Role of umbilical interleukin-6, procalcitonin and C-reactive protein measurement in the dia gnosis of fetal inflammatory response syndrome

2021 ◽  
Vol 86 (2) ◽  
pp. 80-85
Author(s):  
Zbyněk Straňák ◽  
◽  
Ivan Berka ◽  
Jan Širc ◽  
Jan Urbánek ◽  
...  

Overview Objective: Fetal Inflammatory Response Syndrome (FIRS) is a serious complication accompanied by increased neonatal mortality and morbidity. Early dia­gnosis of FIRS is essential to detect high risk infants. The aim of the study was to evaluate the correlation between interleukin-6 
(IL-6), procalcitonin (PCT), C-reactive protein (CRP) in cord blood and histologically proven funisitis/ chorioamnionitis in high-risk infants after preterm birth. Methods: Blood sampling for the measurement of inflammatory bio­markers was performed immediately after placental delivery and umbilical cutting. Umbilical and placental inflammatory changes were assessed using a recently released scoring system (Amsterdam Placental Workshop Group Consensus). Results: One hundred preterm infants (30.5 ± 2.5 gestational week, birth weight 1,443 ± 566 grams) and 21 health term infants were analyzed. Histologic chorioamnionitis was confirmed in 19% cases and chorioamnionitis with funisitis in 7% cases. Thirty-three infants (33%) fulfilled criteria of FIRS (funistis and/ or umbilical IL-6 > 11 ng/ L). The presence of FIRS correlated significantly with maternal leukocytosis (P < 0.001), preterm premature rupture of membrane (P < 0.001) and preterm uterine contraction (P < 0.0001). In comparison to preterm and healthy term infants we found statistically significant higher levels of umbilical inflammatory bio­markers (IL-6, PCT, CRP) in FIRS group (P < 0.0001). Composite mortality and morbidity (bronchopulmonary dysplasia, intraventricular haemorrhage, periventricular leukomalacia) was higher in FIRS group (28.1 vs 22.4% in preterm group). However, the difference was not statistically significant (P = 0.53). Conclusion: Our study confirmed the correlation of umbilical inflammatory bio­markers levels (IL-6, PCT, CRP) and the presence of FIRS. We did not find significant adverse impact of FIRS on neonatal mortality and morbidity. Nevertheless, our results could be influenced by the size of study group and strict inclusion criteria (only cases after C-section were analyzed). Keywords: fetal inflammatory response syndrome – neonatal mortality – morbidity – interleukin-6 – C-reactive protein – procalcitonin – chorioamnionitis and funisitis

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Lívia Helena M. Pereira ◽  
Juliana R. Machado ◽  
Janaínna G. P. Olegário ◽  
Laura P. Rocha ◽  
Marcos V. Silva ◽  
...  

Anatomopathologic studies have failed to define the fetal inflammatory response syndrome (FIRS) as a cause of fetal death. Here, liver fragments of perinatal autopsies were collected at a university hospital from 1990 to 2009 and classified according to the cause of death, perinatal stress, and gestational age (GA) of the fetus. IL-6, TNF-α, and C-reactive protein (CRP) expression were immunostained, respectively, with primary antibody. Cases with congenital malformation, ascending infection, and perinatal anoxia showed increased IL-6, CRP, and TNF-α, respectively. Prematures presented higher expression of IL-6 whereas term births showed higher expression of CRP. Cases classified as acute stress presented higher expression of IL-6 and TNF-αand cases with chronic stress presented higher expression of CRP. GA correlated negatively with IL-6 and positively with CRP and TNF-α. Body weight correlated negatively with IL-6 and positively with CRP and TNF-α. Despite the diagnosis of FIRS being clinical and based on serum parameters, the findings in the current study allow the inference of FIRS diagnosis in the autopsied infants, based on anin situliver analysis of these markers.


1999 ◽  
Vol 96 (3) ◽  
pp. 287-295 ◽  
Author(s):  
Annika TAKALA ◽  
Irma JOUSELA ◽  
Klaus T. OLKKOLA ◽  
Sten-Erik JANSSON ◽  
Marjatta LEIRISALO-REPO ◽  
...  

Criteria of the systemic inflammatory response syndrome (SIRS) are known to include patients without systemic inflammation. Our aim was to explore additional markers of inflammation that would distinguish SIRS patients with systemic inflammation from patients without inflammation. The study included 100 acutely ill patients with SIRS. Peripheral blood neutrophil and monocyte CD11b expression, serum interleukin-6, interleukin-1β, tumour necrosis factor-α and C-reactive protein were determined, and severity of inflammation was evaluated by systemic inflammation composite score based on CD11b expression, C-reactive protein and cytokine levels. Levels of CD11b expression, C-reactive protein and interleukin-6 were higher in sepsis patients than in SIRS patients who met two criteria (SIRS2 group) or three criteria of SIRS (SIRS3 group). The systemic inflammation composite score of SIRS2 patients (median 1.5; range 0–8, n = 56) was lower than that of SIRS3 patients (3.5; range 0–9, n = 14, P = 0.013) and that of sepsis patients (5.0; range 3–10, n = 19, P< 0.001). The systemic inflammation composite score was 0 in 13/94 patients. In 81 patients in whom systemic inflammation composite scores exceeded 1, interleukin-6 was increased in 64 (79.0%), C-reactive protein in 59 (72.8%) and CD11b in 50 (61.7%). None of these markers, when used alone, identified all patients but at least one marker was positive in each patient. Quantifying phagocyte CD11b expression and serum interleukin-6 and C-reactive protein concurrently provides a means to discriminate SIRS patients with systemic inflammation from patients without systemic inflammation.


2015 ◽  
Vol 86 (12) ◽  
Author(s):  
Daiva Bartkevičienė ◽  
Ingrida Pilypienė ◽  
Diana Ramašauskaitė ◽  
Jolita Zakarevičienė ◽  
Dalia Laužikienė ◽  
...  

2002 ◽  
Vol 102 (3) ◽  
pp. 279-286
Author(s):  
A. BUNESCU ◽  
J. WIDMAN ◽  
R. LENKEI ◽  
P. MENYES ◽  
K. LEVIN ◽  
...  

Platelets and leucocytes are important effector cells of the haemostatic and inflammatory responses to tissue injury. To investigate the effects of surgical trauma on platelet activation (assessed by measuring levels of P-selectin and β-thromboglobulin), leucocyte activation (CD11b expression) and leucocyte-platelet interactions (leucocyte-platelet complexes), 30 patients undergoing primary hip arthroplasty were studied before and at the end of surgery, and on days 1 and 10 post-operatively, using a whole-blood flow cytometry assay. The inflammatory response was followed by measurement of the levels of C-reactive protein and interleukin-6 in plasma, and the activation of coagulation was monitored by determination of prothrombin fragment 1+2 levels. On day 1 post-operatively a significantly increased expression of CD11b on monocytes was noted, but no direct correlation was found between monocyte activation and interleukin-6 production or C-reactive protein at this time point. The percentage of monocyte-platelet and neutrophil-platelet complexes was markedly increased on day 10 post-operatively compared with pre-operative levels, and levels of these complexes were significantly positively correlated with β-thromboglobulin levels. Activation of coagulation (prothrombin fragment 1+2) on day 10 post-operatively was positively correlated with the extent of surgical trauma (duration of surgery, amount of blood loss) and with the increase in platelet activation (β-thromboglobulin). In conclusion, hip arthroplasty induces platelet and coagulation activation, and also an inflammatory response that is maintained for more than 10 days post-operatively. This indicates an interaction between the immune and the haemostatic systems in the post-operative phase after hip arthroplasty.


2013 ◽  
Vol 64 (5) ◽  
pp. 488-495 ◽  
Author(s):  
Megan L. Salter ◽  
Bryan Lau ◽  
Shruti H. Mehta ◽  
Vivian F. Go ◽  
Sean Leng ◽  
...  

Cytokine ◽  
2011 ◽  
Vol 53 (3) ◽  
pp. 342-346 ◽  
Author(s):  
Hidenori Nishida ◽  
Takeshi Horio ◽  
Yoshihiko Suzuki ◽  
Yoshio Iwashima ◽  
Takeshi Tokudome ◽  
...  

2004 ◽  
Vol 13 (5-6) ◽  
pp. 377-380 ◽  
Author(s):  
Leszek Tylicki ◽  
Bogdan Biedunkiewicz ◽  
Dominik Rachon ◽  
Tomasz Nieweglowski ◽  
Lukasz Hak ◽  
...  

BACKGROUND: Ozone as a strong oxidant may induce an inflammatory response.Aim: The hypothesis was verified as to whether ozonated autohemotherapy using an ozone dose in therapeutic range changes the plasma concentration of C-reactive protein and interleukin-6, markers of inflammation.Methods: In a controlled, single-blind, cross-over study, 12 chronically hemodialyzed patients with peripheral arterial disease were exposed to nine sessions of autohemotherapy with blood exposure to oxygen as a control followed by nine sessions of ozonated autohemotherapy with an ozone concentration of 50 μg/ml.Results: There was no statistical difference between C-reactive protein levels at baseline (1.53±1.01 mg/l), after nine sessions of control autohemotherapy (1.48±0.96 mg/l), and after nine sessions of ozonated autohemotherapy (1.55±0.84 mg/l). There was also no statistical difference between the interleukin-6 serum concentration at baseline (438±118 pg/ml), after nine sessions of control autohemotherapy (444±120 pg/ml), and after nine sessions of ozonated autohemotherapy (466±152 pg/ml).Conclusion: The results of this study suggest that ozonated autohemotherapy using an ozone concentration of 50 μg/ml does not induce an inflammatory response.


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