TNF-α and Interleukin-6 Levels in Clinical Early Onset Neonatal Sepsis Toward Acute Liver Injury
DOI:
https://doi.org/10.21776/ub.jkb.2017.029.03.6Keywords:
Acute liver injury, clinical early neonatal sepsis, IL-6 level, TNF-α levelAbstract
TNF-α and IL-6 level have an important role in acute liver injury during early onset neonatal sepsis. This study aims to investigate the correlation of TNF-α and IL-6 levels in neonates with clinical early onset neonatal sepsis toward the occurrence of acute liver injury 44 neonates with clinical early onset neonatal sepsis based on SIRS criteria and Rodwell hematologic scored ≥3 were included in this study. Acute liver injury is defined as elevated of AST, ALT, or AST: ALT ratio <1. TNF-α and IL-6 levels were measured using ELISA methods. This study showed that TNF-α correlated significantly with AST level (p<0,001, r=0,570), ALT level (p<0,001, r=0,554), and AST: ALT ratio (p<0,001, r=0,652). This study also showed that IL-6 correlated significantly with AST level (p<0,001, r=0,523), ALT level (p<0,001, r=0,482), AST: ALT ratio (p<0,001, r=0,603). Regression test using backward methods showed that TNF-α influence acute liver injury (indicated by AST, ALT, and AST: ALT ratio) more than IL-6. We concluded that TNF-α and IL-6 level in clinical early onset neonatal sepsis correlated with acute liver injury, whereas early onset neonatal sepsis was correlated with acute liver injury.
Keywords: Acute liver injury, clinical early neonatal sepsis, IL-6 level, TNF-α level
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Robinson DT, Kumar P, and Cadichon SB. Neonatal Sepsis in the Emergency Department. Clinical Pediatric Emergency Medicine. 2008; 9(3): 160-168.
Meem M, Modak JK, Mortuza R, Morshed M, Islam MS, and Saha SK. Biomarkers for Diagnosis of Neonatal Infections: A Systematic Analysis of Their Potential as a Point-of-Care Diagnostics. Journal of Global Health. 2011; 1(2): 201-209.
Badan Penelitian dan Pengembangan Kesehatan Departemen Kesehatan Republik Indonesia. Riset Kesehatan Dasar (RISKESDAS) 2007. Laporan Nasional 2007. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Departemen Kesehatan, Republik Indonesia; 2007.
Nesseler N, Launey Y, Aninat C, Morel F, Malledant Y, Seguin P. Clinical Review: The Liver in Sepsis. Journal Critical Care. 2012; 16(5): 235.
Li Z, Xiao Z, Li Z, Zhong Q, Zhang Y, and Xu F. 116 Cases of Neonatal Early-Onset or Late-Onset Sepsis: A Single Center Retrospective Analysis on Pathogenic Bacteria Species Distribution and Antimicrobial Susceptibility. International Journal of Clinical Experimental Medicine. 2013; 6(8): 693-699.
Soultati A and Dourakis SP. Liver Dysfunction in the Intensive Care Unit. Annals of Gastroenterology. 2005; 18(1): 35-45.
Kramer L, Jordan B, Druml W, Bauer P, and Metnitz PG. Incidence and Prognosis of Early Hepatic Dysfunction in Critically Ill Patients. A Prospective Multicenter Study. Critical Care Medicine. 2007; 35(4): 1099–1104.
Kaplan MM, Chopra S, and Travis AC. Approach to the Patient with Abnormal Liver Function Tests. (Online) 2011. http://www.uptodate.com/contents /approach-to-the-patient-with-abnormal-liver-biochemical-and-function-tests
New KJ, Eaton S, Elliott KRF, Spitz L, and Quant PA. Effect of Lipopolysaccharide and Cytokines on Oxidative Metabolism in Neonatal Rat Hepatocytes. Journal of Pediatric Surgery. 2001; 36(2): 338-340.
Helk E, Bernin H, Ernst T, et al. Tnfa-Mediated Liver Destruction by Kupffer Cells and Ly6Chi Monocytes during Entamoeba Histolytica Infection. PLoS Pathogens. 2013; 9(1): 1003096.
Neviere R, Parsons PE, and Wilson KC. Sepsis and the Systemic Inflammatory Response Syndrome: Definitions, Epidemiology, and Prognosis. (Online) 2011. http://cursoenarm.net/UPTODATE /contents/mobipreview.htm?0/10/ 160?source=see_link [diakses tanggal 28 Mei 2013].
Yang YY. Can Serum Cytokines Predict Hepatic Cytokine Expression in Liver Cirrhosis? Journal of the Chinese Medical Association. 2013; 74(11): 485-486.
Khair KB, Rahman MA, Sultana T, Roy CK, Rahman Q, and Shahidullah M. Role of Hematologic Scoring System in Early Diagnosis of Neonatal Septicemia. Bangabandhu Sheikh Mujib Medical University Journal. 2010; 3(2): 62-67.
Makkar M, Gupta C, Pathak R, Garg S, and Mahajan NC. Performance Evaluation on Hematologic Scoring System in Early Diagnosis of Neonatal Sepsis. Journal of Clinical Neonatology. 2013; 2(1): 25-29.
Narasimha A and Kumar MLH. Significance of Hematological Scoring System (Hss) in Early Diagnosis of Neonatal Sepsis. Indian Journal of Hematology Blood Transfusion. 2011; 27(1): 14–17.
Melkie M, Yigeremu M, Nigussie P, et al. Robust Reference Intervals for Liver Function Test (LFT) Analytes in Newborns and Infants. BMC Research Notes. 2012; 5: 493.
Thapa BR and Anuj Walia. Liver Function Tests and Their Interpretation. Symposium: Newer Diagnostic Tests. Indian Journal Pediatric. 2007; 74(7): 663-671.
Salem SY, Sheiner E, Hillel Vardi EZ, Vardi IS, and Mazor M. Risk Factors for Early Neonatal Sepsis. Archives of Gynecology and Obstetrics. 2006; 274: 198–202.
Tuuli M. Optimal Antibiotic Therapy of Neonates at Risk of Early Onset Sepsis. [Dissertation]. University of Tartu, Estonia. 2010.
Simonsen KA, Anderson-Berry AL, Delair SF, and Davies HD. Early-Onset Neonatal Sepsis. Clinical Microbiology Reviews. 2014; 27(1): 21–47.
Sankar MJ, Agarwal R, Deorari AK, and Paul VK. Sepsis in the Newborn. Indian Journal of Pediatric. 2008; 75(3): 261-266.
Vergnano S, Sharland M, Kazembe P, Mwansambo C, and Heath P. Neonatal Sepsis: An International Perspective. Arch Dis Child Fetal Neonatal. 2005; 90(3): 220-224.
Dellinger RP, Levy MM, Rhodes A, et al. Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock: 2012. Critical Care Medicine. 2013; 41(2); 580-637.
Schwabe RF and Brenner DA. Mechanisms of Liver Injury. TNF-ΑInduced Liver Injury: Role of IKK, JNK, and ROS Pathways. American Journal of Physiology. Gastrointestinal and Liver Physiology. 2006; 290(4): G583–G589
Chiesa C, Panero A, Osborn JF, Simonetti AF, and Pacifico L. Diagnosis of Neonatal Sepsis: A Clinical and Laboratory Challenge. Clinical Chemistry. 2004; 50(2): 279-287.
Gomella TL, Cunningham MD, Eyal FG, and Zenk KE. Sepsis in Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs. New York: Mc.Graw Hill Company; 2009; pp. 665-671.
Fan Y and Yu JL. Umbilical Blood Biomarkers for Predicting Early-Onset Neonatal Sepsis. World Journal of Pediatrics. 2012; 8(2): 101-108.
Bender L, Thaarup J, Varming K, Krarup H, and Ebbesen. Early and Late Markers for the Detection of Early-Onset Neonatal Sepsis. An Abstract. Danish Medical Bulletin. 2008; 55(4): 219-223.
Bokun LV, Huang J, Yuan H, Yan W, Hu G, and Wang J. Tumor Necrosis Factor- as a Diagnostic Marker for Neonatal Sepsis: A Meta-Analysis. The Scientific World Journal. 2014; 2014(12): 471463.
Dhawan A and Vergani MG. Acute Liver Failure in Neonates. Early Human Development. 2005; 81(12): 1005-1010.
Patricia MC and Davison SM. Neonatal Liver Failure. Seminars in Neonatology. 2003; 8(5): 393–401.
Assenzio B and Martin-Conte EL. Cellular Mechanisms of MOF during Severe Sepsis and Septic Shock. (Online). http://www.intechopen.com/ books/severe-sepsis-and-septic-shock-understanding-a-serious-killer/cellular-mechanisms-of-mof-during-septic-shock [diakses tanggal 13 April 2015].
Ding Y, Lin Y, Zhu T, Huang M, and Xu Q. Interleukin 6 Increases Dysfunction of Organs in Sepsis Rats through Sirtuin 1. International Journal of Clinical and Experimental Medicine. 2014; 7(9): 2593-2598.
Xiaoling Jin, Zimmers TA, Perez EA, Pierce RH, Zhang Z, and Koniaris LG. Paradoxical Effects of Short- and Long-Term Interleukin-6 Exposure on Liver Injury and Repair. Hepatology. 2006; 43(3): 474-484.
Akib AP, Munasir Z, dan Kurniati N. Buku Ajar Alergi-Imunologi Anak Edisi Kedua. Jakarta: Badan Penerbit IDAI; 2008; Hal. 45-47.
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