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Reduced lymphocyte-mediated antifungal capacity in high-risk infants
Linda Witek-Janusek1, Maliha J Shareef, Herbert L Mathews
1Department of Maternal-Child Health, Loyola University of Chicago, Maywood, Illinois 60153, USA.
Insights
Premature infants exhibit reduced lymphocyte antifungal capacity against Candida albicans, impacting their susceptibility. Gestational age is the primary predictor of this impaired immune response in neonates.
Area of Science:
- Immunology
- Neonatology
- Mycology
Background:
- Premature and critically ill infants face heightened susceptibility to Candida albicans infections.
- Candida albicans poses a significant threat to vulnerable neonatal populations.
Purpose of the Study:
- To evaluate the lymphocyte-mediated antifungal capacity in infants.
- To determine the relationship between infant factors (birth weight, prematurity, illness severity) and antifungal immune function.
Main Methods:
- Assessed lymphocyte-mediated growth inhibition of Candida albicans.
- Measured lymphocyte adhesion to Candida albicans.
- Correlated immune function with birth weight, gestational age, and Score for Neonatal Acute Physiology (SNAP).
Main Results:
- Lymphocytes from preterm and low-birth weight infants showed significantly reduced inhibition and adhesion to Candida albicans.
- Infants with higher illness severity (SNAP score ≥10) had diminished antifungal capacity and fungal adhesion.
- Gestational age was the strongest predictor of both lymphocyte-mediated growth inhibition and fungal adhesion.
Conclusions:
- Infant gestational age is a critical determinant of lymphocyte-mediated antifungal immunity.
- Reduced lymphocyte antifungal capacity and adhesion in preterm and ill infants may contribute to increased Candida albicans susceptibility.
- Immune function in neonates is significantly influenced by prematurity and illness severity.
Abstract:
Premature and critically ill infants are highly susceptible to Candida albicans. This study evaluated the lymphocyte-mediated antifungal capacity of infants relative to birth weight, prematurity, and illness severity. Growth inhibition of C. albicans by lymphocytes from preterm and low-birth weight infants was significantly reduced, compared with full-term and normal-weight infants. Lymphocyte growth inhibition of C. albicans is dependent on cell adhesion to the fungus. Compared with full-term infants, lymphocytes from preterm infants had a reduced capacity to adhere to C. albicans. Furthermore, infants with greater severity of illness (score for neonatal acute physiology [SNAP], >or=10) exhibited significantly reduced lymphocyte-mediated antifungal capacity and fungal adhesion. Although gestational age, birth weight, and SNAP were significantly associated with lymphocyte-mediated growth inhibition and adhesion, stepwise regression analysis demonstrated that gestational age best predicted both lymphocyte growth inhibition of and adhesion to the fungus.