title: Red blood cell transfusions can induce proinflammatory cytokines in preterm infants.
abstract: BACKGROUND
  The risk of developing red blood cell (RBC) transfusion-associated necrotizing enterocolitis (TANEC) in preterm infants has recently been emphasized. Our aim was to assess changes in cytokine serum levels after RBC transfusions in a cohort of very preterm infants to evaluate their possible proinflammatory effect.
  
  
  METHODS
  We carried out a prospective observational study. One transfusion event was studied in infants less than 32 weeks' gestation and more than 7 days old (n = 20) admitted to a tertiary neonatal intensive care unit. Interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor-α, interferon-γ (IFN-γ), IL-17, monocyte chemoattractant protein-1 (MCP-1), interferon-γ-induced protein 10 (IP-10), intracellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule serum levels were measured in enrolled patients within 120 minutes before (T0) the RBC transfusion and then within 120 minutes (T1), 12 ± 3 hours (T2), 24 ± 6 hours (T3), and 48 ± 6 hours (T4) after the end of RBC transfusion.
  
  
  RESULTS
  Infants received 19.8 ± 3.0 mL of RBCs at the mean age of 50 ± 18 days. Their hematocrit level increased from 24.1 ± 1.2% to 39.4 ± 2.9%. IL-1β, IL-8, IFN-γ, IL-17, MCP-1, IP-10, and ICAM-1 increased significantly after RBC transfusions.
  
  
  CONCLUSIONS
  Proinflammatory cytokines are increased after RBC transfusion. These findings may contribute to explaining the pathogenesis of TANEC and suggest the opportunity of adopting wise transfusion guidelines that would help to avoid detrimental risks of transfusion-related immunomodulation and of undertransfusion.
authors.affiliation: Department of Neurosciences, Psychology, Drug Research and Child Health.
authors.forename: Carlo
authors.initials: C
authors.lastname: Dani
authors.affiliation: Division of Neonatology.
authors.forename: Chiara
authors.initials: C
authors.lastname: Poggi
authors.affiliation: Division of Neonatology.
authors.forename: Elena
authors.initials: E
authors.lastname: Gozzini
authors.affiliation: Division of Neonatology.
authors.forename: Valentina
authors.initials: V
authors.lastname: Leonardi
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence-Atherothrombotic Diseases Centre, Careggi University Hospital of Florence, Florence, Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: Sereni
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence-Atherothrombotic Diseases Centre, Careggi University Hospital of Florence, Florence, Italy.
authors.forename: Rosanna
authors.initials: R
authors.lastname: Abbate
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence-Atherothrombotic Diseases Centre, Careggi University Hospital of Florence, Florence, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Gori
mesh_terms: D016207:Cytokines / Q000097:blood* / Q000235:genetics; D020345:Enterocolitis, Necrotizing / Q000209:etiology; D017707:Erythrocyte Transfusion / Q000009:adverse effects*; D005260:Female; D005865:Gestational Age; D006801:Humans; D056747:Immunomodulation; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D018836:Inflammation Mediators; D007363:Intensive Care Units, Neonatal; D008297:Male; D011446:Prospective Studies; D015533:Transcriptional Activation
chemical_list: D016207:Cytokines; D018836:Inflammation Mediators