Immunosuppressive Properties of Neonatal Erythroid Cells
Research type
Research Study
Full title
Are umbilical cord erythroid cells immunosuppressive and might they be used to transfuse neonates at risk of necrotising enterocolitis?
IRAS ID
159656
Contact name
Sylvia Armstrong-Fisher
Contact email
Sponsor organisation
Scottish National Blood Transfusion Service
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Necrotising enterocolitis (NEC) is a disease of neonates characterised by inflammation and ischaemic necrosis of intestinal mucosa. The disease causes significant mortality and morbidity including long-term neurodevelopmental impairment. Although its pathogenesis remains poorly understood, several risk factors have been identified. One, enteral feeding, has been apparent for many years. More recent studies have suggested an association between transfusion of blood in the previous 48 hours. But, as no obvious mechanism has been postulated to explain the association, causality is not widely accepted. However, it has recently been claimed that neonatal erythroid cells are able to inhibit otherwise damaging immune responses to gut bacteria. These data suggest that if immunosuppressive neonatal cells were diluted out by transfused cells from adult donors without these properties, then the intestinal immune systems of premature babies might be inappropriately activated by enteral feeding, initiating inflammation and eventually NEC. We propose to take blood samples from umbilical cord blood, premature neonates and healthy adults in order to (1) confirm the observation that cord blood erythroid cells have immunosuppressive properties and express the immunosuppressive enzyme arginase type II, (2) establish the time course of expression of arginase type II with respect to gestational age and (3) determine whether transfusion of adult cells modulates immune function in a way that might predispose to NEC. Finally, we will collect data concerning the association of NEC with the presence of nucleated red cells using a case control study using data from clinical databases.
REC name
North East - Newcastle & North Tyneside 1 Research Ethics Committee
REC reference
14/NE/1209
Date of REC Opinion
15 Dec 2014
REC opinion
Further Information Favourable Opinion