Academic Journal
Molecular Mechanisms Underlying Inflammation in Early-Onset Neonatal Sepsis: A Systematic Review of Human Studies.
| Τίτλος: | Molecular Mechanisms Underlying Inflammation in Early-Onset Neonatal Sepsis: A Systematic Review of Human Studies. |
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| Συγγραφείς: | Vulcănescu A; 'Filantropia' Clinical Municipal Hospital, 200143 Craiova, Romania.; University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Siminel MA; 'Filantropia' Clinical Municipal Hospital, 200143 Craiova, Romania.; Department of Neonatology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Dijmărescu AL; 'Filantropia' Clinical Municipal Hospital, 200143 Craiova, Romania.; Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Manolea MM; 'Filantropia' Clinical Municipal Hospital, 200143 Craiova, Romania.; Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Săndulescu SM; 'Filantropia' Clinical Municipal Hospital, 200143 Craiova, Romania.; Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Rădulescu VM; Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania., Gheorman V; Department of Obstetrics and Gynecology, Buna Vestire Clinic, 200345 Craiova, Romania., Dinescu SN; Clinical Emergency County Hospital, 200642 Craiova, Romania.; Department of Epidemiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania. |
| Πηγή: | Journal of clinical medicine [J Clin Med] 2025 Jul 28; Vol. 14 (15). Date of Electronic Publication: 2025 Jul 28. |
| Τύπος έκδοσης: | Journal Article; Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101606588 Publication Model: Electronic Cited Medium: Print ISSN: 2077-0383 (Print) Linking ISSN: 20770383 NLM ISO Abbreviation: J Clin Med Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Basel, Switzerland : MDPI AG, [2012]- |
| Περίληψη: | Background/Objective: Early-onset neonatal sepsis (EOS), defined as infection occurring within the first 72 h after birth, remains a major contributor to neonatal morbidity and mortality worldwide. Although advances in perinatal care have improved overall outcomes, the diagnosis of EOS continues to be challenging. Clinical presentations are often nonspecific, laboratory confirmation is often delayed, and immune responses vary considerably among neonates. Expanding our understanding of the molecular mechanisms underlying EOS is essential in enhancing early detection, refining risk stratification, and guiding therapeutic strategies. This systematic review aims to synthesize the available information on the molecular pathways involved in EOS, focusing on pathogen-induced inflammation, systemic immune responses, sterile inflammatory processes, interactions between infectious and non-infectious pathways, as well as emerging molecular diagnostic approaches. Methods: A comprehensive review of original research articles and reviews published between January 2015 and January 2025 was conducted; studies were included based on their focus on human neonates and their analysis of molecular or immunological mechanisms relevant to EOS pathogenesis, immune dysregulation, or novel diagnostic strategies. Results: Pathogen-driven inflammation typically involves the activation of Toll-like receptors (TLRs), the recruitment of neutrophils, and the release of pro-inflammatory cytokines such as IL-6, IL-1β, and TNF-α, particularly in response to vertical transmission of organisms like Escherichia coli and Streptococcus agalactiae. Systemic inflammatory responses are marked by cytokine dysregulation, contributing to multi-organ dysfunction. Sterile inflammation, often initiated by hypoxia-reperfusion injury or intrauterine stress, amplifies susceptibility to sepsis. Interactions between immune, metabolic, and endothelial pathways further exacerbate tissue injury. Recent advances, including transcriptomic profiling, microRNA-based biomarkers, and immune checkpoint studies, offer promising strategies for earlier diagnosis and individualized therapeutic options. Conclusions: EOS arises from a complex interplay of infectious and sterile inflammatory mechanisms. A deeper molecular understanding holds promise for advancing correct diagnostics and targeted therapies, aiming to improve neonatal outcomes. |
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| Contributed Indexing: | Keywords: biomarkers; early-onset neonatal sepsis; immune dysregulation; neonatal immune response; sterile inflammation |
| Entry Date(s): | Date Created: 20250814 Latest Revision: 20250817 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC12347463 |
| DOI: | 10.3390/jcm14155315 |
| PMID: | 40806937 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 2077-0383 |
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| DOI: | 10.3390/jcm14155315 |