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@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},
}