Effect of phototherapy on the neutrophil surface markers cluster of differentiation10, cluster of differentiation11c and cluster of differentiation16 and blood picture parameters in neonates: a single-center prospective cohort study

Introduction
Indirect hyperbilirubinemia affects more than 60% of neonates and phototherapy (PT) is the standard method of treatment. Its effects on different blood cell characteristics are still being studied.


Objective
To evaluate the effect of PT on neutrophil functions through assessing the expression of cluster of differentiation 16 (CD16), CD11c, and CD10, and complete blood count parameters.


Patients and methods
This prospective cohort study included 54 admitted newborns greater than or equal to 35 weeks of gestation weighing greater than or equal to 2.5 kg presenting with indirect neonatal hyperbilirubinemia requiring only PT according to American Academy of Pediatrics guidelines. Neutrophil surface markers and complete blood count parameters were measured before and after PT as well as serum bilirubin.


Results
There was a significant increase in CD16 and CD10 expression and a significant decrease in CD11c expression after PT (P=0.002, 0.011, and 0.008, respectively). A statistically significant decrease in hemoglobin level, red blood cell count, red cell distribution width, hematocrit concentration, mean corpuscular volume and reticulocytic count was also detected (P<0.001). There was a significant decrease in the percentile values for neutrophils (P<0.001). A significant increase in the percentile values as well as in the absolute counts for lymphocytes (P=0.01 and 0.002, respectively) was noted, whereas a decrease in platelet count and volume following exposure to PT was also detected (P=0.002 and <0.001, respectively).


Conclusion
Postphototherapy, neutrophils showed an increased surface expression of CD10, CD16, and a decreased expression of CD11c. PT affected different parameters in the blood picture as well, which shows that it could cause many inflammatory and immune status changes in neonates.