[The influence of delivery and perinatal risk factors on the concentration of cystatine C in umbilical cord blood]. / Wplyw porodu i czynników ryzyka okoloporodowego na stezenie cystatyny C we krwi pepowinowej.

UNLABELLED: Cystatin C--a low molecular protein, recognized as a sensitive marker of glomerular filtration rate and inhibitor of the lisosomal proteolitic enzymes in the organism. It is produced continuously and released to biological fluids. The concentration of cystatin C in the cord blood is higher and more diverse than in the peripheral blood with children and adults. THE AIM OF THIS STUDY: To determinate the range of the concentrations cystatin C in the umbilical cord blood and to research the influence of delivery and perinatal risk factors on concentration of cystatin C in cord blood. MATERIAL AND METHODS: The study included 444 newborns born by spontaneous deliveries and cesarean sections. In both subgroups, term neonates, preterm and some amount of newborns with additional perinatal risk factors (hipotrofia, infection, asphyxia) were found. Clinical evaluation, blood tests and USG examination were performed. Blood cord samples were analyzed entirely in the neonates with normal USG image of urinary tract was normal. RESULTS: The mean cystatine C concentration in umbilical cord blood were 1.65 +/- 0.44 mg/l. There were not differences in the mean cystatin C concentration between term and preterm newborns without additional risk factors. The most important factor influencing cystatin C concentration appeared to be the kind of delivery In neonates born by spontaneous delivery mean cystatin C concentration was significantly higher (1.82 mg/l) than in neonates born by cesarean sections (1.48 mg/l). Mean cystatin C concentration was strongly correlated with a lactic acid concentration and a length of delivery. CONCLUSIONS: Statistically higher concentrations of cystatine C were found in neonates born by spontaneous delivery. Laktacidemia is probably one of the factors responsible for elevation of cystatin C concentration in the cord blood. Higher cystatine C level can be recognized as a mechanism protecting the neonate from local or/and systemic proteolytic activity.

Risk of allergy development correlates with IL-4 receptor expression on newborns' monocytes and Th lymphocytes.

BACKGROUND: IL-4 receptor (IL-4R) overexpression on immunoregulatory/effector cells was found in allergic patients. However, its role in allergy development remains unclear. The aim of this study was to assess the correlation between IL-4R expression and allergy development within the first year of life. MATERIAL/METHODS: IL-4R expression on monocytes and Th lymphocytes of 43 newborns was analyzed using flow cytometry. Plasma levels of IL-4, -12 and IFN-gamma were also measured using ELISA. The same parameters were assessed one year later. Furthermore, clinical evaluation was performed every three months for one year. RESULTS: Mean IL-4R expression on monocytes and Th lymphocytes did not differ at birth. After one year it increased on Th-lymphocytes and decreased on monocytes. However, among 10 children with severe atopy during the observation period, 8 displayed IL-4R above the mean value for the group on both monocytes and Th cells at birth as well as one year later. No correlation was found between IL-4 or IFN-gamma and IL-4R expression at birth. After one year, significant IL-4 increases and IFN-gamma decreases were observed which correlated with IL-4R expression. IL-4R expression on the newborns' monocytes correlated negatively with IL-12 plasma level; however, it was statistically significant only in the children developing allergy. Moreover, only in these patients was a significant decrease in IL-12 found after one year. CONCLUSIONS: IL-4R-dependent over-signaling in newborns' monocytes and Th lymphocytes could contribute to Th1/Th2 imbalance. IL-4R overexpression on newborns' monocytes and lymphocytes could be an early risk marker of allergy development.