title: Immune cell subsets at birth may help to predict risk of late-onset sepsis and necrotizing enterocolitis in preterm infants.
abstract: BACKGROUND
  Parameters predicting late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) in preterm infants would be valuable. Ten-color flow-cytometry enables the estimation of cellular immune status requiring only small sample volumes.
  
  
  OBJECTIVE
  Identifying predictive parameters for LOS and NEC in the cellular immune status of preterm infants.
  
  
  METHODS
  In this prospective study in 40 preterm infants (week 26+0 to 30+6) and 10 healthy full-term newborn infants (control group, week 37+0 to 40+6), flow cytometric analyses of lymphocyte subpopulations were performed between the 2nd and the 6th day of life, with a follow-up until the preterm infant reached the calculated gestational age of week 40. Patients' episodes of infections and NEC were analyzed according to the NEO-KISS criteria of the German National Reference Center.
  
  
  RESULTS
  Ten preterm infants showed events within the first week of life and were excluded from the analysis. Of the other 30, five developed NEC, twelve LOS. In patients with LOS, the proportion of double-negative (DN) T cells was significantly elevated compared to patients without LOS, while immune-regulatory CD56bright and CD56negCD16+ NK cells were significantly decreased (p<0.05). Patients with NEC showed a reduction in the NK cell proportion (<3.7%) and significantly decreased naïve cytotoxic CD45RA+CD62L+ T cells (p<0.05).
  
  
  CONCLUSIONS
  NK cells and DN-T cell counts within the first week of life may be predictors for NEC and LOS in preterm infants. In order to identify patients at risk early, further analysis of these populations might be of interest.
authors.affiliation: University Hospital Frankfurt, Germany. Electronic address: konrad.bochennek@kgu.de.
authors.forename: Konrad
authors.initials: K
authors.lastname: Bochennek
authors.affiliation: University Hospital Frankfurt, Germany.
authors.forename: Esther
authors.initials: E
authors.lastname: Fryns
authors.affiliation: University Hospital Frankfurt, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Wittekindt
authors.affiliation: University Hospital Frankfurt, Germany.
authors.forename: Horst
authors.initials: H
authors.lastname: Buxmann
authors.affiliation: University Hospital Frankfurt, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Quaiser
authors.affiliation: University Hospital Frankfurt, Germany.
authors.forename: Doris
authors.initials: D
authors.lastname: Fischer
authors.affiliation: University Hospital Frankfurt, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Klingebiel
authors.affiliation: Hannover Medical School (MHH), Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Koehl
authors.affiliation: University Hospital Frankfurt, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Schloesser
authors.affiliation: University Hospital Frankfurt, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Huenecke
mesh_terms: D015415:Biomarkers / Q000097:blood; D020345:Enterocolitis, Necrotizing / Q000097:blood*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood / Q000276:immunology*; D007235:Infant, Premature, Diseases / Q000097:blood*; D016131:Lymphocyte Subsets; D008297:Male; D018805:Sepsis / Q000097:blood*
chemical_list: D015415:Biomarkers
keywords: Cellular immune status; Double-negative T cells; Late-onset sepsis; NK-cells; Necrotizing enterocolitis (NEC); Neonatology