Relationship of Serum Mannose-Binding Lectin Levels with the Development of Sepsis: a Meta-analysis

Abstract

Many studies have evaluated the association between serum levels of mannose-binding lectin (MBL) and sepsis; however, the findings are inconclusive and conflicting. For a better understanding of MBL in sepsis, we conducted a comprehensive meta-analysis. Potential relevant studies were identified covering Science Citation Index, the Cochrane Library, PubMed, Embase, CINAHL, and Current Contents Index databases. Two reviewers extracted data and assessed studies independently. Statistical analyses were conducted with the version 12.0 STATA statistical software. Ten papers were collected for meta-analysis. Results identified that sepsis patients had considerably lower MBL level than those in the controls (standardized mean difference (SMD) = 1.59, 95 % confidence interval (95%CI) = 0.86∼2.31, P < 0.001). Ethnicity-subgroup analysis showed that sepsis patients were associated with decreased serum MBL level in contrast to the healthy controls in Asians (SMD = 3.07, 95%CI = 1.27∼4.88, P = 0.001) and Caucasians (SMD = 1.00, 95%CI = 0.35∼1.65, P = 0.003). In the group-stratified subgroup analysis, subjects with lower serum MBL level did underpin susceptibility to sepsis in the infants subgroup (SMD = 2.57, 95%CI = 1.59∼3.55, P < 0.001); however, this was not the case in the adults subgroup (SMD = 0.13, 95%CI = -1.30∼1.55, P = 0.862). Our study suggests an important involvement of serum MBL level in sepsis patients considering their lower level compared to controls, especially among infants.

Low Serum Mannose Binding Lectin (MBL) Levels and -221 YX Genotype of MBL2 Gene Are Susceptible to Neonatal Sepsis in the Chinese Han Population

“…Our data were in line with the study of Auriti et al (21) and Liu and Ning (22), who reported that low MBL levels increased the risk of nosocomial sepsis. Our results were also concordant with the study of Gao et al (14), who described that sepsis in the infant subgroup had considerably lower MBL level than those in the controls in Asians and Caucasians. But our results were in apparent contrast to the high MBL expression reported in the neonates with necrotizing enterocolitis (20).…”

“…The associations between MBL2 gene polymorphisms, circulating MBL levels, and susceptibility and out- comes in sepsis have been reported in several studies but have shown conflicting results (10)(11)(12)(13). Moreover, the concentrations of MBL may be diverse in patients with different ethnicities and ages (14). And little is known about the relationship between MBL and neonatal sepsis in the Chinese Han population.…”

The Lectin Complement Pathway in Patients with Necrotizing Soft Tissue Infection

“…The latter is activated by multimeric pattern recognition molecules (PRMs) comprising collagen and globular recognition domains and includes mannose-binding lectin (MBL), Ficolin-1, Ficolin-2 and Ficolin-3. MBL deficiency is associated with bacterial infections [8,9], but there are limited data regarding ficolins and infections. Nevertheless, decreased survival was found in septic patients with polymorphisms in the promoter region of the FCN1 gene [10], and survival tended to be lower in patients with community-acquired pneumonia and low Ficolin-2 level [11].…”

Changes in Mannose-Binding Lectin and Collectin Kidney 1 Levels in Sepsis Patients With and Without Disseminated Intravascular Coagulation

“…5,14,15 A recent meta-analysis reported that MBL levels in patients with sepsis were significantly lower than those in healthy participants. 15 Huh et al reported that although MBL levels in patients with severe sepsis were higher than those in patients with septic shock, MBL levels in nonsurvivors with septic shock were lower than those in survivors with septic shock. 16 However, Zhao et al reported that MBL levels in patients with sepsis with DIC upon arrival at the emergency department were higher than those in patients without DIC.…”