Serum soluble E- and L-selectin in the very early neonatal period
Introduction
Both E- and L-selectin are cell adhesion molecules. E-Selectin is expressed by the endothelium after activation at sites of acute inflammation and is significant in neutrophil and some T-cell migration to the site of injury [1], [2], [3]. L-Selectin is a 90–100-kDa surface glycoprotein, constitutively expressed by mammalian leukocytes, granulocytes, lymphocytes and monocytes. It is responsible for the initial leukocyte attachment to inflamed endothelium and high endothelial venules of peripheral lymph nodes [1], [4], [5]. After cellular activation, the extracellular part of L-selectin molecule is rapidly shed from the cell surface [1], [4], [5]. L-Selectin is down regulated by chemotactic agents and it is involved in homotypic aggregation [1]. Selectins are unique, because their role is restricted to direct leukocyte interaction with vascular endothelium and their ligands are carbohydrate epitopes on endothelial cells or on leukocytes [1]. Both selectins take part in the first step of the ‘adhesion cascade’, the ‘rolling of leukocytes’, leading to the extravasation of the white cells to the sites of inflammation, infection or damage [6]. For this reason, their soluble forms (sE- and sL-selectin, respectively), are considered early and reliable markers of the immune activation and response. Moreover, sE-selectin has been reported to be a potent angiogenic factor [7] and a reliable marker of infection and sepsis in neonates [8] as well as of endothelial activation [1], [6], while baseline sL-selectin of the leukocyte function and maturity [1].
The purpose of this study was to evaluate neonatal serum concentrations of the sE- and sL-selectin in the very early neonatal period, to establish reference values for both of them and to compare them with the respective ones in healthy adults.
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Materials and methods
Following approval by the Ethics Committee of our Teaching Hospital and receipt of informed maternal consent, peripheral blood samples (∼1 ml) were obtained from 40 (21 males and 19 females) healthy, term neonates, of mean (range) gestational age at birth 39.5 weeks (37.0–42.0), birth weight 3250 g (2610–3860), on the second and fifth day of life. The neonates were infection-free as judged by clinical examination and serum CRP values (<3.5 mg/l), measured in the same samples as sE- and
Results
Mean (±S.D., min, max) values of sE- and sL-Selectin in box-plots, in the study population are depicted in Fig. 1, Fig. 2, respectively.
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Neonatal serum values (mean±S.D.) of sE-Selectin both on the second (139±48 ng/ml) and fifth (111±35 ng/ml) day of life were found to be highly increased, as compared with those in controls (48±13 ng/ml; P<4×10−11 and P<4×10−10, respectively) (Fig. 1).
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In contrast, sL-selectin values were significantly lower on both the second (674±223 ng/ml) and the fifth
Discussion
Our findings show that in healthy, term, infection-free neonates, both sE- and sL-selectin are essential constituents of the neonatal circulation from birth, suggesting that constitutive shedding of both selectins is an established component of the neonatal immune system, in agreement with previous reports on them [8], [9] and on adhesion molecules of the immunoglobulin superfamily [8], [10], [11].
The highly elevated neonatal serum sE-selectin values, more than double already from the second
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