IL-1Β urinário como biomarcador preditivo de sepse neonatal em pré-termos

Abstract

Purpose: Sepsis in preterm neonates with very low birth weight (VLBW) may be fatal due to difficult and late diagnosis. Our hypothesis is that excess levels of pro-inflammatory cytokines in the blood are secreted in the urine due to renal filtration to remove their systemic overload, besides being a noninvasive sampling and easy to obtain. Our aim was to investigate urinary biomarkers for early detection of sepsis in preterm neonates. Methods: Urine of patients with gestational age less than 34 weeks and birth weight below 1.5 kg were collected for comparative analysis between culture-confirmed sepsis (case) and no sepsis symptoms(control) using a cytokine panel of 27 markers. Results: Variables with statistical difference between groups were: gender, respiratory distress syndrome, parenteral nutrition and outcome (discharge and death). Among the 27urinary biomarkers, six showed significant differences (IL-1β, IL-1ra, IL-2, IL-17A, MCP-1, MIP-1β); however,IL-1βshowed to be the most important predictive urinary biomarker for early detection of sepsis in preterm neonates, with an accuracy of 85% and a relative risk of 7.3 when higher levels are detected above the cutoff value of 1.082 pg/mL. Conclusion: The cytokine IL-1β was shown to be an important predictive biomarker for the early detection of sepsis in neonatal preterm of very low birth weight constituting a less invasive and rapid collection method.