Soluble L-selectin, a marker of immune activation, in neonatal infection.
L-Selectin is an adhesion molecule shed from the surface of lymphocytes and granulocytes upon activation. Soluble L-selectin in the plasma can thus reflect immune activation and is elevated in several pathological states. Our objective was to evaluate plasma levels of L-selectin as an immune activation marker in neonates and to determine whether it can serve as a marker of infection, either neonatal or congenital, or if it is affected by the mode of delivery and obstetrical or perinatal complications. A solid-phase ELISA was used on 89 sera from neonates less than 2 days of age, according to the manufacturer's instructions. Levels of soluble L-selectin in the neonate were lower than those of older infants and children and comparable to the levels seen in adults. There was no difference between levels of soluble L-selectin of premature (median, 1172 ng/ml) and full-term babies (median, 1151 ng/ml) or between babies born via vaginal (median, 1233 ng/ml) or cesarean delivery (median, 1146 ng/ml). Conditions such as preeclampsia or administration of steroids to the mother did not affect the levels of L-selectin in the neonate. In contrast, the presence of maternal clinical chorioamnionitis resulted in an increase in levels of L-selectin in the neonate (median, 1377 vs 1072 ng/ml, p = 0.02), as did neonatal sepsis (median, 1331 vs 1149 ng/ml, p = 0.026). Soluble L-selectin, and thus immune activation level, is highest in neonates with neonatal infection and needs to be further evaluated as a surrogate marker for diagnosing sepsis in the neonate.
Kourtis
A P
AP
Division of Infectious Diseases, Epidemiology and Immunology, Emory University School of Medicine, Atlanta, GA 30322, USA. akourti@pol.net
Lee
F K
FK
Stoll
B J
BJ
D015415:Biomarkers / Q000097:blood; D002821:Chorioamnionitis / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019041:L-Selectin / Q000097:blood / Q000276:immunology*; D008213:Lymphocyte Activation / Q000276:immunology; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D018805:Sepsis / Q000175:diagnosis / Q000276:immunology*; D018709:Statistics, Nonparametric
D015415:Biomarkers; D019041:L-Selectin