Circulating DNA and neutrophil-derived biomarkers in neonatal sepsis: brief report
Neutrophil extracellular traps (NETs) contribute to innate immunity in sepsis, but their diagnostic value in neonates is unclear. We evaluated whether circulating NET-associated biomarkers discriminate septic from non-infected neonates. In this prospective observational study 96 neonates (≥34 weeks...
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| Autori principali: | , , , |
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| Natura: | Article (Journal) |
| Lingua: | inglese |
| Pubblicazione: |
18 May 2026
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| In: |
International journal of molecular sciences
Year: 2026, Volume: 27, Fascicolo: 10, Pages: 1-8 |
| ISSN: | 1422-0067 |
| DOI: | 10.3390/ijms27104500 |
| Accesso online: | Verlag, kostenfrei, Volltext: https://doi.org/10.3390/ijms27104500 Verlag, kostenfrei, Volltext: https://www.mdpi.com/1422-0067/27/10/4500 
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| Note sull'autore: | Ana Maria Behrami, Jasmin Knopf, Michael Boettcher and Chinedu Ulrich Ebenebe |
| Riassunto: | Neutrophil extracellular traps (NETs) contribute to innate immunity in sepsis, but their diagnostic value in neonates is unclear. We evaluated whether circulating NET-associated biomarkers discriminate septic from non-infected neonates. In this prospective observational study 96 neonates (≥34 weeks gestational age) with clinical suspicion of infection were enrolled (36 sepsis, 60 controls). Serum cell-free DNA (cfDNA), myeloperoxidase–DNA complexes (MPO-DNA), neutrophil elastase–DNA complexes (NE-DNA), and citrullinated histone H3 (H3cit) were measured alongside CRP and IL-6 at days 1, 3, and 5. Diagnostic performance was assessed by receiver operating characteristic (ROC) analysis with bootstrap confidence intervals. CRP (AUC 0.75, 95% CI 0.66–0.85) and IL-6 (AUC 0.73, 95% CI 0.61–0.83) showed the best diagnostic performance. cfDNA demonstrated moderate discrimination (AUC 0.72, 95% CI 0.60–0.84) but was only transiently elevated at day 1. MPO-DNA (AUC 0.47), NE-DNA (AUC 0.44), and H3cit (AUC 0.47) performed no better than chance. Within the sepsis group, MPO-DNA and NE-DNA at day 3 strongly correlated with the immature-to-total neutrophil ratio (ρ = 0.76 and 0.72), suggesting these markers reflect neutrophil degranulation rather than NET formation. NET-associated biomarkers do not improve diagnostic accuracy for neonatal sepsis beyond CRP and IL-6. These findings support the concept that neonatal innate immune responses differ fundamentally from adult patterns. |
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| Descrizione del documento: | Gesehen am 13.07.2026 |
| Descrizione fisica: | Online Resource |
| ISSN: | 1422-0067 |
| DOI: | 10.3390/ijms27104500 |