title: Increased levels of interleukin-6 in tracheal aspirate fluid are indicative of fetal inflammation in ventilated extremely low gestational age newborns.
abstract: OBJECTIVE
  To determine whether increased serum and/or tracheal aspirate fluid (TAF) levels of IL-6 at birth are associated with fetal inflammation in ventilated extremely low gestational age newborns (ELGAN).
  
  
  METHODS
  A total of 36 ELGAN who required mechanical ventilation were enrolled in this study. The patients were classified into two groups: 19 infants who displayed histological evidence of funisitis, which is a marker of fetal inflammation, (funisitis group) and 17 infants without funisitis (comparison group). TAF samples were obtained during routine endotracheal suctioning performed within 2 hours of birth.
  
  
  RESULTS
  The funisitis group exhibited significantly higher TAF IL-6 levels than the comparison group (2245 vs. 113 pg/mg total protein; p<0.001). The serum IL-6 levels of the funisitis group were also significantly elevated compared with those of the comparison group (median: 737 vs. 136 pg/mL, p=0.017). Receiver operating characteristic curve analysis of the association between IL-6 levels and the presence of funisitis revealed that the TAF IL-6 concentration had a higher area under the curve (0.947) than the serum IL-6 concentration (0.719). At a cut-off value of 216 pg/mg total protein, the TAF IL-6 level exhibited sensitivity and specificity values of 94.7% and 86.7%, respectively, for detecting funisitis.
  
  
  CONCLUSIONS
  Elevated TAF IL-6 levels at birth are strongly associated with funisitis. The TAF IL-6 concentration is a useful marker for detecting fetal inflammation in ventilated ELGAN.
authors.affiliation: Department of Neonatology, Hyogo Prefectural Kobe Children's Hospital Perinatal Center, 1-1-1 Takakuradai, Suma-Ku, Kobe-Shi, Hyogo 654-0081, Japan.
authors.forename: Sota
authors.initials: S
authors.lastname: Iwatani
authors.forename: Masami
authors.initials: M
authors.lastname: Mizobuchi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tanaka
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Fujioka
authors.forename: Keiko
authors.initials: K
authors.lastname: Wada
authors.forename: Hitomi
authors.initials: H
authors.lastname: Sakai
authors.forename: Seiji
authors.initials: S
authors.lastname: Yoshimoto
authors.forename: Hideto
authors.initials: H
authors.lastname: Nakao
mesh_terms: D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D001826:Body Fluids / Q000378:metabolism; D016022:Case-Control Studies; D002821:Chorioamnionitis / Q000097:blood / Q000175:diagnosis / Q000378:metabolism*; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D006801:Humans; D062071:Infant, Extremely Premature / Q000097:blood / Q000378:metabolism*; D007231:Infant, Newborn; D018836:Inflammation Mediators / Q000097:blood / Q000378:metabolism; D015850:Interleukin-6 / Q000097:blood / Q000378:metabolism*; D008297:Male; D011247:Pregnancy; D012121:Respiration, Artificial; D014132:Trachea / Q000378:metabolism
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6
keywords: extremely low gestational age newborns; funisitis; interleukin-6; tracheal aspirate fluid