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ORIGINAL ARTICLE
Korean J Pediatr 1995 October;38(10) :1307-1314.
Changes of Serum Tumor Necrosis Factor- and Interleukin-1 in the Sepsis of Neonates
Mi Yeon Lee (Lee MY)1, Yeon Kyun Oh (Oh YK)1, Ji Hyun Cho (Cho JH)2
1Department of Pediatrics, Wonkwong University School of Medicine, Iri, Korea
2Department of Clinical Pathology, Wonkwong University School of Medicine, Iri, Korea
Copyright © 1995 by The Korean Pediatric Society
ABSTRACT
Purpose : Cytokines have recently been identified as important endogenous mediators of the host immune response to bacterial infection. But little is clarify about serum levels of cytokines in neonatal sepsis. The aim of this study was to know the changes of the level of cytokines during neonatal sepsis, to compare the level of cytokines in gram negative and gram positive bacterial sepsis, and to examine the correlation of cytokines in relation to hemodynamic changes. Methods : In the prospective study, levels of tumor necrosis factor-(TNF-) and interleukin-1(IL-1) were measured in a peripheral blood serum from 13 septic neonates who were admitted in neonatal intensive care unit of Wonkwang University Hospital by specific enzyme-linked immunosorbent assay, Serum samples were collected at presentation and at 12, 24, 24, 48 hours thereafter. Results : The results were as follows : 1) Serum levels of TNF-(223,4565.99pg/ml vs 32.211.39pg/ml) & IL-1(85.522.4pg/ml vs 13.293.86pg/ml) at presentation were significantly higher in the group of neonatal sepsis compare to those of the control group(p<0.05). 2) After the therapy with antibiotics, TNF- & Il-1 decreased nearly to the level of the control group within 24 and 12 hours, respectively. 3) Serum levels of TNF-(348.0399.9o9pg/ml, p<0.005) & IL-1(94.8930.16pg/ml, p<0.02) at presentation in the group of neonatal sepsis with gram negative bacteria were significantly higher than those of the control group. 4) Serum levels of TNF-(78.125.88pg/ml) IL-1(74.6235.75pg/ml) at presentation in the group of neonatal sepsis with gram positive bacterial were higher than those of the control group, but, were not statistically significant. 5) Serum levels of TNF-(p<0.02) and IL-1 in the group of neonatal sepsis with gram negative bacteria were higher than those of the group0 with gram positive bacteria. 6) Changes in the serum levels of TNF- and Il-1 in the neonatal sepsis were not correlated with hemodynamic changes except the changes of IL-1 with changes of diastolic pressure which was standardized with birth weight(r=0.52). Conclusion : In conclusion, TNF- AND Il-1 levels are elevated in the neonates with sepsis, especially in gram negative bacterial infection. And incerased serum levels of TNF- & IL-1 might be caused by gram negative bacertial endotoxin.
Keywords: Neonatal sepsis | TNF- | IL-1
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