Pathogenic Escherichia coli infection increases IL-6 and inflammatory response in neonatal sepsis, implying a need for targeted treatments.
Description Late-onset neonatal sepsis (LOS) is often the result of systemic bacteremia developing between 3-90 days of age, predominantly in prematurely born populations. An initial spike of IL-6 serum levels is a hallmark diagnostic tool and has been implicated as a source for the resulting cytokine storm. Yet, other than antibiotics, there is a lack of effective therapeutics targeting the overwhelming inflammatory response. We performed single-organism infections of pathogenic and commensal clinical E. coli isolates to compare the acute cytokine response in our LOS model in neonatal (postnatal day 5-7) and periweaning (postnatal day 17-20) pups. As expected, neonatal pups had increased bacterial burden and mortality during pathogenic infection compared to periweaning-age and commensal infection. An in-depth, 32-cytokine analysis of serum, liver, and spleen revealed overall elevated and tissue-specific inflammation in the neonates with a positive correlation of IL-6 serum levels to many cytokines (MCP-1, M-CSF, MIP-1β, etc.). Isolate-specific responses were assessed in an in vitro co-culture model with RAW-blue macrophages. While both isolates induced inflammatory NFκB/AP-1 activation, commensal E. coli caused elevated IL-1β while pathogenic E. coli led to significantly elevated IL-6. Both age- and pathogenic-specific inflammatory activation suggest unique signaling from the E. coli infection and the neonatal response, calling for neonatal-specific treatment options. Funding Sources Mayo Clinic Graduate School of Biomedical Sciences R01 DK134366 (Knoop) T32 DK124190-04 (Muske) Topic Categories Microbial, Parasitic, and Fungal Immunology (MPF)
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Muske et al. (2025) studied this question.
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