ENDOGENOUS CYTOKINES IN
NEONATAL SEPSIS AND RELATIONSHIP WITH NEUTROPHIL COUNT
Özdemir
MA, Özt¨¹rk MA, Sonu H, Arslan D,Poyrazoğlu MH, G¨¹neş T
Erciyes University, Medical Faculty, Kayseri,
Turkey
Objective: The aim of this study
was to determine plasma levels of granulocyte colony-stimulating factor
(G-CSF) and granulocyte macrophage colony-stimulating factor (GM-CSF) and
their relationship with leucocyt count, neutrophil count, results of
cultures and sepsis scores in neonatal sepsis.
Methods: 43 newborns gestational
ages were between 7 hours and 37 days with sepsis were included in the
study. The severity of sepsis reevaluated using Tollner¡¯s scoring system.
We analyzed complete blood count, peripheral blood film, plasma G-CSF and
CM-CSF.Blood and cerebrospinal fluid cultures were obtained. Plasma G-CSF
and GM-CSF levels were determined with double sandwich enzyme immunoassay
method at first and seventy days.
Results:Endogenous G-CSF levels
were higher in in patients who had high sepsis score as well as in patients
with neutropenia and leukopenia and blood culture positive for Gr(-)
microorganisms. G-CSF levels was also higer in acute phase of infection
than late phase.It was also higer in preterm infants and who had poor
prognosis than term babies. There was an inverse and linear correlation
between neutrophil count and G-CSf levels. Endogenous GM-CSf levels were
lower in the first and seventh days of infection.
Conclusion: This study has shown
that bacterial toxins are an important stimulator of G-CSF production and
G-CSF production possibly by a feed-back mechanism and premature infants
are capable of producing enough levels of G-CSF. Low levels of GM-CSF in
sepsis are attributed to low production, rapid clearance from circulation
and that it may be a cytokine related to a microenvironment.