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Polymorphonuclear leukocyte function in the preterm neonate: effect of chronologic age
S S Usmani1, J S Schlessel, C G Sia
1Department of Pediatrics, North Shore University, Hospital-Cornell University Medical College, Manhasset, New York 11030.
Pediatrics
|May 1, 1991
Summary
Chronologic age significantly impacts polymorphonuclear leukocyte (PMN) function in preterm infants. While PMN chemiluminescence and motility improve with age, chemotactic function remains impaired even at 32.5 weeks cumulative age.
Area of Science:
- Neonatal Immunology
- Cellular Immunology
- Pediatric Hematology
Background:
- Polymorphonuclear leukocytes (PMNs) are crucial for infant immunity.
- Immune function in preterm neonates is often immature.
- Understanding PMN development is vital for assessing infection risk.
Purpose of the Study:
- To investigate the effect of chronologic age on PMN function in preterm neonates.
- To compare PMN function in preterm neonates with term neonates and adults.
- To determine if gestational age or chronologic age is more influential in PMN maturation.
Main Methods:
- Evaluated PMN chemiluminescence, random motility, and chemotactic motility in 38 preterm neonates (<32 weeks gestation).
- Measurements were taken weekly during the first month of life.
- Compared data with 14 term neonates and 7 adults.
Main Results:
- Initially, preterm neonates showed significantly lower PMN function compared to term neonates and adults.
- PMN function significantly improved over the 21-day study period in preterm infants.
- By day 21, chemiluminescence and random motility normalized, but chemotactic motility remained impaired.
Conclusions:
- Chronologic age, rather than gestational age, appears to drive PMN functional maturation in preterm infants.
- While some PMN functions mature by 32.5 weeks cumulative age, chemotaxis may require longer development.
- Findings suggest a prolonged maturation process for specific immune cell functions in extremely preterm infants.