Probisearch S.L.U., C/Santiago Grisolía, 2, 28760 Tres Cantos, Spain
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Kaneko M, Sato M, Ogasawara K, Imamura T, Hashimoto K, Momoi N, Hosoya M. Serum cytokine concentrations, chorioamnionitis and the onset of bronchopulmonary dysplasia in premature infants. J Neonatal Perinatal Med 2018; 10:147-155. [PMID: 28409755 DOI: 10.3233/npm-171669] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate the relationships between serum cytokine concentrations and chorioamnionitis (CAM) and CAM-related bronchopulmonary dysplasia (BPD) in premature infants. METHODS Serum was collected at 0 and 7 days after birth from 36 premature infants born at <32 weeks of gestation. We examined the relationships between 30 cytokine concentrations and CAM, BPD, and other perinatal factors. RESULTS On day 0, GM-CSF, IL-15, IL-17, IL-2, IL-2R, VEGF, and MIG concentrations were significantly higher in the CAM group (n = 17) than in the non-CAM group (n = 19). These concentrations had decreased by day 7 and were similar in both groups. The IL-12p70 concentration on day 0 was significantly lower in the BPD group (n = 16) than in the non-BPD group (n = 15). BPD incidence was similar between the CAM and non-CAM groups. CONCLUSIONS These data support the hypothesis that intrauterine inflammation is not a primary risk factor for BPD. The immunological environment at birth or soon after, rather than intrauterine fetal inflammation (e.g., CAM), is a primary risk factor for BPD onset in preterm infants. Decreased inflammatory responses are particularly relevant, as indicated by the relationship between BPD and low serum IL-12p70 concentrations on day 0.
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10
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Gómez M, Moles L, Espinosa-Martos I, Bustos G, de Vos WM, Fernández L, Rodríguez JM, Fuentes S, Jiménez E. Bacteriological and Immunological Profiling of Meconium and Fecal Samples from Preterm Infants: A Two-Year Follow-Up Study. Nutrients 2017; 9:E1293. [PMID: 29186903 PMCID: PMC5748744 DOI: 10.3390/nu9121293] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 11/13/2017] [Accepted: 11/22/2017] [Indexed: 02/06/2023] Open
Abstract
An abnormal colonization pattern of the preterm gut may affect immune maturation and exert a long-term influence on the intestinal bacterial composition and host health. However, follow-up studies assessing the evolution of the fecal microbiota of infants that were born preterm are very scarce. In this work, the bacterial compositions of fecal samples, obtained from sixteen 2-year-old infants were evaluated using a phylogenetic microarray; subsequently, the results were compared with those obtained in a previous study from samples of meconium and feces collected from the same infants while they stayed in the neonatal intensive care unit (NICU). In parallel, the concentration of a wide range of cytokines, chemokines, growth factors and immunoglobulins were determined in meconium and fecal samples. Globally, a higher bacterial diversity and a lower interindividual variability were observed in 2-year-olds' feces, when compared to the samples obtained during their first days of life. Hospital-associated fecal bacteria, that were dominant during the NICU stay, seemed to be replaced, two years later, by genera, which are usually predominant in the healthy adult microbiome. The immune profile of the meconium and fecal samples differed, depending on the sampling time, showing different immune maturation statuses of the gut.
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Affiliation(s)
- Marta Gómez
- Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, 28040 Madrid, Spain.
- Servicio de Pediatría Hospital Francesc de Borja, 46702 Gandía, Valencia, Spain.
| | - Laura Moles
- Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, 28040 Madrid, Spain.
| | | | - Gerardo Bustos
- Servicio de Neonatología, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain, Red SAMID.
| | - Willem M de Vos
- Laboratory of Microbiology, Wageningen University, 6708 PB Wageningen, The Netherlands.
- Department of Bacteriology and Immunology, University of Helsinki, 00100 Helsinki, Finland.
| | - Leónides Fernández
- Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, 28040 Madrid, Spain.
- Probisearch, SLU, Tres Cantos, 28760 Madrid, Spain.
| | - Juan M Rodríguez
- Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, 28040 Madrid, Spain.
- Probisearch, SLU, Tres Cantos, 28760 Madrid, Spain.
| | - Susana Fuentes
- Laboratory of Microbiology, Wageningen University, 6708 PB Wageningen, The Netherlands.
| | - Esther Jiménez
- Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, 28040 Madrid, Spain.
- Probisearch, SLU, Tres Cantos, 28760 Madrid, Spain.
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Andalas M, Hakimi M, Nurdiati DS, Astuti I, Ichsan I, Wahyuniati N, Imran I, Harapan H. Lack of association between the −1082 (A/G) IL-10 polymorphism (rs1800896) and spontaneous preterm birth in the Indonesian Acehnese population. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.poamed.2016.11.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Necrotising enterocolitis (NEC) is an uncommon, but devastating intestinal inflammatory disease that predominantly affects preterm infants. NEC is sometimes dubbed the spectre of neonatal intensive care units, as its onset is insidiously non-specific, and once the disease manifests, the damage inflicted on the baby's intestine is already disastrous. Subsequent sepsis and multi-organ failure entail a mortality of up to 65%. Development of effective treatments for NEC has stagnated, largely because of our lack of understanding of NEC pathogenesis. It is clear, however, that NEC is driven by a profoundly dysregulated immune system. NEC is associated with local increases in pro-inflammatory mediators, e.g. Toll-like receptor (TLR) 4, nuclear factor-κB, tumour necrosis factor, platelet-activating factor (PAF), interleukin (IL)-18, interferon-gamma, IL-6, IL-8 and IL-1β. Deficiencies in counter-regulatory mechanisms, including IL-1 receptor antagonist (IL-1Ra), TLR9, PAF-acetylhydrolase, transforming growth factor beta (TGF-β)1&2, IL-10 and regulatory T cells likely facilitate a pro-inflammatory milieu in the NEC-afflicted intestine. There is insufficient evidence to conclude a predominance of an adaptive Th1-, Th2- or Th17-response in the disease. Our understanding of the accompanying regulation of systemic immunity remains poor; however, IL-1Ra, IL-6, IL-8 and TGF-β1 show promise as biomarkers. Here, we chart the emerging immunological landscape that underpins NEC by reviewing the involvement and potential clinical implications of innate and adaptive immune mediators and their regulation in NEC.
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Administration of Bifidobacterium breve PS12929 and Lactobacillus salivarius PS12934, two strains isolated from human milk, to very low and extremely low birth weight preterm infants: a pilot study. J Immunol Res 2015; 2015:538171. [PMID: 25759843 PMCID: PMC4352454 DOI: 10.1155/2015/538171] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 09/08/2014] [Accepted: 09/16/2014] [Indexed: 11/24/2022] Open
Abstract
The preterm infant gut has been described as immature and colonized by an aberrant microbiota. Therefore, the use of probiotics is an attractive practice in hospitals to try to reduce morbidity and mortality in this population. The objective of this pilot study was to elucidate if administration of two probiotic strains isolated from human milk to preterm infants led to their presence in feces. In addition, the evolution of a wide spectrum of immunological compounds, including the inflammatory biomarker calprotectin, in both blood and fecal samples was also assessed. For this purpose, five preterm infants received two daily doses (~109 CFU) of a 1 : 1 mixture of Bifidobacterium breve PS12929 and Lactobacillus salivarius PS12934. Bacterial growth was detected by culture-dependent techniques in all the fecal samples. The phylum Firmicutes dominated in nearly all fecal samples while L. salivarius PS12934 was detected in all the infants at numerous sample collection points and B. breve PS12929 appeared in five fecal samples. Finally, a noticeable decrease in the fecal calprotectin levels was observed along time.
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Oliver RS, Lamont RF. Infection and antibiotics in the aetiology, prediction and prevention of preterm birth. J OBSTET GYNAECOL 2013; 33:768-75. [DOI: 10.3109/01443615.2013.842963] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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15
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Abstract
OBJECTIVE To examine the interaction of the cytokines interleukin-1 receptor antagonist (IL)-1Ra, IL-6 and IL-10 to predict preterm birth (PTB) in pregnant Hispanic women (n=470). STUDY DESIGN In this prospective study, demographic data were obtained prenatally and birth outcome data were obtained from the medical chart. Cytokines were measured from plasma obtained at 22 to 24 weeks gestation. Data analysis utilized logistic regression. RESULT PTB was predicted by level of IL-1Ra (odds ratio (OR)=2.55; 95% confidence interval (CI)=1.24, 5.24). The interaction between IL-1Ra and IL-6 and between IL-1Ra and IL-10 was significant (Wald=4.01, P=0.04 and Wald=8.84, P<0.003, respectively) and was also predictive of PTB. As IL-1Ra levels increased while IL-10 levels were low, the probability of PTB greatly increased. CONCLUSION The interactions of select cytokines and cytokine receptor antagonists were associated with PTB. Future research should focus on the changes in cytokines during pregnancy to identify critical periods of change, and examine predictors of the cytokine response.
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16
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Association of depressive symptoms with inflammatory biomarkers among pregnant African-American women. J Reprod Immunol 2012; 94:202-9. [DOI: 10.1016/j.jri.2012.01.007] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 12/13/2011] [Accepted: 01/03/2012] [Indexed: 11/21/2022]
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17
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Arababadi MK, Aminzadeh F, Hassanshahi G, Khorramdelazad H, Norouzi M, Zarandi ER, Rezayati M, Kennedy D. Cytokines in Preterm Delivery. Lab Med 2012. [DOI: 10.1309/lmy9ilpgsetu2co0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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18
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Funisitis is associated with increased interleukin-10 gene expression in cord blood mononuclear cells in preterm infants ≤32 weeks of gestation. Eur J Obstet Gynecol Reprod Biol 2011; 155:31-5. [DOI: 10.1016/j.ejogrb.2010.11.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 09/30/2010] [Accepted: 11/23/2010] [Indexed: 01/27/2023]
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19
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Lyon D, Cheng CY, Howland L, Rattican D, Jallo N, Pickler R, Brown L, McGrath J. Integrated review of cytokines in maternal, cord, and newborn blood: part I--associations with preterm birth. Biol Res Nurs 2009; 11:371-6. [PMID: 20034950 DOI: 10.1177/1099800409344620] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Preterm birth (PTB; spontaneous delivery prior to 37 weeks gestation) affects one out of eight infants born in the United States and is the most common cause of neonatal morbidity and mortality. Although the pathogenesis of PTB is multifactorial, a growing body of literature supports the hypothesis that one cause of PTB is inflammation in pregnancy. Investigators have implicated mediators of inflammation, most notably proinflammatory cytokines, as being associated with and perhaps a playing a causal role in the pathogenesis of preterm labor and adverse early fetal outcomes. Though researchers have pursued the association of cytokines with preterm labor and subsequent early adverse fetal outcomes as a line of research, there has been little integration of diverse findings across studies. This systematic review appraises the empirical evidence from human studies for the association of levels of cytokines in blood with preterm labor and adverse early fetal outcome to examine the current state of the science in this important area of biobehavioral research. The most consistent finding is that increased levels of proinflammatory cytokines, particularly interleukin (IL) 6, IL-beta1, and tumor necrosis factor alpha (TNF-alpha), are associated with PTB as compared to levels found at term birth. However, there have been relatively few studies and results have not been consistent. Therefore, further research is needed to elucidate the association of these inflammatory mediators with adverse pregnancy outcomes.
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Affiliation(s)
- Debra Lyon
- Department of Family and Community Health Nursing, Virginia Commonwealth University, Richmond, VA 23298, USA.
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20
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Balossini V, Monzani A, Rapa A, Vivenza D, Caristo E, Oderda G. Interleukin-10 and transforming growth factor-beta1 in cord blood: relationship with paternal allergy and cesarean section. Acta Paediatr 2009; 98:812-6. [PMID: 19183122 DOI: 10.1111/j.1651-2227.2008.01194.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To measure Interleukin-10 (IL-10) and transforming growth factor-beta1 (TGF-beta1) in cord blood and assess their relationship with parental allergy and perinatal characteristics. METHODS In a neonatal care unit 212 consecutive full-term and appropriate for gestational age newborns were recruited. IL-10 and TGF-beta1 levels were determined in cord blood by high sensitivity ELISA. Perinatal characteristics, mode of delivery and presence of allergy in parents were recorded. RESULTS Out of 212 newborns, 136 were of non-allergic parents and 76 (35.8%) of one or both allergic parents. In newborns of allergic fathers median IL-10 levels tended to be lower (0.67 vs. 1.06 pg/mL, p = 0.07) and TGF-beta1 levels were significantly lower (40.9 vs. 45.3 ng/mL, p = 0.008) than in newborns of non-allergic parents. Multiple general regression analysis showed that presence of paternal allergy (beta=-0.19, p = 0.003) to be born by cesarean section (beta=-0.21, p = 0.03) and younger gestational age (beta= 0.14, p = 0.04) independently contributed to decrease TGF-beta1 levels (multiple R = 0.38, p < 0.0001). CONCLUSION Paternal allergy and cesarean section are associated to decreased TGF-beta1, which might be the mediator of the increased risk of atopy development. Cord blood IL-10 and TGF-beta1 levels of our newborn series could be used as reference values for further studies on these relationships.
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Affiliation(s)
- V Balossini
- Department of Paediatrics, Università del Piemonte Orientale, Novara, Italy
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21
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Yu HJ, Park EA, Kim JY, Cho SJ, Kim YJ, Park HS, Ha EH. Relationship between cord blood level of IL-12 in preterm newborns and development of wheezing. KOREAN JOURNAL OF PEDIATRICS 2008. [DOI: 10.3345/kjp.2008.51.7.754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Hyo Jung Yu
- Department of Pediatrics, Ewha Womans University, School of Medicine, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, Ewha Womans University, School of Medicine, Seoul, Korea
| | - Ji Young Kim
- Department of Pediatrics, Ewha Womans University, School of Medicine, Seoul, Korea
| | - Soo Jin Cho
- Department of Pediatrics, Ewha Womans University, School of Medicine, Seoul, Korea
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, Ewha Womans University, School of Medicine, Seoul, Korea
| | - Hye Sook Park
- Department of Preventive Medicine, Ewha Womans University, School of Medicine, Seoul, Korea
| | - Eun Hee Ha
- Department of Preventive Medicine, Ewha Womans University, School of Medicine, Seoul, Korea
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22
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Koklu E, Kurtoglu S, Akcakus M, Yikilmaz A, Coskun A, Gunes T. Intima-media thickness of the abdominal aorta of neonate with different gestational ages. JOURNAL OF CLINICAL ULTRASOUND : JCU 2007; 35:491-7. [PMID: 17436319 DOI: 10.1002/jcu.20335] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
PURPOSE To determine aortic intima-media thickness (aIMT) values in newborns with different gestational ages and to asses the effect of antenatal steroids on aIMT. METHODS Two hundred forty newborns from healthy mothers had their distal abdominal aIMT measured during abdominal sonographic examination. The neonates were divided into 4 groups (60 in each group) according to gestational age: group I (25-28 weeks), group II (29-32 weeks), group III (33-37 weeks), and group IV (38-42 weeks). RESULTS The interobserver and intersubject intraclass correlation coefficient was 0.93 and 0.94, respectively. Mean aIMT was 0.316 mm, 0.335 mm, 0.348 mm, and 0.385 mm, respectively, in group I, II, III, and IV, increasing significantly with gestational age at birth (p < 0.0001). There was no apparent effect of antenatal steroid use on aIMT. Multivariate regression models for mean aIMT demonstrated a significant association with aortic lumen diameter (p < 0.0001). CONCLUSION Abdominal aIMT can be reproducibly measured in neonates and may be a useful tool for epidemiologic studies.
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Affiliation(s)
- Esad Koklu
- Division of Neonatology, Department of Pediatrics, Erciyes University, School of Medicine, 38039 Kayseri, Turkey
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Widing L, Bechensteen AG, Mirlashari MR, Vetlesen A, Kjeldsen-Kragh J. Evaluation of nonleukoreduced red blood cell transfusion units collected at delivery from the placenta. Transfusion 2007; 47:1481-7. [PMID: 17655592 DOI: 10.1111/j.1537-2995.2007.01287.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The objective of this study was to evaluate the suitability of cord blood (CB) as a source of red blood cells (RBCs) for autologous transfusion. STUDY DESIGN AND METHODS CB was collected in 150-mL storage containers with citrate phosphate dextrose (CPD) as anticoagulant and stored in either saline, adenine, glucose, and mannitol (SAG-M; n = 18) or phosphate, adenine, glucose, guanosine, saline, and mannitol (PAGGS-M; n = 18) for 35 days at 4 degrees C. Hematologic status and hemolysis were studied. The lipopolysaccharide (LPS)-induced production of tumor necrosis factor (TNF)-alpha and transforming growth factor (TGF)-beta1 from CB monocytes was analyzed after incubation with addition of weekly sampled supernatants from the CB RBC units. Five additional units (PAGGS-M) were leukoreduced and thereafter analyzed as indicated above. RESULTS Hemolysis increased significantly over time, in SAG-M more than in PAGGS-M. During storage in both media, the number of white blood cells (WBCs) decreased, and the LPS-induced production of TNF-alpha and TGF-beta1 decreased and increased, respectively. There were no significant changes in the LPS-induced production of TNF-alpha and TGF-beta1 in the leukoreduced CB RBC units. CONCLUSION Hemolysis in CB RBC units increased significantly over time, and PAGGS-M appears to be superior to SAG-M as a preservation solution for CB RBC. The changes in LPS-induced TNF-alpha and TGF-beta1 production over time were probably caused by substances released from apoptotic and/or necrotic WBCs. Further studies are needed to identify both which substances are responsible for the changes in LPS-induced cytokine release and the clinical significance hereof.
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Affiliation(s)
- Line Widing
- Departments of Pediatrics and Immunology & Transfusion Medicine, Ullevål University Hospital, University of Oslo, Kirkeveien 166, N-0407 Oslo, Norway
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24
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Park JY, Kim JY, Cho SJ, Kim YJ, Park HS, Ha EH, Park EA. Cord blood IL-10, IL-12 in preterm newborns as predictors of respiratory distress syndrome and bronchopulmonary dysplasia. KOREAN JOURNAL OF PEDIATRICS 2007. [DOI: 10.3345/kjp.2007.50.3.248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jee Yoon Park
- Department of Pediatrics, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Ji Young Kim
- Department of Pediatrics, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Soo Jin Cho
- Department of Pediatrics, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Hye sook Park
- Department of Preventive Medicine, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Eun Hee Ha
- Department of Preventive Medicine, Ewha Womans University, College of Medicine, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, Ewha Womans University, College of Medicine, Seoul, Korea
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25
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Maródi L. Innate cellular immune responses in newborns. Clin Immunol 2005; 118:137-44. [PMID: 16377252 DOI: 10.1016/j.clim.2005.10.012] [Citation(s) in RCA: 162] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2005] [Revised: 09/28/2005] [Accepted: 10/03/2005] [Indexed: 02/06/2023]
Abstract
Innate immunity assures the first line of defense against pathogenic microorganisms. Innate immune responses induced by bacteria, fungi, or viral replication are triggered by granulocytes, monocytes, macrophages, dentritic cells, and natural killer cells. Neonatal deficiency of innate cellular immunity includes a decreased production of interferons, IL-12/IL-23, and IL-18, and other proinflammatory cytokines, an impaired type-1 response of macrophages to IFN-gamma, the most potent macrophage-activating agent in vivo, and to lipopolysaccharide, the primary constituent of the outer membrane of Gram-negative bacteria. An increasing body of evidence suggests impaired responses of neonatal monocytes and macrophages to multiple TLR ligands. This review will discuss recent advances in understanding innate cellular immunity in human neonates, with respect to selected aspects of immune functions that may be related to increased susceptibility to infections. Components of TLR signaling and the immune consequence that may result from neonatal deficiencies will be highlighted. A better understanding of innate immunity can make the development of techniques possible by which physicians more accurately tailor prevention and treatment of neonatal infections.
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Affiliation(s)
- László Maródi
- Department of Infectiology and Pediatric Immunology, Medical and Health Science Center, University of Debrecen, Nagyerdei Krt. 98, H-4012 Debrecen, Hungary.
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26
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Förster-Waldl E, Sadeghi K, Tamandl D, Gerhold B, Hallwirth U, Rohrmeister K, Hayde M, Prusa AR, Herkner K, Boltz-Nitulescu G, Pollak A, Spittler A. Monocyte toll-like receptor 4 expression and LPS-induced cytokine production increase during gestational aging. Pediatr Res 2005; 58:121-4. [PMID: 15879290 DOI: 10.1203/01.pdr.0000163397.53466.0f] [Citation(s) in RCA: 127] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Premature newborns are highly susceptible to severe bacterial infections. This is partially due to their immature innate immune system, characterized by decreased neutrophil and monocyte activity as well as by reduced concentrations of complement factors. However, additional mechanisms might be important for innate immunity and are still the subject of considerable debate. The importance of pattern recognition domains such as Toll-like receptors (TLR) has been fully acknowledged within the last few years. Therefore, we investigated age-related monocyte TLR4 expression and lipopolysaccharide-induced cytokine secretion from very low birth weight infants (VLBWI) and from newborns after wk 30 of gestation in comparison to healthy adults. In VLBWI, expression of TLR4 surface protein, detected by flow cytometry, and TLR4-specific mRNA, quantified by real time-PCR, were significantly reduced in comparison to mature infants and to adults. Reduced TLR4 expression was paralleled by significantly diminished ex vivo LPS stimulated IL-1beta, IL-6, and tumor necrosis factor-alpha secretion into whole blood. We conclude that, in VLBWI, the minimized expression of TLR4 contributes to the susceptibility of VLBWI to infections with Gram-negative bacteria due to the lack of cytokines to boost initial immune response.
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Affiliation(s)
- Elisabeth Förster-Waldl
- Department of Pediatrics and Juvenile Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
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27
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Malhotra I, Mungai P, Muchiri E, Ouma J, Sharma S, Kazura JW, King CL. Distinct Th1- and Th2-Type prenatal cytokine responses to Plasmodium falciparum erythrocyte invasion ligands. Infect Immun 2005; 73:3462-70. [PMID: 15908375 PMCID: PMC1111871 DOI: 10.1128/iai.73.6.3462-3470.2005] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Prenatal immunity to Plasmodium falciparum merozoite proteins involved in erythrocyte invasion may contribute to the partial protection against malaria that is acquired during infancy in areas of stable malaria transmission. We examined newborn and maternal cytokine and antibody responses to merozoite surface protein-1 (MSP-1), ribosomal phosphoprotein P0 (PfP0), and region II of erythrocyte binding antigen-175 (EBA-175) in infant-mother pairs in Kenya. Overall, 82 of 167 (50%), 106 of 176 (60%), and 38 of 84 (45%) cord blood lymphocytes (CBL) from newborns produced one or more cytokines in response to MSP-1, PfP0, and EBA-175, respectively. Newborns of primigravid and/or malaria-infected women were more likely to have antigen-responsive CBL than were newborns of multigravid and/or uninfected women at delivery. Newborn cytokine responses did not match those of their mothers and fell into three distinct categories, Th1 (21 of 55 CBL donors produced only gamma interferon and/or interleukin 2 [IL-2]), Th2 (21 of 55 produced only IL-5 and/or IL-13), and mixed Th1/Th2 (13 of 55). Newborns produced more IL-10 than adults. High and low levels of cord blood IL-12 p70 production induced by anti-CD40 activation were associated with malaria-specific Th1 and Th2 responses, respectively. Antigen-responsive CBL in some newborns were detected only after depletion of IL-10-secreting CD8 cells with enrichment for CD4 cells. These data indicate that prenatal sensitization to blood-stage Plasmodium falciparum occurs frequently in areas where malaria is holoendemic. Modulation of this immunity, possibly by maternal parity and malaria, may affect the acquisition of protective immunity against malaria during infancy.
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Affiliation(s)
- Indu Malhotra
- Center for Global Health and Diseases, Case Western Reserve University, 2103 Cornell Rd., WRC Room 4132, Cleveland, OH 44106-7286, USA
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28
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Brustoski K, Möller U, Kramer M, Petelski A, Brenner S, Palmer DR, Bongartz M, Kremsner PG, Luty AJF, Krzych U. IFN-gamma and IL-10 mediate parasite-specific immune responses of cord blood cells induced by pregnancy-associated Plasmodium falciparum malaria. THE JOURNAL OF IMMUNOLOGY 2005; 174:1738-45. [PMID: 15661939 DOI: 10.4049/jimmunol.174.3.1738] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Available evidence suggests that immune cells from neonates born to mothers with placental Plasmodium falciparum (Pf) infection are sensitized to parasite Ag in utero but have reduced ability to generate protective Th1 responses. In this study, we detected Pf Ag-specific IFN-gamma(+) T cells in cord blood from human neonates whose mothers had received treatment for malaria or who had active placental Pf infection at delivery, with responses being significantly reduced in the latter group. Active placental malaria at delivery was also associated with reduced expression of monocyte MHC class I and II in vivo and following short term in vitro coculture with Pf Ag compared with levels seen in neonates whose mothers had received treatment during pregnancy. Given that APC activation and Th1 responses are driven in part by IFN-gamma and down-regulated by IL-10, we examined the role of these cytokines in modulating the Pf Ag-specific immune responses in cord blood samples. Exogenous recombinant human IFN-gamma and neutralizing anti-human IL-10 enhanced T cell IFN-gamma production, whereas recombinant human IFN-gamma also restored MHC class I and II expression on monocytes from cord blood mononuclear cells cocultured with Pf Ag. Accordingly, active placental malaria at delivery was associated with increased frequencies of Pf Ag-specific IL-10(+)CD4(+) T cells in cord blood mononuclear cell cultures from these neonates. Generation and maintenance of IL-10(+) T cells in utero may thus contribute to suppression of APC function and Pf Ag-induced Th1 responses in newborns born to mothers with placental malaria at delivery, which may increase susceptibility to infection later in life.
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Affiliation(s)
- Kim Brustoski
- Department of Parasitology, Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
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Blanco-Quirós A, Arranz E, Solis G, Garrote JA, Mayo A. High cord blood IL-10 levels in preterm newborns with respiratory distress syndrome. Allergol Immunopathol (Madr) 2004; 32:189-96. [PMID: 15324648 DOI: 10.1016/s0301-0546(04)79238-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The development of respiratory distress syndrome (RDS) is closely related to fetal immaturity, although the participation of inflammatory mechanisms also seems to be likely. We previously reported high interleukin-10 (IL-10) levels in cord blood from preterm infants. In the present study, we investigate the possible role of IL-10 and IL-12 in preterm newborns with RDS, a disease that is also closely related to gestational age. PATIENTS AND METHODS Cord blood levels of IL-10 and IL-12 (p70 + p40) were determined by ELISA in 20 preterm infants who later developed RDS, in 21 preterm infants without RDS and in 31 full term newborns. In 11 patients follow-up samples could be also obtained between 2 and 14 days of life. RESULTS Preterm infants with RDS showed higher IL-10 (27 vs 10.8 pg/mL; p: 0.0003) and lower IL-12 (188 vs 384; p: 0.002) levels in cord blood than premature infants without RDS and full term newborns (IL-10: 3.2 pg/mL, p: 0.0001; IL-12: 352 pg/mL; p: 0.002). The differences remained statistically significant after correction for the effect of gestational age between both preterm groups. CONCLUSIONS The results obtained may be related to an immature cytokine response in premature infants, but the IL-12/IL-10 imbalance found in our patients also supports the hypothesis that inflammation plays a role in RDS.
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Affiliation(s)
- A Blanco-Quirós
- Department of Pediatrics and Immunology, Institute of Genetics and Molecular Biology (IBGM), University of Valladolid, Spain.
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Zittermann A, Dembinski J, Stehle P. Low vitamin D status is associated with low cord blood levels of the immunosuppressive cytokine interleukin-10. Pediatr Allergy Immunol 2004; 15:242-6. [PMID: 15209957 DOI: 10.1111/j.1399-3038.2004.00140.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The cytokine interleukin-10 (IL-10) plays a pivotal regulatory role in tolerizing exogenous antigens. Experimental data indicate that low cellular availability of the vitamin D hormone 1,25-dihydroxyvitamin D [1,25(OH)2D] results in a down-regulation of IL-10 concentrations. The tissue production of an adequate amount of 1,25(OH)2D depends on a high circulating 25-hydroxyvitamin D (25-OHD) level. The present study was thus aimed at evaluating the associations between season of birth, vitamin D status, and the allergy risk markers IL-10 and total immunoglobulin (IgE) in newborns. Cord blood was obtained from 49 infants born during the summer half year (mid-April to mid-October, geographic latitude 51 degrees N) and from 47 infants born during the winter half year (mid-October to mid-April, geographic latitude of 51 degrees N). Serum levels of 25-OHD were 99% higher, and IL-10 levels were 43% higher in the summer half year compared with the winter half year (p < 0.001 and p = 0.018). Moreover, the ratio of IL-10 to total IgE was 124% higher in the summer half year compared with the winter half year (p = 0.039). Serum levels of 25-OHD were correlated with IL-10 levels (r = +0.22; p < 0.05). Mothers' age, gestational ages, birth weights and serum 1,25(OH)2D levels did not differ between study groups. We conclude that the low vitamin D status of infants born in winter may at least in part adversely affect biomarkers of allergy risk.
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Affiliation(s)
- Armin Zittermann
- Department of Nutrition Science, University of Bonn, Bonn, Germany.
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31
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Hillyer LM, Woodward B. Interleukin-10 concentration determined by sandwich enzyme-linked immunosorbent assay is unrepresentative of bioactivity in murine blood. Am J Physiol Regul Integr Comp Physiol 2004; 285:R1514-9. [PMID: 14615407 DOI: 10.1152/ajpregu.00378.2003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Two experiments were performed, each using six male and six female C57BL/6J mice collectively ranging from 4 wk to 17 mo of age. Blood was obtained following CO2 anesthesia, and the IL-10 concentration of each serum sample was determined both by sandwich enzyme-linked immunosorbent assay (ELISA) and by bioassay. In the first experiment, mean serum IL-10 immunoactivity was 9.3 pg/ml while the mean bioactivity was 700 times greater, i.e., 6.5 ng/ml. However, the bioassay required sample dilution, which might have released bound cytokine that the ELISA could also detect. In the second experiment, therefore, the ELISA was applied to samples diluted to 20% as for the bioassay. Nevertheless, the immunoassay continued to detect only a small fraction of the serum IL-10 identified by the bioassay (mean values: 32.4 pg/ml vs. 2.6 ng/ml). Although currently the preferred method, the sandwich ELISA is inappropriate for quantification of blood IL-10 concentrations. Moreover, studies of the actions of IL-10 are needed at the concentrations revealed in the blood by bioassay and currently considered supraphysiological.
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Affiliation(s)
- L M Hillyer
- Department of Human Biology and Nutritional Sciences, University of Guelph, Guelph, ON, Canada N1G 2W1
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32
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Dembinski J, Behrendt D, Martini R, Heep A, Bartmann P. Modulation of pro- and anti-inflammatory cytokine production in very preterm infants. Cytokine 2003; 21:200-6. [PMID: 12788309 DOI: 10.1016/s1043-4666(02)00498-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND In premature infants, outcome of infection-associated complications is heterogeneous despite advances in antibiotic treatment and diagnosis. Information on the immune response in preterm infants is limited. Immune modulatory strategies require detailed analysis of mediators and their kinetics. OBJECTIVE To determine the kinetics of IL-1beta, TNFalpha, IL-6, IL-8, IL-10, gammaINF and G-CSF in preterm and term infants in an ex vivo cord blood culture (CBC) endotoxin model. DESIGN AND METHODS Cord blood of 25 infants was obtained immediately after birth from the fetal side of the placenta and incubated in culture medium (RPMI 1640) in the presence or absence of 500 pg/ml lipopolysaccharide (LPS) for 48h. TNFalpha, IL-1beta, IL-6 and IL-8 were measured by sequential immunometric assay (IMMULITE, DPC Biermann, Germany); IL-10 (Milenia Biotec, Bad Nauheim, Germany), gammaINF (Diaclone, Besancon, France) and G-CSF (R & D Systems, Wiesbaden, Germany) were determined by ELISA in supernatants at 0, 4, 8, 12, 24 and 48h. Infants were stratified into three gestational age groups (< or =32 weeks, 33-36 weeks, > or =37 weeks). Variations between the groups were first analyzed for significance by Kruskal-Wallis test and pairs were compared by Mann-Whitney-U test. Effects of gestational age, leucocyte count, hematocrit and frequency of antenatal steroid exposure were tested by linear regression analysis. To correct a possible impact of variable, WBC count, cytokine levels were adjusted according to individual leucocyte numbers. RESULTS LPS-stimulated maximum levels of IL-6, IL-1beta,TNFalpha and G-CSF in CBC were significantly lower in very preterm infants compared to more advanced gestational age groups. After adjusting the cytokine levels for 10(5) leucocytes, a significant effect of gestational age on IL-6 and G-CSF production (p<0.05) was detected. A non-significant trend towards reduced cytokine levels was observed following multiple antenatal steroid exposures. IL-10:TNFalpha ratio increased in very preterm neonates when compared with the advanced gestational age, although the increase was not significant. CONCLUSIONS Pro-inflammatory cytokine activity in CBC correlates with gestational age, whereas IL-10 does not. Although ex vivo synthesis of IL-1beta, TNFalpha, IL-6, G-CSF in CBC depends in part on leucocyte numbers, IL-6 and G-CSF synthesis appeared to be related to immaturity. Non-significant effects of multiple antenatal steroid exposure and increased IL-10:TNFalpha ratio in preterm neonates, observed in a small sample size, warrant further investigation.
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Affiliation(s)
- Joerg Dembinski
- Division of Neonatology, Center of Pediatrics, University of Bonn, Adenauerallee 119, 53113 Bonn, Germany.
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Power LL, Popplewell EJ, Holloway JA, Diaper ND, Warner JO, Jones CA. Immunoregulatory molecules during pregnancy and at birth. J Reprod Immunol 2002; 56:19-28. [PMID: 12106881 DOI: 10.1016/s0165-0378(01)00146-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Regulation of the maternal immune response to the fetal allograft is essential for the success of pregnancy and delivery of a well-developed neonate. Numerous mechanisms have been postulated to mediate this. We hypothesised that the potent immunosuppressive molecules TGF-beta1 and IL-10 could contribute to this regulation in the mother and neonate during gestation. In comparison to non-pregnant women, TGF-beta1 and cortisol levels were increased significantly in mid (16-18 weeks) and late pregnancy (>37 weeks, no labour), with levels of both highest in late gestation. In contrast, IL-10 levels were significantly lower in maternal plasma in mid-gestation compared with that from late pregnancy and from non-pregnant women. TGF-beta1, IL-10 and cortisol were all detectable in umbilical cord blood plasma with TGF-beta1 levels significantly decreased in association with labour in contrast to cortisol levels that increased with labour. IL-10 levels in cord plasma were comparable to those of adults and did not change with mode of delivery. Elevated levels of TGF-beta1, but not IL-10, in the maternal and neonatal circulation could have a role in immunoregulation of the maternal response to the fetal allograft as well as growth and development of the fetus.
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Affiliation(s)
- Lynsey L Power
- Allergy and Inflammation Sciences Division, School of Medicine, University of Southampton, Southampton, UK
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Dembinski J, Behrendt D, Reinsberg J, Bartmann P. Endotoxin-stimulated production of IL-6 and IL-8 is increased in short-term cultures of whole blood from healthy term neonates. Cytokine 2002; 18:116-9. [PMID: 12096927 DOI: 10.1006/cyto.2002.0880] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
To assess the stimulated production of Interleukin-6 and Interleukin-8 in healthy term neonates compared to adults, and to study the effect of labour on the capacity of cytokine secretion, 20 healthy term neonates (11 delivered by elective caesarean section, (ECS) group; 9 vaginally delivered, (VD) group) were included in the study, and five healthy adult volunteers served as controls. Spontaneous and lipopolysaccharide (LPS)-stimulated IL-6 and IL-8 secretion in short-term umbilical whole blood cultures was determined. Spontaneous IL-6 (IL-8) secretion was detected in only a few samples with maximum levels of 14 (23) pg/ml. After 4 h of LPS incubation median IL-6 levels increased to 2026 (339-2547) pg/ml (VD group) and 1670 (704-2037) pg/ml (ECS group). Median IL-8 concentration after LPS stimulation was 2142 (738-4053) pg/ml in the VD group and 1483 (1036-2934) pg/ml ECS group. Interleukin-6 and IL-8 levels following LPS-stimulation in both groups markedly exceeded the values of adult controls. Stimulated cytokine secretion showed no significant difference between VD and ECS groups. Spontaneous cytokine production in cord blood is variable and related to individual cytokine expression and regulation. The pro-inflammatory response to endotoxin as determined by ex vivo LPS-stimulation of short-term whole blood cultures of term neonates, in contrast to spontaneous cytokine secretion, exceeds adult levels and appears to be independent of the mode of delivery and labour.
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Affiliation(s)
- J Dembinski
- Department of Neonatology, University of Bonn, Adenauerallee 119, Bonn, D-53113, Germany.
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Dembinski J, Behrendt D, Heep A, Dorn C, Reinsberg J, Bartmann P. Cell-associated interleukin-8 in cord blood of term and preterm infants. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2002; 9:320-3. [PMID: 11874870 PMCID: PMC119935 DOI: 10.1128/cdli.9.2.320-323.2002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
To assess the effect of gestational age and labor on the interleukin-8 (IL-8) concentration in whole cord blood and serum, IL-8 levels were determined simultaneously in cord blood serum and lysate in 134 infants. Following the elimination of some of the samples due to exclusion criteria, the data for 99 uninfected infants (71 term and 28 preterm) and 9 infants with neonatal bacterial infection delivered either vaginally or by elective or emergency cesarean section were analyzed. The effects of labor and gestational age were tested by analysis of variance. IL-8 was not detectable in the serum of 25 infants, whereas IL-8 levels in whole blood were measurable in all of the samples. The median IL-8 conncentrations in whole cord blood lysate were 106 pg/ml (range, 20 to 415 pg/ml) in preterm infants and 176 pg/ml (range, 34 to 1,667 pg/ml) in term infants. In contrast to the IL-8 levels in serum, IL-8 levels in whole blood were reduced after ECS. Gestational age had no independent effect on the IL-8 concentrations in either serum or whole blood; these concentrations increased in infected infants after labor. We conclude that the neonatal proinflammatory response to labor stress was more evident in the concentrations of IL-8 in whole blood than in serum. The levels of IL-8 in whole-blood lysate reflect proinflammatory stimulation in neonates and may be a useful diagnostic tool for the early diagnosis of neonatal infection.
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Affiliation(s)
- J Dembinski
- Department of Neonatalogy, Center of Pediatrics, University of Bonn, Bonn D-53113, Germany.
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