Affiliations: Department of Neonatology, Ain Shams University,
Cairo, Egypt | Department of Pediatric Immunology, Ain Shams
University, Cairo, Egypt | Department of Clinical Pathology, Ain Shams
University, Cairo, Egypt | Neonatology Unit, Benha Children's Hospital, Cairo,
Egypt
Note: [] Corresponding author: Ghada Ibrahim Gad, MD, Ain Shams
University Children's Hospital, Abbaseya, Cairo, Egypt. Tel.: +2 012 378 6879;
E-mail: ghadawael2006@yahoo.com
Abstract: Objectives: To evaluate CD11b expression by neutrophils in the first
12 hours of life in preterm newborns with respiratory distress syndrome (RDS)
as a marker of systemic inflammation and an indicator for severity of illness.
Subjects and methods: In this prospective case-control study,
we obtained peripheral blood samples from subjects during the first 12 hours of
life. We measured CD11b expression by neutrophils using flow cytometry.
Surfactant was not used for treatment of RDS due to economic reasons. The
clinical severity of RDS was graded into 4 sub-categories based on the initial
radiographic findings. Expression of CD11b was compared between groups.
Correlation analyses between CD11b, RDS severity, and clinical outcomes were
done using spearman correlation coefficient. Results: We studied 60 preterms with RDS (Cases) and 30
Controls. CD11b expression was significantly increased in Cases compared to
Controls and differed significantly among the 4 radiological sub-categories
within Cases; the highest being in RDS grade 4 and lowest in RDS grade 1. CD11b
expression was significantly higher among RDS neonates who received mechanical
ventilation compared to those who did not, and in neonates who developed
bronchopulmonary dysplasia (BPD) or died compared to those who did not. CD11b
expression in Cases was negatively correlated with gestational age and
positively correlated with the severity of RDS. Conclusion: CD11b expression as a marker of systemic
neutrophil activation is markedly increased in preterm newborns with RDS who
did not receive surfactant. It can serve as an indicator for the severity of
illness and adverse outcomes of RDS. The response of CD11b expression to
surfactant treatment and its impact on outcomes in infants with RDS needs to be
explored.
