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Subject Area

Pediatrics

Article Type

Original Study

Abstract

Objective To determine potential diagnostic and prognostic values of programmed death receptor-1 (PD-1) expression in neonatal sepsis. Background In neonatal ICUs across the world, sepsis is a frequent disease associated with high rates of death and morbidity. In sepsis, chronic immunosuppression following a fast proinflammatory response results in high rates of morbidity and death. PD-1 (CD279) is an immunoglobulin superfamily cell surface receptor that inhibits proinflammatory activity. Patients and methods This prospective observational study was carried out on 102 newborns. They were divided into two groups: group I (cases group) (n = 52) included newborns with suspected or proven sepsis, while group II (control group) (n = 50) included age and sex-matched newborns, who did not develop neonatal sepsis. Group I was further subdivided into group Ia (n = 42), which included the surviving newborns and group Ib (n = 10), which included the nonsurviving newborns. Results Mean fluorescence intensity for PD-1 was significantly higher in cases than in controls (P < 0.05). Mean fluorescence intensity with a cutoff point more than 1610.1 has the highest sensitivity (71.15%) and specificity (60%) for the prediction of sepsis, negative predictive value (66.7%), and positive predictive value (64.9%). PD-1 percentage on lymphocytes has the highest sensitivity (80%) and specificity (66.67%) in the prediction of mortality with a cutoff point more than 3.09. Conclusion The expression of PD-1 on lymphocytes may serve as a diagnostic marker for newborn sepsis and a mortality predictor.

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