title: Mannose-binding lectin does not act as an acute-phase reactant in adults with community-acquired pneumococcal pneumonia.
abstract: The objective of this work was to study the role of mannose-binding lectin (MBL) and C-reactive protein (CRP) in pneumococcal pneumonia, to determine whether MBL acts as an acute-phase reactant and whether the severity of the disease correlates with MBL levels. The study comprised 100 patients with pneumococcal pneumonia. The pneumonia severity score was calculated and graded into a risk class of mortality (Fine scale). The MBL genotypes and the levels of MBL and CRP at the acute and recovery phases were determined. Fifty patients with the wild-type MBL genotype showed higher MBL levels in each phase (P < 0.001) and an increased risk to developing bacteraemia, odds ratio (OR) 2.74, 95% confidence interval (CI) 1.01-7.52) (P = 0.02), but this did not correlate with the pneumonia severity class. CRP levels in the acute phase, 79.53 mg/l [standard deviation (s.d.) 106.93], were higher in the subjects with positive blood cultures (P = 0.003), and remained higher [20.12 mg/l (s.d. 31.90)] in the group of patients with an underlying disease (P = 0.01). No correlation was observed between the levels of MBL and CRP in each phase, or with the pneumonia severity score. We cannot conclude that MBL acts uniformly as an acute-phase reactant in pneumococcal pneumonia. MBL levels do not correlate well with the severity of the pneumonia. The risk of developing bacteraemia could be enhanced in individuals with the wild-type MBL genotype.
authors.affiliation: Service of Immunology, Hospital Son Dureta, 07198 Palma de Mallorca, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Perez-Castellano
authors.forename: M
authors.initials: M
authors.lastname: Peñaranda
authors.forename: A
authors.initials: A
authors.lastname: Payeras
authors.forename: J
authors.initials: J
authors.lastname: Milà
authors.forename: M
authors.initials: M
authors.lastname: Riera
authors.forename: J
authors.initials: J
authors.lastname: Vidal
authors.forename: F
authors.initials: F
authors.lastname: Pujalte
authors.forename: A
authors.initials: A
authors.lastname: Pareja
authors.forename: C
authors.initials: C
authors.lastname: Villalonga
authors.forename: N
authors.initials: N
authors.lastname: Matamoros
mesh_terms: D000210:Acute-Phase Reaction; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000235:genetics / Q000378:metabolism / Q000401:mortality; D017714:Community-Acquired Infections / Q000235:genetics / Q000378:metabolism* / Q000401:mortality; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D037601:Mannose-Binding Lectin / Q000235:genetics / Q000378:metabolism*; D008875:Middle Aged; D011018:Pneumonia, Pneumococcal / Q000235:genetics / Q000378:metabolism* / Q000401:mortality; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013296:Streptococcus pneumoniae
chemical_list: D037601:Mannose-Binding Lectin