Article Text
Abstract
Background Infection and inflammation can be antecedents of Neonatal Encephalopathy (NE) and increase the risk of neurological sequelae. Vitamin D is a potent immunomodulator and may alter the systemic inflammatory repose in NE.
Aim To investigate the in vitro effect of 1,25(OH)2D3 on whole blood intracellular neutrophil production of ROI in NE patients at 72–96 h of age.
Methods Infants with NE were recruited and their demographics details, grade of NE, MRI results, outcome and placental histology were recorded. Whole blood was taken between 72 -96 h of age and analysed using flow cytometry for Toll-like Receptor (TLR)4, CD11b and reactive oxygen intermediates (ROI) in both monocytes and neutrophils in the presence of Lipopolysaccharide (LPS) and/or 1,25(OH)2D3.
Results Five neonates with NE were recruited and all received therapeutic hypothermia (TH). At 72–96 h of age following TH there was enhanced production of monocyte and neutrophil ROI in the presence of LPS and this was augmented by 1,25(OH)2D3 pretreatmentin vitro. Similar effects were seen on TLR4 and CD11b production in both neutrophils and monocytes.
Conclusion 1,25(OH)2D3 increases the productionof ROI in neutrophils and which may not be beneficial in NE in which an augmented systemic inflammation is underway.