The Role of Mannose-Binding Lectin in Susceptibility to Infection in Preterm Neonates

Abstract

Preterm neonates are susceptible to infection due to a combination of sub-optimal immunity and increased exposure to invasive organisms. Mannose-binding lectin (MBL) is a component of the innate immune system, which may be especially important in the neonatal setting. The objective of this study was to investigate the impact of MBL on susceptibility and severity of infection in preterm neonates during their first month of life. One hundred fifty eight preterm neonates were genotyped for MBL mutations by heteroduplex analyses. Consecutive serum MBL levels were measured by ELISA and clinical and laboratory data, including blood cultures, were collected for each baby. A third of the premature neonates had genetically determined MBL deficiency. In addition, MBL levels were also low in the first week of life and lower in neonates with a wild type genotype who were less than 28 wk gestation or a birth weight of less than 1000 g, thereby increasing the number of neonates with a low MBL level at birth. MBL deficiency was associated with an increased risk of sepsis (p Ͻ 0.01). This study indicates that MBL levels are low in neonates at birth and renders premature neonates to an increased risk of infection. (Pediatr Res 63: 680-685, 2008)

The developing human preterm neonatal immune system: A case for more research in this area

“…Reduced MBL serum levels have been linked to an increased risk of infection [57; 58; 59; 60; 61]. Preterm infants generally display lower MBL serum levels [58]. Moreover, common functional polymorphisms in the MBL2 gene resulting in variations in MBL serum levels may further increase susceptibility to infection in some infants [62; 63].…”

Prediction of sepsis-related outcomes in neonates through systematic genotyping of polymorphisms in genes for innate immunity and inflammation: a narrative review and critical perspective

“…Indeed, the clinically relevant issue is not which alleles an infant possesses, but how much functional MBL is produced. The discrepancies in the results between studies carried out in ethnically diverse populations 24,29,30 may be difficult to reconcile without systematic evaluation of the circulating MBL levels. However, there is a good side to this, because measurement of MBL may eventually prove to be a better predictor of sepsis than genotyping and, as a corollary, MBL replacement therapy should be helpful in individuals lacking it.…”

“…Aydemir et al 21 Härtel et al 9 Abu-Maziad et al 22 Auriti et al 23 Koroglu et al 24 Spiegler et al 25 Abdel-Hady et al 26 Bertalan et al 27 Reiman et al 28 Dzwonek et al 29 van Der Zwet et al 30 Schueller et al 31 Derzbach et al 32 Härtel et al 33 Baier et al 34 Göpel et al…”

“…39 One especially entangled situation concerns MBL. 24,29 This protein presents a series of polymorphisms that interfere with assembly of functional multimers. As a consequence, individuals who are homozygous for any given mutation, or heterozygous for two distinct mutations, present severe deficiency in this innate microbicidal factor.…”

Λεκτίνη συνδεόμενη με τη μαννόζη (mannose-binding lectin, MBL) και περιγεννητικές λοιμώξεις

“…Μάλιστα, μειωμένα επίπεδα της πρωτεΐνης MBL, έχει βρεθεί ότι σχετίζονται με υψηλό κίνδυνο σήψης κατά τον πρώτο μήνα μετά τον τοκετό. Περαιτέρω δεδομένα για τον ρόλο της MBL στο ανοσιακό σύστημα του νε ογνού περιγράφονται παρακάτω [30,31].…”