Preterm Bebeklerde Umbilikal Kord Kanı İnterferon γ ile Uyarılabilen Protein-10 (IP-10) Düzeyleri ile Klinik ve Laboratuvar Parametreleri Arasındaki İlişki

Year 2024, , 145 - 151, 18.12.2024

Ulviye Kırlı , Ener Cagri Dınleyıcı , Neslihan Tekın , Arif Aksıt

https://doi.org/10.47572/muskutd.1487183

Abstract

İnterferon γ ile uyarılabilen protein-10 (IP-10) güçlü inflamatuar mediatörlerden biridir. Çalışmamızda antenatal erken membran rüptürü (PPROM), fetal inflamatuar yanıt sendromu (FIRS) ve prematüreliğe bağlı morbiditeleri olan veya olmayan prematüre bebeklerde kordon kanı IP-10 düzeylerinin karşılaştırılması amaçlanmıştır. 37. gebelik haftasının altında doğan 85 prematüre bebek çalışmaya dahil edildi. Doğum anında umbilikal korddan alınan kan örneklerinde ELİSA yöntemi ile interlökin (IL)-6 ve IP-10 düzeyleri ölçüldü. Tüm olgularda prematüreliğe bağlı gelişebilecek komplikasyonlar (respiratuar distres sendromu, erken ve geç başlangıçlı sepsis, nekrotizan enterokolit, intraventriküler kanama, prematüre retinopatisi, bronkopulmoner displazi) ve mortalite kaydedildi. Kordon kanında 11 pg/ml üzerinde olan IL-6 düzeyleri FIRS olarak kabul edildi. PPROM’lu grupta (n=27, %31.8) kordon kanında medyan IP-10 seviyesi diğer gruplara göre anlamlı derecede yüksek bulundu (IP-10=345.6 pg/ml vs. 28.3 pg/ml, p<0.001). FIRS saptanan olgularda (n=36, %42.4) kordon kanında medyan IP-10 düzeyi FIRS saptanmayanlara göre anlamlı derecede yüksek saptandı (p<0.001). Erken başlangıçlı sepsis gelişen olgularda da kordon kanında medyan IP-10 seviyesi anlamlı derecede yüksek idi (p=0.019). Prematüreliğe bağlı diğer morbiditeler ile kordon kanı IP-10 düzeyi arasında anlamlı bir ilişki bulunamadı. Çalışmamızda fetal inflamasyonu olan ve erken başlangıçlı sepsis gelişen prematüre bebeklerde kordon kanında IP-10 seviyelerinin yüksek olduğu saptanmıştır. Kordon kanında yüksek IP-10 seviyesi, neonatal sepsis gelişen/gelişecek prematüre bebeklerde intrauterin inflamasyonu göstermek için erken bir belirteç olarak kullanılabilir.

Keywords

Fetal İnflamatuar Yanıt Sendromu, İnflamasyon, İnterferon γ İle Uyarılabilen Protein-10, Prematürite, Sepsis

The Relationship Between Umbilical Cord Blood Interferon γ-Inducible Protein-10 (IP-10) Levels and Clinical and Laboratory Parameters in Preterm Infants

Abstract

Interferon γ-inducible protein-10 (IP-10) is one of the potent inflammatory mediators. This research aims to compare cord blood IP-10 levels in preterm infants with or without antenatal preterm prelabor rupture of the membranes (PPROM), fetal inflammatory response syndrome (FIRS) and prematurity related morbidities. We enrolled 85 newborns with gestational age below 37 weeks. Umbilical cord blood samples were obtained at delivery and stored. Cord blood IP-10 and interleukin (IL)-6 levels measured with ELISA test. All enrolled preterm infants have been followed-up for prematurity related conditions including respiratory distress syndrome, early and late onset sepsis, necrotising enterocolitis, intraventricular haemorrhage, premature retinopathy, bronchopulmonary dysplasia and mortality. FIRS defined as IL-6 levels of umbilical cord above 11 pg/ml. Cord blood median IP-10 levels were significantly higher in PPROM group (n=27, 31.8%) than in the group without PPROM (IP-10=345.6 pg/ml vs. 28.3 pg/ml, p<0.001). Cord blood median IP-10 levels were significantly higher in preterm infants with FIRS (n=36, 42.4%) compared to infants without FIRS (p<0.001). Cord blood median IP-10 levels were also higher in preterm infants with early onset sepsis than those without early onset sepsis (p=0.019). We did not observe relationship between cord blood IP-10 levels and other prematurity-related complications. Increased cord blood IP-10 levels have been observed in preterm infants with fetal inflammation and who developed early onset sepsis. Cord blood IP-10 could be considered an early marker for intrauterine inflammation and its effect on fetal outcomes, such as the development of neonatal sepsis in preterm infants.

Keywords

Fetal Inflammatory Response Syndrome, Inflammation, Interferon γ-inducible Protein-10, Prematurity, Sepsis

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