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Kalia N, Singh J, Kaur M. The ambiguous role of mannose-binding lectin (MBL) in human immunity. Open Med (Wars) 2021; 16:299-310. [PMID: 33681468 PMCID: PMC7917369 DOI: 10.1515/med-2021-0239] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 01/22/2021] [Accepted: 01/29/2021] [Indexed: 12/30/2022] Open
Abstract
Mannose-binding lectin (MBL) and lectin complement pathway have become targets of increasing clinical interest. Many aspects of MBL have been recently explored, including the structural properties that allow it to distinguish self from non-self/altered-self structures. Experimental evidences have declared the additional 5′- and 3′-variants that in amalgamation with well-known secretor polymorphisms change MBL function and concentration. Moreover, the current review highlights the differential behavior of MBL on exposure with extra/intracellular pathogens and in autoimmune diseases, stressing the fact that “high MBL levels can increase diseases susceptibility,” a paradox that needs justification. Attributable to these discrepancies, no absolute level of MBL deficiency could be defined so far and thus must be interpreted for specific diseases through case–control population-specific designs. Overall, it is evident that further research is needed about MBL and the lectin pathway of complement. Particularly, the transformative role of MBL over evolution is of interest and its role with regard to pathogenesis of different diseases and potential therapeutic targets within the respective pathways should be further explored. Apart from this, it is necessary to adopt an extensive locus-wide methodology to apprehend the clinical significance of MBL2 polymorphisms in a variety of infectious diseases by the future studies.
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Affiliation(s)
- Namarta Kalia
- Department of Molecular Biology and Biochemistry, Guru Nanak Dev University, Amritsar, India.,Department of Biological Sciences, George Washington University, Washington, DC 20052, USA
| | - Jatinder Singh
- Department of Molecular Biology and Biochemistry, Guru Nanak Dev University, Amritsar, India
| | - Manpreet Kaur
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, India
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Radnay ZB, Udvardy M, Papp M, Hársfalvi J, Rejto L, Pál I, Illés Á, Kiss A. Evaluation of Mannose-Binding Lectin is a Useful Approach to Predict the Risk of Infectious Complications Following Autologous Hematopoietic Stem Cell Transplantation. Transplant Proc 2017; 48:3397-3405. [PMID: 27931588 DOI: 10.1016/j.transproceed.2016.08.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 07/27/2016] [Accepted: 08/22/2016] [Indexed: 01/03/2023]
Abstract
Hematopoietic stem cell transplantation (HSCT) associated immunocompromised state carries high risk of infectious complications. Mannose-binding lectin (MBL) is an acute phase protein involved in innate immune response. Serum MBL level is genetically determined and quite stable. According to literature, significant association was shown between low MBL concentrations and serious infections. The association between serum MBL level and frequency and severity of infections was studied in 186 patients following autologous HSCT. Double-monoclonal antibody sandwich enzyme-linked immunosorbent assay was used to determine MBL antigen level in sera. MBL levels were measured around 100 days following transplantation, in a period without active infection. Twenty-one patients (11%) were MBL deficient. The median time of first infection and number of infections during the first year post-transplantation were not significantly different between patients with MBL deficiency and those without MBL deficiency. The occurrence and number of infections after HSCT correlated with the MBL/C-reactive protein ratio. The number of severe infections was not higher among those with MBL deficiency. The occurrence of infections after the pre-engraftment period during the first year post-transplantation was significantly different in patient groups separated by MBL cut-off level. The MBL/C-reactive protein ratio might be a useful marker of infectious complications. MBL measurement may be helpful in antibiotic treatment. In case of MBL deficiency, earlier and more intensive treatment may be indicated.
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Affiliation(s)
- Z B Radnay
- Department of Hematology, Institute for Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
| | - M Udvardy
- Department of Hematology, Institute for Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - M Papp
- Department of Gastroenterology, Institute for Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - J Hársfalvi
- Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary; Clinical Research Center, Faculty of Medicine, University of Debrecen, Hungary
| | - L Rejto
- Department of Hematology, Institute for Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - I Pál
- Department of Hematology, Institute for Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Á Illés
- Department of Hematology, Institute for Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - A Kiss
- Department of Hematology, Institute for Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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Frakking FNJ, Brouwer N, Dolman KM, van Woensel JBM, Caron HN, Kuijpers TW, van de Wetering MD. Mannose-binding lectin (MBL) as prognostic factor in paediatric oncology patients. Clin Exp Immunol 2011; 165:51-9. [PMID: 21488869 PMCID: PMC3110321 DOI: 10.1111/j.1365-2249.2011.04398.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Deficiency of mannose-binding lectin (MBL) has been suggested to influence duration of febrile neutropenia and prognosis in paediatric oncology patients. However, there is no consensus on the definition of MBL deficiency. In a cohort of children with cancer, we investigated (i) how to determine MBL deficiency and (ii) whether MBL is a prognostic factor for disease severity. In 222 paediatric oncology patients, 92 healthy children and 194 healthy adults, MBL plasma levels and MBL2 genotype (wild-type: A, variant: O) were determined. Event-free survival (EFS), overall survival (OS) and paediatric intensive care unit (PICU) admissions were recorded prospectively. In febrile neutropenic patients admitted to the PICU, disease severity was assessed by clinical, microbiological and laboratory parameters. An optimal cut-off value for MBL deficiency was determined to be < 0·20 µg/ml. Wild-type MBL2 genotype patients, including the XA/XA haplotype, had increased MBL levels compared to healthy individuals. MBL deficiency was associated with decreased EFS (P = 0·03), but not with need for PICU admission. A trend for a twice increased frequency of septic shock (80% versus 38%, P = 0·14), multiple organ failure (40% versus 17%, P = 0·27) and death (40% versus 21%, P = 0·27) was observed in the absence of microbiological findings. MBL deficiency was associated with decreased EFS and possibly with an increased severity of disease during PICU admission after febrile neutropenia in the absence of any association with microbiological findings. These findings suggest prognosis to be worse in MBL-deficient compared to MBL-sufficient paediatric oncology patients.
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Affiliation(s)
- F N J Frakking
- Emma Children's Hospital, Academic Medical Center (AMC), Sanquin Research and Landsteiner Laboratory, AMC, University of Amsterdam, the Netherlands
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Thye T, Niemann S, Walter K, Homolka S, Intemann CD, Chinbuah MA, Enimil A, Gyapong J, Osei I, Owusu-Dabo E, Rüsch-Gerdes S, Horstmann RD, Ehlers S, Meyer CG. Variant G57E of mannose binding lectin associated with protection against tuberculosis caused by Mycobacterium africanum but not by M. tuberculosis. PLoS One 2011; 6:e20908. [PMID: 21695215 PMCID: PMC3112207 DOI: 10.1371/journal.pone.0020908] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Accepted: 05/16/2011] [Indexed: 11/17/2022] Open
Abstract
Structural variants of the Mannose Binding Lectin (MBL) cause quantitative and qualitative functional deficiencies, which are associated with various patterns of susceptibility to infectious diseases and other disorders. We determined genetic MBL variants in 2010 Ghanaian patients with pulmonary tuberculosis (TB) and 2346 controls and characterized the mycobacterial isolates of the patients. Assuming a recessive mode of inheritance, we found a protective association between TB and the MBL2 G57E variant (odds ratio 0.60, confidence interval 0.4–0.9, P 0.008) and the corresponding LYQC haplotype (Pcorrected 0.007) which applied, however, only to TB caused by M. africanum but not to TB caused by M. tuberculosis. In vitro, M. africanum isolates bound recombinant human MBL more efficiently than did isolates of M. tuberculosis. We conclude that MBL binding may facilitate the uptake of M. africanum by macrophages, thereby promoting infection and that selection by TB may have favoured the spread of functional MBL deficiencies in regions endemic for M. africanum.
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Affiliation(s)
- Thorsten Thye
- Department of Molecular Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
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Brouwer N, Frakking FNJ, van de Wetering MD, van Houdt M, Hart M, Budde IK, Strengers PFW, Laursen I, Houen G, Roos D, Jensenius JC, Caron HN, Dolman KM, Kuijpers TW. Mannose-Binding Lectin (MBL) Substitution: Recovery of Opsonic Function In Vivo Lags behind MBL Serum Levels. THE JOURNAL OF IMMUNOLOGY 2009; 183:3496-504. [DOI: 10.4049/jimmunol.0900445] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Frakking FN, Brouwer N, van de Wetering MD, Budde IK, Strengers PF, Huitema AD, Laursen I, Houen G, Caron HN, Dolman KM, Kuijpers TW. Safety and pharmacokinetics of plasma-derived mannose-binding lectin (MBL) substitution in children with chemotherapy-induced neutropaenia. Eur J Cancer 2009; 45:505-12. [DOI: 10.1016/j.ejca.2008.11.036] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2008] [Revised: 10/29/2008] [Accepted: 11/24/2008] [Indexed: 11/24/2022]
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Huttunen R, Aittoniemi J, Laine J, Vuento R, Karjalainen J, Rovio AT, Eklund C, Hurme M, Huhtala H, Syrjänen J. Gene-environment Interaction between MBL2 Genotype and Smoking, and the Risk of Gram-positive Bacteraemia. Scand J Immunol 2008; 68:438-44. [DOI: 10.1111/j.1365-3083.2008.02149.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mannose-binding lectin deficiency is associated with early onset of polyarticular juvenile rheumatoid arthritis: a cohort study. Arthritis Res Ther 2008; 10:R32. [PMID: 18334024 PMCID: PMC2453777 DOI: 10.1186/ar2386] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2007] [Revised: 02/29/2008] [Accepted: 03/11/2008] [Indexed: 12/26/2022] Open
Abstract
Background Mannose-binding lectin (MBL) is an innate immune protein. The aim of our study was to determine whether genetically determined MBL deficiency is associated with susceptibility to juvenile rheumatoid arthritis (JRA) and whether MBL2 genotypes are associated with JRA severity. Methods In a retrospective cohort study of 218 patients with polyarthritis (n = 67) and oligoarthritis (n = 151), clinical and laboratory disease variables were obtained by clinical examination and chart reviews. Healthy Caucasian adults (n = 194) served as control individuals. MBL2 gene mutations were determined by Taqman analysis to identify genotypes with high, medium and low expression of MBL. Functional MBL plasma concentrations were measured using enzyme-linked immunosorbent assay. Associations between clinical and laboratory variables and MBL2 genotypes were determined by Kruskal-Wallis and χ2 tests. Results MBL2 genotype frequencies were similar in polyarthritis and oligoarthritis patients as compared with control individuals. MBL plasma concentrations were associated with the high, medium and low MBL genotype expression groups (P < 0.01). In polyarthritis patients, the presence of low-expressing (deficient) MBL2 genotypes was associated with early age at onset of disease (P = 0.03). In oligoarthritis patients, patients with low-expressing MBL2 genotypes were more often in remission (81%) than patients in the medium (54%) and high (56%) genotype groups (P = 0.02). The remaining clinical and laboratory variables, such as arthritis severity index, presence of radiographic erosions and antinuclear antibody positivity, were not associated with MBL2 genotypes. Conclusion Genetically determined MBL deficiency does not increase susceptibility to JRA, but MBL deficiency is associated with a younger age at onset of juvenile polyarthritis. On the other hand, MBL-deficient children with juvenile oligoarthritis are more often in remission. Therefore, MBL appears to play a dual role in JRA.
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van Till JWO, Modderman PW, de Boer M, Hart MHL, Beld MGHM, Boermeester MA. Mannose-binding lectin deficiency facilitates abdominal Candida infections in patients with secondary peritonitis. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2008; 15:65-70. [PMID: 17978009 PMCID: PMC2223851 DOI: 10.1128/cvi.00297-07] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2007] [Revised: 08/20/2007] [Accepted: 10/19/2007] [Indexed: 01/04/2023]
Abstract
Mannose-binding lectin (MBL) deficiency due to variations in the MBL gene is associated with increased susceptibility to infections. In this study, the association between MBL deficiency and the occurrence of abdominal yeast infection (AYI) in peritonitis patients was examined. Eighty-eight patients with secondary peritonitis requiring emergency laparotomy were included. MBL genotype (wild type [WT] versus patients with variant genotypes), MBL plasma concentrations, and Candida risk factors were examined in patients with and those without AYI (positive abdominal yeast cultures during [re]laparotomy). A variant MBL genotype was found in 53% of patients with AYI and 38% of those without AYI (P = 0.18). A significantly higher proportion of variant patients had an AYI during early peritonitis (during first laparotomy) than WT patients (39% versus 16%, respectively; P = 0.012). Patients with AYI had lower MBL levels than did patients without AYI (0.16 microg/ml [0.0 to 0.65 microg/ml] versus 0.65 microg/ml (0.19 to 1.95 microg/ml); P = 0.007). Intensity of colonization (odds ratio [OR], 1.1; 95% confidence interval [CI], 1.0 to 1.1), MBL plasma concentrations of <0.5 microg/ml (OR, 4.5; 95% CI, 1.2 to 16.3), and numbers of relaparotomies (OR, 1.7; 95% CI, 1.0 to 2.8) were independently associated with AYI. In summary, deficient MBL plasma levels were independently associated with the development of AYI in patients with secondary peritonitis and seemed to facilitate early infection.
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Thiel S. Complement activating soluble pattern recognition molecules with collagen-like regions, mannan-binding lectin, ficolins and associated proteins. Mol Immunol 2007; 44:3875-88. [PMID: 17768106 DOI: 10.1016/j.molimm.2007.06.005] [Citation(s) in RCA: 182] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2007] [Indexed: 01/31/2023]
Abstract
Mannan-binding lectin (MBL), L-ficolin, M-ficolin and H-ficolin are all complement activating soluble pattern recognition molecules with recognition domains linked to collagen-like regions. All four may form complexes with four structurally related proteins, the three MBL-associated serine proteases (MASPs), MASP-1, MASP-2 and MASP-3, and a smaller MBL-associated protein (MAp19). The four recognition molecules recognize patterns of carbohydrate or acetyl-group containing ligands. After binding to the relevant targets all four are able to activate the complement system. We thus have a system where four different and/or overlapping patterns of microbial origin or patterns of altered-self may be recognized, but in all cases the signalling molecules, the MASPs, are shared. MASP-1 and MASP-3 are formed from one gene, MASP1/3, by alternative splicing generating two different mRNAs from a single primary transcript. Similarly MASP-2 and MAp19 are both generated from one gene, MASP-2/MAp19, by alternative splicing. A number of non-synonymous polymorphisms of the four recognition molecules and of the MASPs are known, and the implications of these alterations are being studied. The clinical impact of deficiencies will be discussed.
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Affiliation(s)
- Steffen Thiel
- Department of Medical Microbiology and Immunology, University of Aarhus, Wilhelms Meyers Allé, 8000 Aarhus C, Denmark.
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Frakking FNJ, Brouwer N, van Eijkelenburg NKA, Merkus MP, Kuijpers TW, Offringa M, Dolman KM. Low mannose-binding lectin (MBL) levels in neonates with pneumonia and sepsis. Clin Exp Immunol 2007; 150:255-62. [PMID: 17711490 PMCID: PMC2219357 DOI: 10.1111/j.1365-2249.2007.03479.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We investigated whether deficiency of mannose-binding lectin (MBL), a component of innate immunity, is associated with neonatal pneumonia and sepsis during the first 72 h, i.e. early onset, and during the first month after birth. In 88 neonatal intensive care patients (71 premature), MBL2 genotype and MBL plasma levels at birth were determined prospectively by Taqman analysis and enzyme-linked immunosorbent assay, respectively. Thirty-five neonates (40%) had low, i.e. </= 0.7 microg/ml, MBL plasma levels at birth. Median (interquartile range) MBL plasma levels in 32 no early-onset sepsis (EOS) cases, 44 possible EOS cases and 11 EOS cases were 1.57 (0.57-2.67) microg/ml, 1.05 (0.41-1.70) microg/ml and 0.20 (0.10-0.77) microg/ml, respectively (P < 0.01). During the first month, 28 neonates (32%) had no infection, 49 (55%) had suspected infection, five (6%) had pneumonia and six (7%) had culture-proven sepsis. Low MBL levels at birth were associated both with an increased risk of developing pneumonia (OR: 12.0; 95% CI: 1.1-126.1; P = 0.04) and culture-proven sepsis (OR: 15.0; 95% CI: 1.5-151.3; P = 0.02). These results were confirmed by genetic analysis of MBL deficiency. Low MBL levels at birth are associated with an increased risk of early-onset sepsis, culture-proven sepsis and pneumonia during the first month of life.
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Affiliation(s)
- F N J Frakking
- Departments of Clinical Immunology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands.
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Schlapbach LJ, Aebi C, Otth M, Luethy AR, Leibundgut K, Hirt A, Ammann RA. Serum levels of mannose-binding lectin and the risk of fever in neutropenia pediatric cancer patients. Pediatr Blood Cancer 2007; 49:11-6. [PMID: 17143875 DOI: 10.1002/pbc.21097] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Fever in neutropenia (FN) is a frequent complication in pediatric oncology. Deficiency of mannose-binding lectin (MBL), an important component of innate immunity, is common due to genetic polymorphisms, but its impact on infections in oncologic patients is controversial. This study investigated whether MBL serum levels at cancer diagnosis are associated with the development of FN in pediatric cancer patients. PROCEDURE Serum MBL was measured using ELISA. Frequency, duration, and cause of FN were assessed retrospectively. Association with MBL level was analyzed using uni- and multivariate Poisson regression taking into account both intensity and duration of chemotherapy. RESULTS In 94 children, with a cumulative follow-up time of 81.7 years, 177 FN episodes were recorded. Patients with both very low MBL levels (<100 microg/L; risk ratio (RR), 1.93; 95% CI, 1.14-3.28; P = 0.014) and normal MBL levels (>or=1,000 microg/L; RR, P = 0.011) had significantly more frequent FN episodes than patients with low MBL levels (100-999 microg/L). Patients with very low MBL levels had significantly more episodes of FN with severe bacterial infection (bacteremia or pneumonia; RR, 4.49; 1.69 = 11.8; P = 0.003), while those with normal MBL levels had more FN episodes with no microbial etiology identified (RR, 1.85; 1.14 = 3.03; P = 0.014). CONCLUSIONS Very low MBL levels are associated with more frequent FN episodes, mainly due to severe bacterial infections. The surprising finding that children with normal MBL levels had more frequent FN episodes than those with low MBL levels needs testing in prospective studies.
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Affiliation(s)
- L J Schlapbach
- Department of Pediatrics, University of Bern, Bern, Switzerland
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Abstract
The human collectin, mannose‐binding lectin (MBL), is an important protein of the humoral innate immune system. With multiple carbohydrate‐recognition domains, it is able to bind to sugar groups displayed on the surfaces of a wide range of microorganisms and thereby provide first‐line defence. Importantly, it also activates the complement system through a distinctive third pathway, independent of both antibody and the C1 complex. Three single point mutations in exon 1 of the expressed human MBL‐2 gene appear to impair the generation of functional oligomers. Such deficiencies of functional protein are common in certain populations, e.g. in sub‐Saharan Africa, but virtually absent in others, e.g. indigenous Australians. MBL disease association studies have been a fruitful area of research and implicate a role for MBL in infective, inflammatory and autoimmune disease processes. Overall, there appears to be a genetic balance in which individuals generally benefit from high levels of the protein. However, in certain situations, reduced levels of circulating MBL may be beneficial to the host and this may explain the persistence of the deleterious gene polymorphisms in many population groups.
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Affiliation(s)
- R M Dommett
- Infectious Diseases and Microbiology Unit, Institute of Child Health, UCL, 30 Guilford Street, London WC1N 1EH, UK
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Abstract
Mannan-binding lectin (MBL) is a plasma protein of the innate immune system with the ability to initiate antimicrobial and inflammatory actions. MBL deficiency is common. More than 10% of the general population may, depending on definition, be classified as MBL deficient, underlining the redundancy of the immune system. Ongoing research attempt to illuminate at which conditions MBL deficiency may lead to disease. With examples, this review illustrates the diversity of results obtained so far.
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Affiliation(s)
- S Thiel
- Department of Medical Microbiology and Immunology, University of Aarhus, DK8000 Denmark.
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Siassi M, Riese J, Steffensen R, Meisner M, Thiel S, Hohenberger W, Schmidt J. Mannan-binding lectin and procalcitonin measurement for prediction of postoperative infection. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2005; 9:R483-9. [PMID: 16277709 PMCID: PMC1297609 DOI: 10.1186/cc3768] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2005] [Revised: 06/07/2005] [Accepted: 06/20/2005] [Indexed: 01/04/2023]
Abstract
Introduction Postoperative infection is a major cause of morbidity and mortality. We investigated two serum markers for their ability to identify patients at risk for postoperative infection. Mannan-binding lectin (MBL) is a central molecule of the innate immune system and MBL deficiency is known to predispose to infection. Procalcitonin (PCT) is a sensitive marker for bacterial infection. Methods We investigated 162 patients undergoing elective surgery for cancer of the gastrointestinal tract. Patients were classified as having no complications (group A), having infection for unknown reason (group B) or having sepsis after events like aspiration or anastomotic leakage (group C). Analysis was done pre- and postoperatively for serum levels of MBL, PCT and C-reactive-protein. DNA was preoperatively sampled and stored and later analysed for genetic polymorphisms of MBL. Results The preoperative serum levels of MBL were significantly lower in group B patients than in group A patients (1332 ± 466 ng/ml versus 2523 ± 181 ng/ml). PCT measured on day one post-surgery was significantly higher in group B patients than in group A (3.33 ± 1.08 ng/ml versus 1.38 ± 0.17 ng/ml). Patients with an aberrant MBL genotype had a significantly higher risk of postoperative infections than wild-type carriers (p < 0.05). Conclusion Preoperative MBL and early postoperative PCT measurement may help identify patients at risk for postoperative infection.
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Affiliation(s)
- Michael Siassi
- Department of Surgery, University Hospital Erlangen, Erlangen, Germany
| | - Jutta Riese
- Department of Surgery, University Hospital Erlangen, Erlangen, Germany
| | - Rudi Steffensen
- Regional Centre for Blood Transfusion and Clinical Immunology, Aalborg Hospital, Aalborg, Denmark
| | - Michael Meisner
- Department of Anaesthesiology, University Hospital Jena, Jena, Germany
| | - Steffen Thiel
- Department of Medical Microbiology and Immunology, University of Aarhus, Aarhus, Denmark
| | - Werner Hohenberger
- Professor, Department of Surgery, University Hospital Erlangen, Erlangen, Germany
| | - Joachim Schmidt
- Department of Anaesthesiology, University Hospital Erlangen, Erlangen, Germany
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Klein NJ, Kilpatrick DC. Is there a role for mannan/mannose-binding lectin (MBL) in defence against infection following chemotherapy for cancer? Clin Exp Immunol 2004; 138:202-4. [PMID: 15498027 PMCID: PMC1809207 DOI: 10.1111/j.1365-2249.2004.02604.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- N J Klein
- Institute of Child Health, University College London, London, UK.
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Nuytinck L, Shapiro F. Mannose-binding lectin: laying the stepping stones from clinical research to personalized medicine. Per Med 2004; 1:35-52. [PMID: 29793226 DOI: 10.1517/17410541.1.1.35] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
As a key component of the complement system, mannose-binding lectin (MBL) is one of the linchpins of innate immunity. It is, therefore, not surprising that MBL2 genetic variants affecting the quantity and activity of the MBL protein in serum have been associated with increased susceptibility to infection and autoimmune diseases, and with poorer prognostic outcomes. This enhanced risk is particularly the case for children and immunosuppressed patients, especially when immunity is further compromised by coexistent primary or secondary immune deficiencies. In several disease areas, such as sepsis, cystic fibrosis, and recurrent childhood infections, the association between low MBL-producing allelic variants and disease risk and/or severity is particularly strong. It is here that the use of MBL testing and replacement therapy has reached the threshold of personalized medicine. The role of MBL in health and disease, advances in MBL testing methodologies and key areas for possible applications of MBL replacement therapy are reviewed.
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Affiliation(s)
- Lieve Nuytinck
- Innogenetics NV, Diagnostics - Genetic Testing Program, Innogenetics NV, Technologiepark 6, B-9052 Gent, Belgium.
| | - Fred Shapiro
- Innogenetics NV, Department of Clinical Development and Medical Affairs, Innogenetics NV, Industriepark Zwijnaarde 7/4, B-9052 Gent, Belgium
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