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Disease Markers
Volume 2015, Article ID 981981, 6 pages
http://dx.doi.org/10.1155/2015/981981
Research Article

Study on the Usefulness of APR Scores from the Viewpoint of Proinflammatory Cytokines

1Division of Neonatology, Center for Maternal Fetal and Neonatal Medicine, National Hospital Organization Nishisaitama Chuo National Hospital, Tokorozawa-shi, Saitama-ken 359-1151, Japan
2Division of Neonatology, Musashino Red Cross Hospital, Musashino-shi 180-8610, Japan
3Shino-Test Corporation, 2-29-14 Oonodai Minami-ku, Sagamihara-shi 252-0331, Japan
4Division of Pediatrics, Nagoya City West Medical Center, Nagoya-shi 462-8508, Japan

Received 18 August 2014; Revised 26 November 2014; Accepted 18 December 2014

Academic Editor: Carlo Chiarla

Copyright © 2015 T. Nakamura et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Delayed diagnosis and treatment of newborn infection adversely impact outcomes. Clinical laboratory parameters have aimed to obtain the most correct and prompt diagnosis and treatment of this disease. This study simultaneously observed changes over time in APR as well as proinflammatory cytokines and anti-proinflammatory cytokines and aims to clarify usefulness of APR scores. Methods. We evaluated the usefulness of acute phase reactants (APR) in 46 newborns whose serum up to age 7 days had been stored, with comparison of three types (Group I: infection 15, Group F: fetal inflammatory response syndrome 17, and Group C: control 14) of APR-based scores, those of C-reactive protein (CRP), alpha1-acid glycoprotein (AGP), and haptoglobin (Hp), with proinflammatory cytokine levels. APR scores for CRP, AGP, and Hp and the levels of the proinflammatory cytokines IL-1β, IL-6, IL-8, IL-10, and TNFα were determined. Results. The cytokine levels started to increase from age 0 days and then decreased rapidly. The three APR scores, CRP, AG, and Hp, were elevated at age 0 days and then gradually decreased in infection (Group I) and fetal inflammatory response syndrome (Group F). The duration of antibiotic administration according to APR scores was significantly shorter in Group F than in Group I. Conclusion. This study demonstrated APR scores to be more useful for deciding whether antibiotics should be discontinued than proinflammatory cytokine levels.