The significance of the cytokine system in the pathogenesis of perinatal complications in the neonate with very low and extremely low body weight
The objective. To study the role of interleukin (IL)-1 α, IL -6, IL-10, IL-1 receptor antagonist (IL-1RA) in the development of some perinatal complications in the neonate with very low and extremely low body weight. Patients and methods. Using the ELISA method the values of IL-1a, iL-6, IL-10, IL-1RA and cortisol in blood serum of 165 neonate with RDS, pneumonias (n = 80) and sepsis (n = 20) were studied. Results. As was found, cytokine concentrations in blood serum did not have any relation with the body weight and gestational age but depended on the character of perinatal complications. In patients with RDS, higher IL-10, IL-1RA concentrations (p = 0.001) and a negative correlation between the levels of IL-10 and cortisol (r = -0.45; p = 0.04) were observed against the background of enhanced IL-1a levels (p = 0.01). The neonates with pneumonias as compared with RDS were characterized by higher values of IL-1RA (p = 0.002), IL-10 (p = 0.0002) and IL-6 (p = 0.000) without a significant increase of IL-1a (p = 0.1) and a positive correlation between the levels of IL-6 and cortisol in blood serum (r = 0.45; p = 0.02). In patients with sepsis, high levels of IL-10 and IL-1RA, extremely low IL-6 concentrations and absence of correlation between the blood serum levels of cortisol and the cytokines under study were prognostically unfavorable. Conclusion. The significance of the cytokine system in the immunopathogenesis of perinatal complications is of mixed nature, their biological effects depend on their concentrations in the circulation and tissues. One of the key moments in realization and prognosis of an infectious process are cytokine-hormonal interactions.