scholarly journals Docosahexaenoic Acid and Arachidonic Acid Levels Are Associated with Early Systemic Inflammation in Extremely Preterm Infants

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1996 ◽  
Author(s):  
Ann Hellström ◽  
William Hellström ◽  
Gunnel Hellgren ◽  
Lois E. H. Smith ◽  
Henri Puttonen ◽  
...  
Keyword(s):  
Arachidonic Acid ◽  
Docosahexaenoic Acid ◽  
Cord Blood ◽  
Correlation Coefficient ◽  
Preterm Infants ◽  
Systemic Inflammation ◽  
Serum Levels ◽  
Postnatal Period ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Fetal and early postnatal inflammation have been associated with increased morbidity in extremely preterm infants. This study aimed to demonstrate if postpartum levels of docosahexaenoic acid (DHA) and arachidonic acid (AA) were associated with early inflammation. In a cohort of 90 extremely preterm infants, DHA and AA in cord blood, on the first postnatal day and on postnatal day 7 were examined in relation to early systemic inflammation, defined as elevated C-reactive protein (CRP) and/or interleukin-6 (IL-6) within 72 h from birth, with or without positive blood culture. Median serum level of DHA was 0.5 mol% (95% CI (confidence interval) 0.2–0.9, P = 0.006) lower than the first postnatal day in infants with early systemic inflammation, compared to infants without signs of inflammation, whereas levels of AA were not statistically different between infants with and without signs of inflammation. In cord blood, lower serum levels of both DHA (correlation coefficient −0.40; P = 0.010) and AA (correlation coefficient −0.54; p < 0.001) correlated with higher levels of IL-6. Levels of DHA or AA did not differ between infants with and without histological signs of chorioamnionitis or fetal inflammation. In conclusion, serum levels of DHA at birth were associated with the inflammatory response during the early postnatal period in extremely preterm infants.

Safety of Allogenic Human Cord Blood Derived Mononuclear Cells for Extreme Preterms Infants at High Risk of Death: A Descriptive Study

2020 ◽  
Author(s):  
Jia Chen ◽  
Yabo Mei ◽  
Xue Du ◽  
Qiuping Li ◽  
Zizhen Wang ◽  
...  
Keyword(s):  
High Risk ◽  
Cord Blood ◽  
Preterm Infants ◽  
Mononuclear Cells ◽  
Human Umbilical Cord ◽  
Risk Of Death ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Risk Potential

Abstract Backgroud Extreme preterm infants are at a high risk for developing preterm complications and death. Despite advances in medical care, many survivors face a lifetime of disability. Objective To assess the short term safety of and four-year follow-up outcomes of allogenic, human umbilical cord blood (hUCB) derived mononuclear cells(MNCs) infusion to extreme preterm infants with high risk potential of death. Method This study was a phase I, open-label, single-arm, single-center trial to evaluate the safety of allogenic, hUCB-MNCs infusion for extreme preterm infants with high risk potential of death. HUCB MNCs characteristics, pre- and postinfusion vital signs and laboratory investigations were recorded. Temporal profiles of cytokines and growth factors from blood were test. Clinical data including mortality rates, preterm complications and follow-up outcomes were recorded. Results After processing, relatively MNCs mean (1.9±0.8) ×106/kg; volume mean (11.25±2.12)ml/kg were infused to 10 extremely preterm infants with high risk of death. No adverse effects were noticed during treatment. 40% received extubation and weaned to nasal CPAP successfully; 30% received lower FiO2; no infants suffered from late onset sepsis; 30% received poor response to MNCs infusion. 40% infants suffered from ROP and only one infant needed laser surgery. No patients suffered from NEC after MNCs infusion. All ten infants who received hUCB MNCs infusion survived inhospital and prevent deterioration of clinical features, but 4 infants discharged against the advice of the doctor by their parents and lost connection. Regarding the rest 6 infants, no home oxygen therapy and rehospitalization, no suffered from other long-term respiratory complications at visit 1～visit 3. One infant showed cerebral palsy at visit 1, no clinical evidence associated this with MNCs infusion. Blood level of HGF significantly increased, but MMP-9, IL-6, IL-8, TNF-α and TGF-β levels were significantly lower at 24h post infusion compared with baseline (P < 0.05).Conclusions Collection, preparation, and infusion of allogenic hUCB MNCs to extreme preterm infants is feasible and safe. Trial registration The study was registered on Chinese Clinical Trials.gov (NO. ChiCTR–OPN - 15006932). Registered 17 August 2015, http://www.chictr.org.cn/edit.aspx?pid=11662&htm=4.

scholarly journals Systemic inflammation associated with mechanical ventilation among extremely preterm infants

Cytokine ◽  
2013 ◽  
Vol 61 (1) ◽  
pp. 315-322 ◽  
Author(s):  
Carl L. Bose ◽  
Matthew M. Laughon ◽  
Elizabeth N. Allred ◽  
T. Michael O’Shea ◽  
Linda J. Van Marter ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Preterm Infants ◽  
Systemic Inflammation ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

scholarly journals Systemic Inflammation and Cerebral Palsy Risk in Extremely Preterm Infants

2014 ◽  
Vol 29 (12) ◽  
pp. 1692-1698 ◽  
Author(s):  
Karl C. K. Kuban ◽  
T. Michael O’Shea ◽  
Elizabeth N. Allred ◽  
Nigel Paneth ◽  
Deborah Hirtz ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Preterm Infants ◽  
Systemic Inflammation ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

scholarly journals Association of Docosahexaenoic Acid and Arachidonic Acid Serum Levels With Retinopathy of Prematurity in Preterm Infants

2021 ◽  
Vol 4 (10) ◽  
pp. e2128771
Author(s):  
Ann Hellström ◽  
Aldina Pivodic ◽  
Lotta Gränse ◽  
Pia Lundgren ◽  
Ulrika Sjöbom ◽  
...  
Keyword(s):  
Arachidonic Acid ◽  
Docosahexaenoic Acid ◽  
Preterm Infants ◽  
Retinopathy Of Prematurity ◽  
Serum Levels

scholarly journals A Randomized Trial of Maternal Docosahexaenoic Acid Supplementation to Reduce Inflammation in Extremely Preterm Infants

2019 ◽  
Vol 69 (3) ◽  
pp. 388-392 ◽  
Author(s):  
Christina J. Valentine ◽  
Kelly A. Dingess ◽  
Jeanne Kleiman ◽  
Ardythe L. Morrow ◽  
Lynette K. Rogers
Keyword(s):  
Docosahexaenoic Acid ◽  
Randomized Trial ◽  
Preterm Infants ◽  
Acid Supplementation ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Cord blood procalcitonin level and early-onset sepsis in extremely preterm infants

2019 ◽  
Vol 38 (9) ◽  
pp. 1651-1657
Author(s):  
Alice Frerot ◽  
Olivier Baud ◽  
Marina Colella ◽  
Ludmia Taibi ◽  
Stéphane Bonacorsi ◽  
...  
Keyword(s):  
Cord Blood ◽  
Preterm Infants ◽  
Early Onset ◽  
Procalcitonin Level ◽  
Early Onset Sepsis ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

scholarly journals Cord Blood Cytokine Levels Correlate With Types of Placental Pathology in Extremely Preterm Infants

2021 ◽  
Vol 9 ◽  
Author(s):  
Hussein Zein ◽  
Khorshid Mohammad ◽  
Lara M. Leijser ◽  
Marie-Anne Brundler ◽  
Adam Kirton ◽  
...  
Keyword(s):  
Cord Blood ◽  
Preterm Infants ◽  
Placental Pathology ◽  
Term Infants ◽  
Group V ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Cytokine Levels ◽  
Post Hoc ◽  
Temporal Profiles

Background: Placental abnormalities are associated with inflammation and have been linked to brain injury in preterm infants. We studied the relationship between placental pathology and the temporal profiles of cytokine levels in extremely pre-term infants.Study Design: We prospectively enrolled 55 extremely preterm infants born between June 2017 and July 2018. Levels of 27 cytokines were measured in blood drawn from the umbilical artery at birth and from infants at 1–3 and 21–28 days of life. Placental pathology was grouped as normal (N), inflammation (I), vasculopathy (V), or combined vasculopathy and inflammation (V+I).Results: Complete data was available from 42 patients. Cord blood median levels of cytokines differed between groups with the highest levels observed in group V+I as compared to groups N, I and V for the following: Eotaxin (p = 0.038), G-CSF (p = 0.023), IFN-γ (p = 0.002), IL-1ra (p &lt; 0.001), IL-4 (p = 0.005), IL-8 (p = 0.010), MCP-1 (p = 0.011), and TNFα (p = 0.002). Post-hoc analysis revealed sex differences between and within the placental pathology groups.Conclusion: Specific types of placental pathology may be associated with differential cytokine profiles in extremely pre-term infants. Sampling from cord blood may help assess the pathological status of the placenta and potentially infer outcome risks for the infant.

scholarly journals Feasibility of Umbilical Cord Blood Collection in Neonates at Risk of Brain Damage—A Step Toward Autologous Cell Therapy for a High-risk Population

2021 ◽  
Vol 30 ◽  
pp. 096368972199206
Author(s):  
Angela Segler ◽  
Thorsten Braun ◽  
Hendrik Stefan Fischer ◽  
Ricarda Dukatz ◽  
Claire-Rachel Weiss ◽  
...  
Keyword(s):  
High Risk ◽  
Cord Blood ◽  
Cell Count ◽  
Brain Damage ◽  
Preterm Infants ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Intensive Training ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

Evidence for umbilical cord blood (UCB) cell therapies as a potential intervention for neurological diseases is emerging. To date, most existing trials worked with allogenic cells, as the collection of autologous UCB from high-risk patients is challenging. In obstetric emergencies the collection cannot be planned. In preterm infants, late cord clamping and anatomic conditions may reduce the availability. The aim of the present study was to assess the feasibility of UCB collection in neonates at increased risk of brain damage. Infants from four high-risk groups were included: newborns with perinatal hypoxemia, gestational age (GA) ≤30 + 0 weeks and/or birthweight <1,500 g, intrauterine growth restriction (IUGR), or monochorionic twins with twin-to-twin transfusion syndrome (TTTS). Feasibility of collection, quantity and quality of obtained UCB [total nucleated cell count (TNC), volume, sterility, and cell viability], and neonatal outcome were assessed. UCB collection was successful in 141 of 177 enrolled patients (hypoxemia n = 10; GA ≤30 + 0 weeks n = 54; IUGR n = 71; TTTS n = 6). Twenty-six cases were missed. The amount of missed cases per month declined over the time. Volume of collected UCB ranged widely (median: 24.5 ml, range: 5.0–102 ml) and contained a median of 0.77 × 108 TNC (range: 0.01–13.0 × 108). TNC and UCB volume correlated significantly with GA. A total of 10.7% (19/177) of included neonates developed brain lesions. To conclude, collection of UCB in neonates at high risk of brain damage is feasible with a multidisciplinary approach and intensive training. High prevalence of brain damage makes UCB collection worthwhile. Collected autologous UCB from mature neonates harbors a sufficient cell count for potential therapy. However, quality and quantity of obtained UCB are critical for potential therapy in preterm infants. Therefore, for extremely preterm infants alternative cell sources such as UCB tissue should be investigated for autologous treatment options because of the low yield of UCB.

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