PEDIATRICS Vol. 64 No. 5 November 1979, pp. 822-828
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Cell-Mediated Immunity in the Newborn: Clinical Aspects

Diane W. Wara MD1 and Douglas J. Barrett MD1

1 Department of Pediatrics, University of California, San Francisco

The clinical observation that the human newborn infant is uniquely susceptible to certain viral, fungal, protozoan, and bacterial infections has suggested that neonates may have impaired cell-mediated immune function. In order to diagnose primary cellular immunodeficiency during the neonatal period, it is necessary to define carefully normal cell-mediated immunity in term infants, premature infants, and infants with intrauterine growth retardation.

CELLULAR IMMUNITY: TERM INFANTS

The total lymphocyte count of a newborn infant is greater than 3,000/cu mm. Ferguson1 evaluated 25 healthy term infants (mean birth weight 3,130 gm) as control subjects for a study of children with intrauterine growth retardation. The healthy infants' total lymphocyte counts were 5,101 ± 1,821/cu mm. The subpopulation of lymphocytes that form total E rosettes and thus are defined as thymic derived lymphocytes has been reported as normal or decreased in term infant cord blood. In Ferguson's study, newborn E rosettes were 58% ± 7% in comparison to adult E rosettes of 57% ± 10%. Using comparable methods, four additional studies documented a decreased percent of E-rosette-forming cells in the cord blood of the newborn. The percent of total rosette formation in 13 cord blood samples averaged 33.3% ± 7.6% with a control adult mean in 15 samples of 5l.0% ± 6.5%.2 E rosettes were present in lower proportion in cord blood (53%) than in adult blood (65%) in a study by Campbell et al.3 Smith et al4 reported 53% rosette-forming cells in cord blood samples in contrast to 60% in adult samples. Ben-Zwi et a15 found 50% E-rosette-forming cells in cord blood in contrast to 59% in adult blood.