Increased plasma concentrations of interleukin-1 receptor antagonist in neonatal sepsis

• Published in: Pediatric research Vol. 37; no. 5; pp. 626 - 629
• Main Authors: DE BONT, E. S. J. M, DE LEIJ, L. H. F. M, OKKEN, A, BAARSMA, R, KIMPEN, J. L. L
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.05.1995
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Female; Humans; Infant; Infant, Newborn; Intensive care medicine; Male; Medical sciences; Receptors, Interleukin-1 - metabolism; Sepsis - immunology; Human; Newborn; Pathophysiology; Septicemia; Mortality; Cytokine; Interleukin 1; Antagonist; Concentration; Morbidity; Blood plasma; Biological receptor
• ISSN: 0031-3998; 1530-0447
• DOI: 10.1203/00006450-199505000-00012

Newborns are prone to severe infections and sepsis. Cytokines such as tumor necrosis factor-alpha and IL-1 beta play a major role in the initiation of the host response to infections. IL-1 receptor antagonist (IL-1ra) is a naturally occurring antagonist of IL-1 beta. We hypothesized that low IL-1ra plasma concentrations might contribute to the high morbidity and mortality of neonatal sepsis. We studied IL-1ra plasma concentrations during neonatal sepsis. Eleven newborns with severe infection or sepsis, 28 newborns suspected as having sepsis, and eight healthy newborns were enrolled in the study. IL-1ra plasma concentrations proved to be increased in the newborns with severe infections or sepsis (5635 +/- 411 ng/L) versus the concentrations in the suspected group (2597 +/- 433 ng/L) and the control group (273 +/- 88 ng/L) (p < 0.001). After the start of antibiotic therapy, the IL-1ra plasma concentrations remained high during the first 16 h. The IL-1 beta plasma concentrations were increased in the group with a proven infection (78 +/- 27 ng/L) versus the suspected group (37 +/- 7 ng/L) (p < 0.05). Interestingly, the mean Il-1RA plasma concentration is a factor 50-100 higher than the IL-1 beta plasma concentrations. We conclude that IL-1ra in newborns is produced in an amount equal to that in adults. An inadequate IL-1ra response does not seem to contribute to the increased morbidity and mortality of neonatal sepsis.