Document Detail


Serum soluble ICAM-1, VCAM-1, L-selectin, and P-selectin levels as markers of infection and their relation to clinical severity in neonatal sepsis.
MedLine Citation:
PMID:  17564956     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Adhesion molecules may play a role in the evolution and severity of neonatal sepsis. The purposes of this study were to determine whether serum soluble intercellular adhesion molecule (ICAM)-1, vascular cell adhesion molecule (VCAM)-1, L-selectin, and P-selectin levels are useful tools in the diagnosis of proven sepsis in newborn infants, and whether their levels are related to the clinical severity of the disease. A cohort of 25 consecutive newborns meeting criteria for clinical sepsis, 10 hemoculture-negative (HC - ) and 15 hemoculture-positive (HC + ), were prospectively followed and compared with 12 healthy newborns (six </= 38 weeks of gestational age and six >/= 39 weeks). Serum soluble (s)ICAM-1, sVCAM-1, sL-selectin, and sP-selectin concentrations were measured at the time of the septic workup, then followed by up to three determinations in each newborn every third day. The Score for Neonatal Acute Physiology (SNAP)-II severity was assessed at the moment of highest clinical severity of the disease. At the beginning of sepsis, sICAM-1 levels increased in both groups, being higher in HC + sepsis than in HC - ; sVCAM-1 only increased slightly in HC + sepsis. Soluble ICAM-1 levels were independently related to group of sepsis, and not to days of life. The best initial sICAM-1 cutoff level for diagnosing HC + neonatal sepsis was 274 microg/L. The highest sICAM-1 levels were positively correlated with SNAP-II scores. Soluble L-selectin and sP-selectin did not change. Soluble ICAM-1 levels increased in HC - and HC + sepsis, but concentrations > 274 microg/L suggest HC + sepsis. These levels were related to the clinical severity of the disease. Soluble VCAM-1 levels increased only slightly in HC + sepsis. Soluble L-selectin and sP-selectin did not change.
Authors:
José Figueras-Aloy; Lilian Gómez-López; José-Manuel Rodríguez-Miguélez; M Dolors Salvia-Roiges; Iolanda Jordán-García; Inmaculada Ferrer-Codina; Xavier Carbonell-Estrany; Rafael Jiménez-González
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Publication Detail:
Type:  Journal Article     Date:  2007-06-12
Journal Detail:
Title:  American journal of perinatology     Volume:  24     ISSN:  0735-1631     ISO Abbreviation:  Am J Perinatol     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-28     Completed Date:  2007-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  331-8     Citation Subset:  IM    
Affiliation:
Servicio Neonatología, Institut Clínic de Ginecologia, Obstetrícia i Neonatologia, Spain.
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MeSH Terms
Descriptor/Qualifier:
C-Reactive Protein / analysis
Health Status Indicators
Humans
Infant, Newborn
Intercellular Adhesion Molecule-1 / blood*
L-Selectin / blood*
P-Selectin / blood*
ROC Curve
Sensitivity and Specificity
Sepsis / blood*
Severity of Illness Index
Shock, Septic / blood*
Vascular Cell Adhesion Molecule-1 / blood*
Chemical
Reg. No./Substance:
0/P-Selectin; 0/Vascular Cell Adhesion Molecule-1; 126547-89-5/Intercellular Adhesion Molecule-1; 126880-86-2/L-Selectin; 9007-41-4/C-Reactive Protein

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