Clinical utility of gastric fluid cytokine levels in preterm infants for predicting histological chorioamnionitis

Chie Matsuguma; Kazumasa Takahashi; Seigo Okada; Rui Tokitaka; Hiroki Hamano; Hidenobu Kaneyasu; Yousuke Fujimoto; Shunji Hasegawa

doi:10.1016/j.cyto.2024.156642

Clinical utility of gastric fluid cytokine levels in preterm infants for predicting histological chorioamnionitis

Cytokine. 2024 May 14:180:156642. doi: 10.1016/j.cyto.2024.156642. Online ahead of print.

Authors

Chie Matsuguma¹, Kazumasa Takahashi², Seigo Okada¹, Rui Tokitaka¹, Hiroki Hamano¹, Hidenobu Kaneyasu¹, Yousuke Fujimoto¹, Shunji Hasegawa¹

Affiliations

¹ Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Japan.
² Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Japan. Electronic address: p-sama@yamaguchi-u.ac.jp.

PMID: 38749278
DOI: 10.1016/j.cyto.2024.156642

Abstract

Background: The risk of various complications, such as neonatal death, early onset sepsis, and chronic lung disease, is increased in infants born to mothers with chorioamnionitis (CAM). However, predicting the diagnosis of histological CAM (hCAM) in the early postnatal period is challenging for clinicians due to pathological considerations. Therefore, an early diagnostic tool for hCAM is needed. Gastric fluid at birth is considered a suitable biomarker for predicting the intrauterine environment because most of its components are from amniotic fluid, and the sampling technique is less invasive. This study aimed to evaluate the clinical utility of cytokines in the gastric fluid of preterm infants at birth as predictors of hCAM.

Methods: We retrieved gastric fluid and serum from 21 preterm infants with a gestational age of ≤ 32 weeks within 1 h after birth and used cytometric bead array to measure the concentrations of interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-alpha, and interferon-gamma. We compared the cytokine concentrations in the gastric fluid and serum of the preterm infants born to mothers with or without hCAM.

Results: The gastric fluid, serum IL-6, and serum IL-10 concentrations were significantly higher in the hCAM group than that in the non-hCAM group. The best cutoff values for predicting hCAM was > 2,855 pg/mL and > 315 pg/mL for IL-6 in the gastric fluid and serum, respectively. Receiver operating characteristic curves showed that gastric fluid IL-6 concentrations correlated more strongly with the presence of hCAM than serum IL-6 concentrations.

Conclusion: IL-6 in the gastric fluid at birth may be a more promising biomarker for predicting the presence of hCAM than that in serum. IL-6 concentration analysis in the gastric fluid at birth might help to diagnose hCAM immediately after birth and improve the prognosis of preterm infants.

Keywords: Chorioamnionitis; Gastric fluid; IL-6; Preterm.