Interleukin 35: A novel candidate biomarker to diagnose early onset sepsis in neonates.
BACKGROUND
Early onset sepsis (EOS) remains a major cause of morbidity and mortality in newborns; however, current diagnostic tools are inadequate. We evaluated the accuracy of a novel cytokine, interleukin (IL)-35, for the diagnosis of EOS in comparison with other infection markers.


METHODS
One hundred fifty-seven neonates with suspected sepsis in the first 3days of life were enrolled in this perspective study. All enrolled patients were divided into infected group and unlikely infected group according to clinical data. IL-35, C-reactive protein (CRP), procalcitonin (PCT), white blood cell (WBC) count, and blood culture were measured once the suspected EOS was documented.


RESULTS
Serum concentration of IL-35 was increased significantly in the infected group compared with the unlikely infected group (median 36.4 versus 27.1pg/ml, respectively, p<0.001). The area under receiver-operating characteristic (ROC) curve were 0.756 for IL-35, 0.713 for PCT (age-adjusted), 0.670 for CRP, and 0.619 for WBC. With a cut-off value of 31.7pg/ml, the diagnostic sensitivity and specificity of IL-35 were 78.48% and 66.67%, respectively. Moreover, unlike PCT concentration, IL-35 concentration did not fluctuate in neonates who were unlikely to be infected (p=0.885).


CONCLUSIONS
The diagnostic performance of IL-35 was superior to that of PCT and other commonly used markers, suggesting that IL-35 may be a valuable tool for EOS diagnosis.
Research Center for Immunologic and Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing, PR China; Ministry of Education Key Laboratory of Child Development and Disorders, PR China; China International Science and Technology Cooperation base of Child development and Critical Disorders, PR China; Chongqing City Key Lab of Child Infection and Immunity, Chongqing Key Laboratory of Pediatrics, Chongqing, PR China.
Wei-Xia
WX
Du
Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, PR China; Ministry of Education Key Laboratory of Child Development and Disorders, PR China; China International Science and Technology Cooperation base of Child development and Critical Disorders, PR China; Chongqing City Key Lab of Child Infection and Immunity, Chongqing Key Laboratory of Pediatrics, Chongqing, PR China.
Yu
Y
He
Research Center for Immunologic and Infectious Diseases, Children's Hospital of Chongqing Medical University, Chongqing, PR China; Ministry of Education Key Laboratory of Child Development and Disorders, PR China; China International Science and Technology Cooperation base of Child development and Critical Disorders, PR China; Chongqing City Key Lab of Child Infection and Immunity, Chongqing Key Laboratory of Pediatrics, Chongqing, PR China.
Hong-Yan
HY
Jiang
Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, PR China; Ministry of Education Key Laboratory of Child Development and Disorders, PR China; China International Science and Technology Cooperation base of Child development and Critical Disorders, PR China; Chongqing City Key Lab of Child Infection and Immunity, Chongqing Key Laboratory of Pediatrics, Chongqing, PR China.
Qing
Q
Ai
Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, PR China; Ministry of Education Key Laboratory of Child Development and Disorders, PR China; China International Science and Technology Cooperation base of Child development and Critical Disorders, PR China; Chongqing City Key Lab of Child Infection and Immunity, Chongqing Key Laboratory of Pediatrics, Chongqing, PR China. Electronic address: yujialin486@126.com.
Jia-Lin
JL
Yu
D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007378:Interleukins / Q000097:blood*; D008297:Male; D000071074:Neonatal Sepsis / Q000097:blood* / Q000175:diagnosis*; D011446:Prospective Studies
D015415:Biomarkers; D007378:Interleukins; C532417:interleukin-35, human
Biomarker; Early onset sepsis; Interleukin 35; Neonate