% IMPORTANT: The following is UTF-8 encoded. This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.
@ARTICLE{Dirks:285046,
author = {Dirks, Johannes and Fortmann, Ingmar and Marißen, Janina
and Pagel, Julia and Reichert, Lilith and Kipke, Henry and
Dammann, Marie-Theres and Göpel, Wolfgang and Birkner, Till
and Dahm, Kilian and Forslund-Startceva, Sofia Kirke and
Viemann, Dorothee and Rupp, Jan and Morbach, Henner and
Härtel, Christoph},
title = {{E}ffect of gestational age on lymphocyte phenotypes in
hospitalized preterm infants.},
journal = {The journal of allergy and clinical immunology},
volume = {157},
number = {2},
issn = {0091-6749},
address = {Amsterdam [u.a.]},
publisher = {Elsevier},
reportid = {DZNE-2026-00170},
pages = {506 - 516},
year = {2026},
abstract = {Preterm infants exhibit an increased susceptibility to
infections. To assess the contribution of adaptive immunity
to this vulnerability, it is crucial to study its postnatal
development.We sought to define profiles of adaptive
immune-cell subsets in large cohorts of preterm infants,
investigating the influence of gestational age (GA) and
perinatal factors on their development.Two German tertiary
care neonatal intensive care unit cohorts (cohort 1: n =
499; cohort 2: n = 78) of hospitalized preterm infants (GA,
22.9-36.4 weeks) underwent flow cytometric phenotyping of
peripheral blood lymphocyte subsets within the first 49 days
of life. MetadeconfoundR package was used to evaluate
(confounding) effects of clinical conditions on lymphocyte
profiles.GA at birth was a primary determinant of profiles
of lymphocyte subsets. The most premature infants displayed
persistently lower CD4+ TH-cell frequencies, an early
transient increase in B cells, and a later expansion of
natural killer cells (TH-low B-high natural killer-high
phenotype). Detailed analysis revealed a less naive but more
effector and regulatory CD4+ T-cell phenotype in preterm
infants with lower GA at birth. Amniotic infection syndrome
further accentuated this 'premature' immune profile, which
was also more prevalent in infants with typical
complications of prematurity. In contrast, female sex was
associated with higher CD4+ TH-cell frequencies.This study
provides a comprehensive characterization of adaptive immune
development in hospitalized preterm infants during the first
weeks of life, demonstrating a strong dependence on GA and
modulation by perinatal factors. The identified distinct
developmental profiles offer a valuable reference framework
for interpreting immune phenotyping data and highlight
potential associations between immunologic immaturity and
clinical outcomes in this vulnerable population.},
keywords = {Humans / Female / Infant, Premature: immunology / Infant,
Newborn / Male / Gestational Age / Phenotype / Lymphocyte
Subsets: immunology / Cohort Studies / Immunophenotyping /
Hospitalization / Killer Cells, Natural: immunology /
Adaptive immunity (Other) / B cells (Other) / T(H) cells
(Other) / amniotic infection syndrome (Other) / preterm
infants (Other) / sex (Other)},
cin = {AG Schultze},
ddc = {610},
cid = {I:(DE-2719)1013038},
pnm = {354 - Disease Prevention and Healthy Aging (POF4-354)},
pid = {G:(DE-HGF)POF4-354},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41138924},
doi = {10.1016/j.jaci.2025.09.030},
url = {https://pub.dzne.de/record/285046},
}