Mannose-binding lectin (MBL) insufficiency protects against the development of systemic inflammatory response after pediatric cardiac surgery

Pągowska‐Klimek, Izabela; Świerzko, Anna St.; Michalski, Mateusz; Moll, Maciej; Szala-Poździej, Agnieszka; Sokołowska, Anna; Krajewski, Wojciech; Cedzyński, Maciej

doi:10.1016/j.imbio.2015.09.010

Cited by 10 publications

(14 citation statements)

References 37 publications

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“…Our results showed the deepest decrease in MBL levels in patients presenting with symptoms of post-bypass sterile SIRS, strongly suggesting MBL involvement in the development of systemic inflammation. This is in agreement with our earlier observations, that postoperative SIRS is related to higher preoperative serum MBL levels and high MBL-producing genotypes [16]. Similar observations were reported by Smithson et al for adult ICU patients [15].…”

Section: Discussionsupporting

confidence: 94%

“…In total, 185 children, aged 3 months to 17 years (mean = 3 years and 4 months) with congenital heart disease on whom cardiac surgery with the use of cardiopulmonary bypass was performed, were recruited to this prospective study. They represented the majority of the cohort analysed previously in relation to preoperative MBL concentrations . Mean basic Aristotle score (BAS) was 7·62 [standard deviation (s.d.)…”

Section: Methodsmentioning

confidence: 99%

“…Our previous study suggested a strong contribution of high preoperative levels of serum MBL (associated with high MBL‐producing genotypes) in the development of SIRS after paediatric cardiac surgery. Here we report data concerning lectin pathway activation during paediatric CPB.…”

Section: Introductionmentioning

confidence: 97%

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Activation of the lectin pathway of complement by cardiopulmonary bypass contributes to the development of systemic inflammatory response syndrome after paediatric cardiac surgery

Pągowska‐Klimek

Świerzko

Michalski

et al. 2016

Clinical and Experimental Immunology

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SummaryThe systemic inflammatory response is a challenge in the management of paediatric patients undergoing cardiac surgery. Although multi-factorial, a contribution by the lectin pathway of complement activation has been postulated. We therefore investigated the changes in serum levels of mannose binding lectin (MBL) and activities of MBL-MBL-associated serine protease (MASP)-1 and MBL-MASP-2 complexes immediately before and during surgery, throughout the first postoperative day and at discharge from the hospital. These changes were analysed in relation to postoperative complications. Blood samples were obtained from 185 children with congenital heart disease undergoing surgical correction with the use of cardiopulmonary bypass: preoperatively (MBL-1), 15 min after initiation of cardiopulmonary bypass (CPB) (MBL-E), 30 min (MBL-2), 4 h (MBL-3), 12 h (MBL-4) and 24 h (MBL-5) post-CPB and at discharge from hospital (MBL-K). Alterations in serum MBL levels were calculated as a ratio of its serum level at subsequent time-points (MBL-2, -3, -4, -5) to the preoperative (MBL-1) value. Decreases in MBL and MBL-MASP complexes were observed in all samples, correlating with a decrease in C4 and increase in C4a, confirming activation of the lectin pathway. Changes in MBL levels between children with an uncomplicated postoperative course and those suffering from infection or low cardiac output syndrome did not differ significantly, but significant differences were observed between the SIRS and non-SIRS groups. Paediatric cardiac surgery with the use of cardiopulmonary bypass activates the complement system via the lectin pathway and the latter contributes to the development of the post-bypass systemic inflammatory response.

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Section: Discussionsupporting

confidence: 94%

Section: Methodsmentioning

confidence: 99%

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Activation of the lectin pathway of complement by cardiopulmonary bypass contributes to the development of systemic inflammatory response syndrome after paediatric cardiac surgery

Pągowska‐Klimek

Świerzko

Michalski

et al. 2016

Clinical and Experimental Immunology

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“…The post-operative course was observed and documented until hospital discharge. Patients were screened for symptoms of post-operative complications (infection, SIRS, LCOS, organ dysfunctions), essentially as described previously 5,6 .…”

Section: Methodsmentioning

confidence: 99%

“…e ., ficolins and some collectins, complexed with enzymes belonging to the MASP (mannose-binding lectin serine protease) family. The involvement of the mannose-binding lectin (MBL)-dependent lectin pathway activation in the inflammatory response following CPB has been documented by us previously 5,6 . Therefore we decided to investigate the significance of particular MASPs and related non-enzymatic (regulatory) proteins.…”

Section: Introductionmentioning

confidence: 93%

Factors involved in initiation and regulation of complement lectin pathway influence postoperative outcome after pediatric cardiac surgery involving cardiopulmonary bypass

Michalski

Pągowska‐Klimek

Thiel

et al. 2019

Sci Rep

Self Cite

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Congenital heart disease (CHD) often requires surgical intervention, and is sometimes associated with life-threatening post-operative complications. We have investigated some factors of the innate immune system involved in the initiation or regulation of complement lectin pathway activation (MASP-1, MASP-2 MASP-3, MAp19, MAp44, ficolin-3) and related them to complications and prognosis in 190 pediatric patients undergoing CHD repair with the use of cardiopulmonary bypass (CPB). Patients with MAp44 levels ≤1.81 µg/ml more frequently experienced low cardiac output syndrome (LCOS), renal insufficiency, systemic inflammatory response syndrome (SIRS) and multiorgan dysfunction (MODS). Low MASP-3 (≤5.18 µg/ml) and high MASP-1 (≥11.7 µg/ml) levels were often associated with fatal outcome. Low ficolin-3 concentrations (≤10.1 µg/ml) were more common among patients experiencing SIRS and MODS than in those without complications. However, patients suffering from SIRS and MODS with low ficolin-3 had a much better prognosis (91% survival vs . 37% among other patients; p = 0.007). A discriminating value of 12.7 µg/ml ficolin-3 yielded 8% vs . 60% mortality (p = 0.001). Our data extend the knowledge concerning involvement of proteins of the lectin pathway in development of post-CPB complications. The potential prognostic value of low preoperative MAp44 and high preoperative ficolin-3 seems promising and warrants independent confirmation.

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Role of nanoparticles in bioimaging, diagnosis and treatment of cancer disorder

Muthuraman

Rishitha

Mehdi

2018

Design of Nanostructures for Theranostics Applications

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Mannose-binding lectin (MBL) insufficiency protects against the development of systemic inflammatory response after pediatric cardiac surgery

Cited by 10 publications

References 37 publications

Activation of the lectin pathway of complement by cardiopulmonary bypass contributes to the development of systemic inflammatory response syndrome after paediatric cardiac surgery

Activation of the lectin pathway of complement by cardiopulmonary bypass contributes to the development of systemic inflammatory response syndrome after paediatric cardiac surgery

Factors involved in initiation and regulation of complement lectin pathway influence postoperative outcome after pediatric cardiac surgery involving cardiopulmonary bypass

Role of nanoparticles in bioimaging, diagnosis and treatment of cancer disorder

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