A method for predicting neonatal infectious and inflammatory pathology

 

The invention relates to medicine, namely to Pediatrics, and can be used to predict local infectious-inflammatory disease in full-term newborns in the first month of life. The essence of the method lies in the fact that at the age of 5-7 days of life determine the CD4+CD95+ lymphocytes and when it is equal to 4.5% and more, predict the occurrence of infectious and inflammatory diseases in the neonatal period. The technical result is the ability to predict with high accuracy the local neonatal infectious and inflammatory pathology before the onset of clinical signs of disease. table 1.

The invention relates to medicine, namely to Pediatrics, and can be used to predict local infectious-inflammatory disease in full-term newborns in the first month of life.

The relevance of the method development is determined by a high frequency of infectious and inflammatory pathology in the structure of morbidity (proportion of local forms of purulent-inflammatory diseases 70-80%) newborns [7, 8]. A widely observed increase in the number of neonatal infections makes you the newborns [2] by defining in cord blood activity of serum lysozyme, when it is less than 40% predicted risk of non-specific infectious diseases in the first 7 days of a child's life.

Disadvantages of method 1. This method does not allow to determine the exact content of lysozyme, as only estimates of its relative activity.

2. The use of live culture bacteria in the reaction for the determination of serum lysozyme leads to a large number of false-negative results, as it is unstable and over time loses its activity.

3. When using this method, possible false-positive results, since the release of lysozyme can be caused by family stress.

4. The lack of data on the accuracy of the method.

A known method for the diagnosis of local forms of infectious-inflammatory disease in full-term newborns by examining indicators of the content in peripheral blood serum interleukin 6 (IL-6) enzyme-linked immunosorbent assay and immunoglobulin M (Ig M) by radial immunodiffusion [4], infectious and inflammatory pathology revealed a decline in IL-6 and increasing the level of Ig M

Disadvantages of method 1. Investigation of IL-6 and IgM is already developed for the diagnosis of neonatal infections, because Innova immune response [1].

2. No forecast is not possible to prevent infectious and inflammatory pathology.

3. It is impossible to talk about low levels of interleukin IL-6, because normal levels are from 0 to 50 IU/ml [1].

4. The high cost of the method used (the cost of the survey 1 child over 5 dollars).

5. Subjective evaluation of the content of IgM using radial immunodiffusion.

The closest technical solution is a method for predicting infectious-inflammatory diseases in premature infants by determination of IgE levels in the peripheral blood of newborns on the 3rd day of life and at the level of IgE over 3.5 IU/ml predict occurrence of infectious and inflammatory pathologies [3].

Disadvantages of method 1. Predicted neonatal infection in premature babies who are always present immunological disorders [6].

2. Increased levels of IgE in the blood is observed in parasitic infections, little is typical for newborns.

3. Increased levels of IgE observed in a number of immune disorders of genetic origin (dysgammaglobulinemia, the syndrome Wiskott-Aldrich and multiple myeloma), which reduces the accuracy of the method.

the TEW-reactive cells and its level in the blood is not increased.

These drawbacks are proposed to be eliminated in the present method.

The technical solution of the inventive method is forecasting a local infectious-inflammatory pathology neonatal period in full-term newborns by defining in the peripheral blood at 5-7-day lives of the relative content of CD4+CD95+ lymphocytes and their value 4.5% and over predict the occurrence of local neonatal infections in the first month of life with an accuracy of 90.0%.

The definition of CD95 molecules on the surface s+lymphocytes is regarded as an indicator of activated T-helper cells, is prepared to accept the signal from FasL molecules and go into apoptosis. Previously, the elevated levels of CD4+CD95+ observed in the blood of women with an internal endometriosis [5]. Probably, the high level of CD95 positive cells in children with developing in the neonatal period infectious pathology may be due to hyperactively the immune system of the fetus during prenatal development.

The novelty of the method Correlation of CD4+CD95+ lymphocytes in the blood of newborns at 5-7 day with the development of neonatal infections traced for the first time.

Distinctive features of the process Definition in the peripheral blood of full-term, nooroa parameter of 4.5% or more, when developing a local infectious-inflammatory pathology in children in the neonatal period.

The method is standard in the following way [9].

1) Isolation of lymphocytes from peripheral venous blood is carried out by a standard method.

2) 100 μl of lymphocytes in a concentration of 1106cells/ml are incubated with 20 μl of monoclonal anti-CD4, FITC labeled, and 20 μl of monoclonal anti-CD95, labeled D, for 30 minutes at room temperature in the dark, after which the cells washed 1 time with 1 ml of saline by centrifugation at 1500 rpm for 2 minutes. Cells resuspended in 500 μl of saline. The reaction accounting is performed on a flow cytometer, determining the percentage of CD4+CD95+ cells in the lymphocyte gate. The result is calculated by the device automatically.

The essence of the method is illustrated by the following examples.

Example 1. Baby A. was born from the first pregnancy occurring on the background of chronic pyelonephritis, complicated by the threat of miscarriage. Delivery at 40 weeks. Estimation on Apgar scale 8-9. Condition at birth satisfactory. On the 5th day in the peripheral blood was determined by the CD4+CD95+ cells, kotoroy pathology. Clinically the child is healthy. On the 15th day of life the child's condition worsened, shortness of breath, cyanosis of nasolabial triangle, acrocyanosis, auscultation of fine basal rales above the surface of the lungs. When x-ray examination revealed infiltrative shadows. Diagnosed with pneumonia of the newborn. The forecast for the claimed method was confirmed.

Example 2. The Century child was born from II pregnancy going on in the background anemia, complicated late preeclampsia, polyhydramnios. Delivery at 39 weeks. Estimation on Apgar scale 8-9. Condition at birth satisfactory. On the 5th day in the peripheral blood was determined by the CD4+CD95+ cells, which amounted to 4.5%, which corresponds to the declared parameter. The forecast of development of neonatal infectious-inflammatory diseases. 10 the day the child is palpable umbilical vein revealed hyperemia and swelling of the umbilical ring. Diagnosed with Phlebitis umbilical vein. The omphalitis. The forecast for the claimed method was confirmed.

Example 3. Baby K was born from the first pregnancy going on in the background vegetative-vascular dystonia of hypotonic type, complicated by the threat of miscarriage. Delivery at 39 weeks. Estimation on Apgar scale 8-9. Sostenitori was 1.9%, lower than the proposed option. Predicted the absence of neonatal infectious-inflammatory diseases. On the 5th day the child was discharged home. Upon further observation on the first month of life is infectious and inflammatory pathologies it is not revealed. The forecast for the claimed method was confirmed.

Advantages of method 1. The possibility of forecasting the local neonatal nfection-inflammatory pathology before the onset of clinical signs of disease.

2. Allows to carry out preventive measures to prevent or severe neonatal infection.

3. The inventive method does not require time-consuming and is 1 hour and 40 minutes

4. The proposed method has high accuracy of 90%.

In this way was examined 50 full-term newborns.

The results of the study are given in the table.

LITERATURE 1. Cetlinski S. A., Kalinina N. M. Immunology for clinicians // s-Pb. 1998 - S. 110.

2. Maltsev, O. A. a Method for predicting infectious diseases in newborns. Patent 2051386. - O. B. "Inventions". - 1995. - 36, II H. - S. 265.

3. Petrov A. M., Emelyanov, A., Zhernosek N. A. A method for predicting infectious-inflammatory Pat A. R. the state of the cytokine system and cellular immunity in infectious-inflammatory diseases in infants abstract. Diss. ... candles. the honey. Sciences. - M., 2002, to 23 C.

5. Sotnikova, N. Yu , Soloviev, A., Antsiferov Y. S., Bukina E. A. features of lymphocyte activation in systemic and local levels in women with internal endometriosis // Honey. immunology. - 1999. - T. 1. - 3-4. - S. 42-43.

6. Torubarov N. A., Koshel, I. C., Yatsyk, Century Blood of the fetus and newborn // M.: Medicine, - 1993. S. 95-117.

7. Shabalov N. P. Neonatology // SPb.: Special literature, 1 ton, 1995, 494 S.

8. Yatsyk, Century Manual of neonatology. M., 1998. 400 S.

9. Boyum A. Isolation of mononuclear cell and granulocytes from human blood and bone marrow // Scand. J. Clin. Lab. Invest. - 1968. - v.21. - 97. - p.77.

Claims

A method for predicting local forms of infectious-inflammatory diseases in term novorojdennyh by examining peripheral blood, characterized in that at the age of 5-7 days of life determine the CD4+CD95+ lymphocytes and when it is equal to 4.5% and more, predict the occurrence of infectious and inflammatory diseases in the neonatal period.

 

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FIELD: medicine, ophthalmology.

SUBSTANCE: in lacrimal liquid one should detect the content of interleukin 8 (IL-8) and that of interleukin 1 beta (IL-1β) to calculate prognostic coefficient (PC) due to dividing the first value by the second one by the following formula: At PC value being below 10.0 one should predict favorable disease flow, and at PC value being above 10.0 - unfavorable flow.

EFFECT: higher accuracy of prediction.

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