Low mannose-binding lectin (MBL) levels in neonates with pneumonia and sepsis

Abstract

SummaryWe 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. Յ 0·7 mg/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) mg/ml, 1·05 (0·41-1·70) mg/ml and 0·20 (0·10-0·77) mg/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.

&lt;i&gt;MBL2&lt;/i&gt; Gene Polymorphism and the Association with Neonatal Sepsis in Egyptian Neonates, a Case Control Study

“…This result somewhat agrees with the result obtained by Ozkan et al [22] who found low producing MBL2 genotypes are significant risk factor for neonatal sepsis in Turkish neonates. Other studies like Frakking et al [27] obtain different results, as they found no relation between the MBL2 gene polymorphism and neonatal sepsis. This discrepancy of results may be explained by different sample size and the variable distribution of MBL2 genotyped in the study population.…”

Lectin pathway of complement activation and relation with clinical complications in critically ill children

“…Low MBL levels in blood from neonates were related to an increased risk of neonatal sepsis and pneumonia (24,25). Cord blood MASP-2 levels tended to be higher for babies with infections (26) and were higher for neonates who developed NEC (17).…”

Host Genetics and Pediatric Sepsis

“…The 3 MBL structural variants D, C, and B are associated with an increased risk for meningococcal infections [64,65], pneumonia and sepsis in neonates [66], acute respiratory infections in children [67], hospitalizations due to infections in children [68], recurrent respiratory infections [69], and viral co-infections in adults with pneumococcal pneumonia [70]. Three studies have examined MBL polymorphisms in patients with invasive pneumococcal disease [71][72][73], with one of these three studies finding a significant association.…”