January 2015 Vol. 3 No. 1

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Original Research Articles

Antimicrobial peptide LL 37 as a novel marker for diagnosis of early onset neonatal sepsis

^*1Manal Abd El-Salam, ¹Heba Saeed Gafar, ¹Marwa Elhady and ²Fatma Anter Madi

¹Department of Pediatrics, Faculty of Medicine (for girls), Al-Azhar University, Cairo, Egypt
²Department of Clinical pathology, Faculty of Medicine (for girls), Al-Azhar University, Cairo, Egypt

*Corresponding Author's E-mail: manal24969@gmail.com

Accepted January 12, 2015

Abstract

Neonatal sepsis (NS) is a potentially life-threatening clinical condition that requires early intervention. Antimicrobial peptides represent the first line of defense against invading pathogens. In addition to its broad spectrum of bactericidal activities, cathelicidin (LL-37) has a wide range of inflammatory/immune modulatory actions. The aim of this work is to assess whether the serum levels of cathelicidin (LL-37) is a useful marker in the diagnosis of neonatal sepsis, and detect its role in establishing the diagnosis and evaluating the prognosis of neonatal sepsis. The study included 30 full term newborn with clinical sepsis within the first 48 h of life. They were selected from the NICU of Al–Zahraa hospital, Al-Azhar University during the period from March 2014 to September 2014. Also the study includes 30 healthy newborn age and sex matched as a control group. Complete blood picture (CBC), differential leukocyte count, blood culture, hsCRP as well as serum level of LL-37 and IL-1β were assessed in both groups. In this study, we found a significant increase in the immature WBCs and decreases in platelets counts in the newborn with clinical sepsis than the control group. The mean serum levels of hsCRP, LL-37 and IL-1β were significantly higher in the newborn with clinical sepsis than the control group. The cut-off value of LL-37 was >0.31 ng/ml, the test was found to have a sensitivity of 93%, specificity of 93%, positive predictive value of 93%, negative predictive value of 93%. The cut-off value of IL-1β was >0.5 Pg/ml. with 86.67% and 100% sensitivity and specificity respectively, the cut of value of hsCRP and I/T were >0.41ng/ml and >0.076 respectively with 93%, 93.33% and 53%, 60% sensitivity and specificity respectively. There is a negative relation between IL-1β and the neonatal survival, while there is no significant relation between LL-37 and the neonatal survival in spite the observed decrease in its level in the neonates’ non-survivors. Antimicrobial peptide LL-37 is a novel marker of early diagnosis of neonatal sepsis and can be used in combination with other acute-phase reactants to follow neonates with early sepsis.

Keywords: Neonatal sepsis, LL-37, IL-1β, I/T ratio