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Perinatal Inflammation Influences but Does Not Arrest Rapid Immune Development in Preterm Babies

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Shraddha Kamdar, Richard Hutchinson, Adam Laing, Fiona Stacey, Katherine Ansbro, Michael R. Millar, Kate Costeloe, William G. Wade, Paul Fleming, Deena L. Gibbons

Original languageEnglish
Article number1284
JournalNature Communications
Volume11
Issue number1
Early online date9 Mar 2020
DOIs
Accepted/In press12 Feb 2020
E-pub ahead of print9 Mar 2020
Published9 Mar 2020

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Abstract

Infection and infection-related complications are important causes of death and morbidity following preterm birth. Despite this risk, there is limited understanding of the development of the immune system in those born prematurely, and of how this development is influenced by perinatal factors. Here we prospectively and longitudinally follow a cohort of babies born before 32 weeks of gestation. We demonstrate that preterm babies, including those born extremely prematurely (<28 weeks), are capable of rapidly acquiring some adult levels of immune functionality, in which immune maturation occurs independently of the developing heterogeneous microbiome. By contrast, we observe a reduced percentage of CXCL8-producing T cells, but comparable levels of TNF-producing T cells, from babies exposed to in utero or postnatal infection, which precedes an unstable post-natal clinical course. These data show that rapid immune development is possible in preterm babies, but distinct identifiable differences in functionality may predict subsequent infection mediated outcomes.

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