Interleukin-6, interleukin-8 and markers of oxidative stress in neoratal sepsis : the effect of exchange trans fusion

الملخص EN

The present study included 43 newborn infants with clinical signs of neonatal sepsis, admitted to the neonatology unit.

Assiut University Hospital (29fuilterm and 14 pre-term with a ratio of 27-16).

Another 19 apparently healthy neonates of matchable age and sex were considered as control (with a ratio of 12/7, 16 full term and 9 preterm).

Alt the studied neonates were assessed clinically Serum levels of C-reactive protein (C R.P).

/nterieukin-6 (IL-6 Interleukin-8 (IL-8) nitric Oxide (SO), lipid peroxide (IPO), superoxide dismutase enzyme (SOD), blood picture, blood culture and arterial blood gases were all estimated for all the studied neonates on admission and 24 hours post exchange transfusion (Ex-7) for 27 neonates who showed signs of severe sepsis.

Early onset neonatal sepsis (EONS) was detected in 27 neonates while late onset neonatal sepsis (LONS) was present in 16 neonates.

Meningitis was present in 11.1%, dionhea with D1C.

in 22.1% pneumonia in 34.8% and umbilical sepsis in 51.1%.

Blood culture was positive for bacterial growth in 51.

1%of cases.

The serum level of each of C.RP, 1L-6, IL-8 .

NO , LPO and % of band cells Were significantly higher among the septicemic neonates m comparison lo the control group (P<0.025.

P

P<(K0O5, P'0005.

P<0.005 and P<0.01 respect.}.

Meanwhile, the mean values of SOD and arterial blood Ph were significantly reduced among the diseased neonates than the control.

Regarding the effect of gestational age on the studied parameters, H was noticed that the mean values ofCR P.

IL-IL-8, NO, IPO and % of hand cells were significantly higher among the fall term as well as the preterm septicemic neonates in comparison to their partners of control group.

On the other hand, arterial pH and SOD were significantly reduced in full term and preterm diseased neonates in comparison to the control.

Neonates with PONS showed significantly higher mean values of C P.

P, 11-6, \'o, IPO and "A of band cells in comparison to those with L.O.N.S.

(P<0.01, P'0.05 P<0.05.

P'0.05 and P-'005 respect ) No significant differences could be detected in the studieded parameters m relation to the type of microorganism.

Post Fx-T, the 27 neonates showed significant improvement in hemoglobin concentration, inarterial blood pH .

serum level of 'IX'0$ and m PaO- on comparison lo these values before Fx-T and to those who did not undergo Fx-T.

Significant drop was observed in the values of WBC, % of band cells, 11-6, C-RP.

LPO tmdHOpoSi Fx-T on comparison lo the values before Fx-T/P'OOS, P 0005 P-GOS.

P<0.025, P<0.05, P<0.025 respect.).

1L-H and SOD did not show significant changes after Exchange - Transfusion.

Significant +ve correlations were detected in all septicemia neonates between each of lL-6,1L-8 and NO (P'<0.01, p< 0.01 respect) and d significant negative correlations between IL-6.IL.-8.

NO and SOD (P< 0.01 for each).

Mortality rate was 25.5% with no significant effect of Ex-T.

furthermore.

The non-survivors showed significantly higher mean values of IL-6.1L-8 .

NO and LPO and significantly reduced values of SOD on comparison to the survivors whether EX'-'T was given or not.

Conclusion: neonatal sepsis is a serious event that is associated with activation of cytokine network and the release of injurious oxidative elements Exchange transfusion is not sufficient alone to improve die outcome of neonatal sepsis and trials of the use of antioxidant enzymes administration and cytokines antagonists should be encouraged.