الفهرس 
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Abstract
Despite improved neonatal care over the past decades, infections remain common and sometimes life threatening in neonates admitted to the neonatal intensive care unit (NICU).
For many years, a search has been ongoing to find predictors of neonatal sepsis that identify effectively patients who are at risk of infection.
The programmed death receptor-1 (PD-1) (CD279) is a cell surface receptor that belongs to the immunoglobulin’s superfamily, first described by Ishida and colleagues in 1992. PD-1 pathway seems to play a role in sepsis-induced immune suppression.
PD-1 is an immune checkpoint and guards against autoimmunity through two mechanisms. First, it promotes apoptosis (programmed cell death) of antigen-specific T-cells in lymph nodes. Second, it reduces apoptosis in regulatory T cells (anti-inflammatory, suppressive T cells).
A negative signal transmitted from the activated PD-1 receptor leads to decreased activity of the immune system by inhibition of the T cell receptor (TCR) or B cell receptor (BCR) connected signalling pathways, decreased production of the cytokines and proteins promoting immune cell survival (e.g. Bcl-2), and increased synthesis of IL-10, which inhibits the immune response.
The aim of our study was to investigate whether neonatal sepsis was associated with early elevation PD-1 on lymphocytes, which would help us in early and accurate diagnosis and early initiation of appropriate therapy as well as response to treatment i.e. prognosis of neonatal sepsis.
This was a prospective observational study. The study was carried out on 102 neonates who fulfilled inclusion and exclusion criteria and were admitted at the neonatal intensive care of Menoufia University Hospital.
The patient group composed of 52 newborns; 32 males (61.5%) and 20 females (38.5%), with mean gestational age of (35.46±2.81 weeks), mean birth weight of (2.51+0.77 kg), 9 neonates (17.3 %) were delivered vaginally and 43 (82.7%) were delivered by CS.
The control group composed of 50 healthy newborns; 24 males (48%) and 26 females (52%), with mean gestational age of (36.2±0.45 weeks), mean birth weight of (2.7+0.43 kg), 10 (20%) neonates were delivered vaginally and 40 (80%) neonates were delivered by CS.