Neonatal neutrophils (PMN) exhibit a well-documented defect in chemotaxis that is associated with several abnormalities of PMN structure and function, including deficient surface expression of CR3 (CD11b/CD18), a critical adhesion molecule, on chemoattractant- activated PMN. We recently documented that deficient surface expression of CR3 on stimulated neonatal PMN is due principally to a deficiency in total cell content of CR3. In the current studies, we tested the hypothesis that total cell CR3 content of PMN is even more profoundly deficient in premature infants and that PMN CR3 content is directly related to gestational age. A sandwich enzyme-linked immunosorbent assay for CR3 showed that PMN lysates from term neonates ( > or = 37 weeks gestation) contain about 60% of adult PMN levels of CR3, whereas PMN from premature infants (range of 27 to 36 weeks gestation) contained a mean of about 30%, ranging from 10% to 48% (P < .001 for term [n = 6] v premature [n = 11] by unpaired t-test). When the relationship between total cell CR3 and gestational age (n = 15) was analyzed, the correlation coefficient was .94 by linear regression, and the Spearman rank correlation was significant with P < .001. PMN content of LFA-1 (CD11a/CD18) was similarly measured for 14 neonates. Term neonates were equivalent to adults in LFA-1 content of their PMN (99.4% +/- 3.2% of paired adult values, n = 6), whereas prematures (28 to 36 weeks gestation) were deficient, overall (69.1% +/- 10.4%, n = 8, P = .035). Below 35 weeks gestation, LFA-1 values ranged from 26% to 65% of paired adult control values, but no infant of > or = 35 weeks gestation had PMN LFA-1 content that was less than 85% of its adult control. We concluded that CR3 total cell content is more profoundly deficient in premature than in term neonates, that at birth there is a direct relationship between PMN CR3 content and gestational age, and that LFA-1 is deficient only in prematures less than 35 weeks of gestational age. Below 30 weeks gestation, CR3 content of PMN approached that seen in genetic deficiency of the CD18 family of leukocyte integrins, or type 1 leukocyte adhesion deficiency, underscoring the severity of this host impairment in very early preterm neonates.

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