Abstract:
Introduction. Bronchopulmonary dysplasia (BPD) and neonatal respiratory
distress syndrome (nRDS) are major complications in preterm infants, often
resulting in long-term health issues. Identifying reliable biomarkers for these
conditions is crucial for improving clinical outcomes. Infectious diseases are a
predominant cause of childhood death. Neonatal infection in particular remains
a common tragedy, with ∼7 million cases and ∼700,000 deaths per year,
currently accounting for 40% of mortality in those under 5 years of age (Hanieh
Talebi et.all.2025).
Objective: to summarize contemporary evidence on the use of circulating
immunological biomarkers in the diagnosis of secondary immunodeficiencies
and to identify promising biomarkers for use in personalized management in
neonates.
Material and methods: The study was analytical, based on a review of the
scientific literature from the PubMed and Google Scholar databases, published
between 2018 and 2023.
Rezults. Studies have highlighted potential biomarkers and mechanisms
involved in their pathogenesis. Endothelin-1 (ET-1) is a promising biomarker
for predicting BPD, as it is associated with bronchoconstriction and pulmonary
hypertension, with elevated levels indicating early risk in preterm infants with
nRDS. Interleukin-6 (IL-6) is another significant biomarker, with higher serum
levels correlating with BPD development, underscoring the role of
inflammation in lung injury. Oxidative stress is also critical, as preterm infants
have immature antioxidant defenses, leading to increased lung tissue damage.
Specifically, neonatal APCs typically produce less proinflammatory
(interleukin-1β [IL-1β], TNF-α) and T helper 1 (Th1) promoting cytokines (IL-
12p70, type 1 IFN), but equal or greater amounts of Th17 promoting cytokines
(IL-23, IL-6) compared with adult cells. Robust neonatal production of IL-6
induces a physiological hepatic acute phase response at birth, including
induction of mannose binding lectin (MBL), C-reactive protein (CRP), and
LPS-binding protein (LBP) that rise in the first week of life, possibly broadly
enhancing resistance to infection, and contributes to healing of tissues injured
during birth. Conclusion. Biomarkers diagnosis in lung lesions in newborn
children has a major diagnostic value for preventing infant mortality and
evolution newborn management.
