Soluble CD14 and neonatal sepsis

Neonatal sepsis is a common and life-threatening disorder. The purpose of this study is to measure soluble CD 14 level in sera from newborns with sepsis, to compare it with other markers, and to study its evolution in Gram negative and Gram positive sepsis. This study included twenty normal newborns as a control group and forty newborns suffering from neonatal septicemia, 26 babies had a positive blood culture [12 Gram positive [cocci] and 14 Gram negative[bacilli]] and 14 cases were suspected of having sepsis on clinical and laboratory findings but a negative blood culture. Soluble CD14 [sCD14], granulocyte-macrophage colony stimulating factor [GM-CSF], Interleukin-8 [IL-8] C-reactive protein [CRP] and Fi-bronectin were measured by enzyme immunoassay. Neonates suffering from septicemia had increased levels of sCD14 [4.47 +/- 1.13 micro mg/ml, P < 0.001], GM - CSF [7.18 +/- 1.5 pg/ml p <0.001], IL-8 [1.61+1.5 micro g/ml p< 0.001] and CRP [12.35 +/- 6.73mg/l p <0.001], and decreased values of Fibronectin [104.27 +/- 33.19mg/ ml P<0.001]. These levels were highly significant when compared with the control. Neonates with a positive blood culture had a significant increase in sCD14 level [5.01 +/- 0.96 micro g/ml] when compared with neonates suspected of having sepsis but with negative blood culture [3.47 +/- 0.60 micro g/ml P < 0.05]. Neonates with Gram-positive sepsis had increased level of sCD14 [4.21 +/- 0.5 [micro g/ml] and CRP [12.0 +/- 3.79 mg/L] which were highly significant [P<0.01, 0.01] Vs neonates with sepsis but with negative blood culture. Fibronectin showed a significant decrease [P<0.05] when both groups are compared [126.48 +/- 24.68 micro g/ ml Vs 86.65 +/- 45.38 micro g/ml] Neonates with Gram negative sepsis showed highly significant increase in both sCD14 level [5.69 +/- 0.67 micro g/ml Vs 3.47 +/- 0.60 micro g/ml] and CRP [18.8 +/- 5.39 Vs 6.14 +/- 2.8 mg/ L] when compared with neonates with sepsis but negative blood culture. SCD14 levels were positively correlated with CRP values in those patients. In conclusion, sCD14 level is increased in newborn infants with sepsis, and it is the most marker that can discriminate between Gram negative organisms. Gram positive organisms and no growth blood culture [F ratio = 24.291 p < 0.001]. The highest level of sCD14 was in Gram negative bacteria and the least was in no growth blood culture suggesting a different contributions of monocyte and macrophage cells in such cases

Apoptosis and chronic renal failure

Apoptosis or programmed cell death is an active from of cell death that is initiated by a number of stimuli and is complicatedely regulated Evidence suggests that apoptosis may play a role in the pathophysiology of immune system in ureania. Indeed accelerated programmed cell death has been observed in lymphocytes monocytes and polymorph nuclear leukocytes patients with chronic renal failure this study included thirty patients with chronic renal failure [Twenty patients haemodialysis treatment and ten on conservative treatment regimen] to evaluate the effect of apoptosis on immune system and its prognostic value with renal functions. Ten normal subjects were also included in this study as control group there is a significant increase in percent lymphocytes apoptosis in haemodialysis and conservative treatment patent vs the control subjects [P < 0.001] which correlates negatively with the decrease of Epidermal growth factor [EGF] [r-0.84-0.61 P < 0.05] and with the decrease in precent lymphocytes [r-0.68, -0.67 p<0.05]. There is a significant decrease in EGF creatinine clearance [C.C.]% lymphocytes% CD19 and CD8 cells in haemodialysis and conservative treatment patients Vs the control subjects [P <0.001, 0.01]. While CD4 decreases significantly in haemodialysis patients only Vs the control subjects [p<0.001] The decrease in C.C., CD 8, CD4 and CD19 correlates inversely with the increase in apoptosis in haemodialysis patients [r-0.76,- 0.76,- 0.76,- 0.7 p<0.05]. The decrease in EGF and C.C. correlates positively with the decrease in CD4 [r 0.73, 0. 65 P <0.05] CD8 [r.0.8, 0.75 p < 0.01] and CD19 [r.0.79, 0.88 p<0.01] in both patients groups. So, there an increase in programmed cell death in lymphocytes subtypes among patients with chronic renal failure. This may be due to the retention of uraemic toxins, and can lead to immune dysfunction in uraemia. These observations may have prognostic and therapeutic implications: in chronic renal failure