Cytokine elaboration in critically ill infants with bacterial sepsis, necrotizing entercolitis, or sepsis syndrome: correlation with clinical parameters of inflammation and mortality.
OBJECTIVE
To test the hypothesis that cytokines might distinguish critically ill infants with bacterial sepsis or necrotizing enterocolitis (NEC) from those with sepsis syndrome and that these elevations would be correlated with clinical variables of inflammation and mortality.


METHODS
We measured plasma and tracheal aspirate (TA) levels of interleukin-8 (IL-8), epithelial neutrophil activating peptide (ENA-78), IL-10, and IL-18 in 84 neonates with suspected sepsis or NEC. Thirty-one infants had bacterial sepsis, 19 had NEC, and 34 infants with negative results on cultures had sepsis syndrome.


RESULTS
Plasma IL-8 and IL-10 levels were significantly increased in infants with bacterial sepsis compared with those in infants with sepsis syndrome. Plasma IL-8, ENA-78, and IL-10 levels were elevated in infants with NEC compared with those in infants with sepsis syndrome. TA IL-8 and IL-10 levels were also increased in infants with bacterial sepsis; TA ENA-78, and IL-18 were not elevated in infants with sepsis or NEC when compared with infants with sepsis syndrome. Plasma and TA cytokine levels correlated with hematologic parameters. Plasma cytokine levels were higher in infants who did not survive than in infants who did survive.


CONCLUSIONS
Plasma and TA cytokine levels are elevated in critically ill infants with bacterial sepsis or NEC compared with those in infants with sepsis syndrome. Our results suggest distinct patterns of cytokine elaboration in different disease states.
Harris
Mary Catherine
MC
Division of Neonatology, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine Philadelphia, Pennsylvania 19104, USA. harrism@email.chop.edu
D'Angio
Carl T
CT
Gallagher
Paul R
PR
Kaufman
David
D
Evans
Jacquelyn
J
Kilpatrick
Laurie
L
D001424:Bacterial Infections / Q000378:metabolism* / Q000401:mortality; D054365:Chemokine CXCL5; D019743:Chemokines, CXC / Q000378:metabolism*; D016638:Critical Illness; D020345:Enterocolitis, Necrotizing / Q000378:metabolism* / Q000401:mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007378:Interleukins / Q000378:metabolism*; D007958:Leukocyte Count; D010976:Platelet Count; D018805:Sepsis / Q000378:metabolism* / Q000401:mortality; D018746:Systemic Inflammatory Response Syndrome / Q000378:metabolism* / Q000401:mortality; D014132:Trachea / Q000378:metabolism
C486263:CXCL5 protein, human; D054365:Chemokine CXCL5; D019743:Chemokines, CXC; D007378:Interleukins