Role of Innate Immunity in Neonatal Infection

Alex G. Cuenca; James L. Wynn; Lyle L. Moldawer; Ofer Levy

doi:10.1055/s-0032-1333412

American Journal of Perinatology, Table of Contents

Am J Perinatol 2013; 30(02): 105-112
DOI: 10.1055/s-0032-1333412

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Role of Innate Immunity in Neonatal Infection

Alex G. Cuenca

¹Department of Surgery, University of Florida, Gainesville, Florida

,

James L. Wynn

²Division of Neonatology, Department of Pediatrics, Vanderbilt University, Nashville, Tennessee

,

Lyle L. Moldawer

¹Department of Surgery, University of Florida, Gainesville, Florida

,

Ofer Levy

³Division of Infectious Diseases, Boston Children's Hospital; Boston, Massachusetts

⁴Harvard Medical School, Leder Program in Human Biology & Translational Medicine, Boston, Massachusetts

› Author Affiliations

Abstract

Newborns are at increased risk of infection due to genetic, epigenetic, and environmental factors. Herein we examine the roles of the neonatal innate immune system in host defense against bacterial and viral infections. Full-term newborns express a distinct innate immune system biased toward T_H2-/T_H17-polarizing and anti-inflammatory cytokine production with relative impairment in T_H1-polarizing cytokine production that leaves them particularly vulnerable to infection with intracellular pathogens. In addition to these distinct features, preterm newborns also have fragile skin, impaired T_H17-polarizing cytokine production, and deficient expression of complement and of antimicrobial proteins and peptides (APPs) that likely contribute to susceptibility to pyogenic bacteria. Ongoing research is identifying APPs, including bacterial/permeability-increasing protein and lactoferrin, as well as pattern recognition receptor agonists that may serve to enhance protective newborn and infant immune responses as stand-alone immune response modifiers or vaccine adjuvants.

Keywords

adjuvants - neonatal sepsis - pathogen recognition receptors - innate immunity

Full Text

References

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