title: Polymorphisms in the mannose binding lectin-2 gene and acute respiratory distress syndrome.
abstract: OBJECTIVE
  The variant alleles in the mannose binding lectin-2 (MBL-2) gene have been associated with MBL deficiency and increased susceptibility to sepsis. We postulate that the variant MBL-2 genotypes are associated with increased susceptibility to and mortality in acute respiratory distress syndrome (ARDS).
  
  
  METHODS
  Nested case-control study.
  
  
  METHODS
  Tertiary academic medical center.
  
  
  METHODS
  Two hundred and twelve Caucasians with ARDS and 442 controls genotyped for the variant X, D, B, and C alleles of codon -221, 52, 54, and 57, respectively.
  
  
  METHODS
  None.
  
  
  RESULTS
  Patients homozygous for the variant codon 54B allele (54BB) had worse severity of illness on admission (p = .007), greater likelihood of septic shock (p = .04), and increased odds of ARDS (adjusted odds ratio, 6.7; 95% confidence interval, 1.5-31) when compared with heterozygotes and homozygotes for the wild-type allele. This association with ARDS was especially strong among the 311 patients with septic shock (adjusted odds ratio, 12.0; 95% confidence interval, 1.9-74). Among the patients with ARDS, the 54BB genotype was associated with more daily organ dysfunction (p = .01) and higher mortality (adjusted hazard rate, 4.0; 95% confidence interval, 1.6-10). Development of ARDS and outcomes in ARDS did not vary significantly with variant alleles of codon -221, 52, and 57, but the power to detect an effect was limited secondary to the low allele frequencies.
  
  
  CONCLUSIONS
  The MBL-2 codon 54BB genotype may be important in ARDS susceptibility and outcome. Additional studies are needed to confirm these findings in other populations.
authors.affiliation: Pulmonary and Critical Care Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Michelle N
authors.initials: MN
authors.lastname: Gong
authors.forename: Wei
authors.initials: W
authors.lastname: Zhou
authors.forename: Paige L
authors.initials: PL
authors.lastname: Williams
authors.forename: B Taylor
authors.initials: BT
authors.lastname: Thompson
authors.forename: Lucille
authors.initials: L
authors.lastname: Pothier
authors.forename: David C
authors.initials: DC
authors.lastname: Christiani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001900:Boston / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D005787:Gene Frequency / Q000235:genetics; D020022:Genetic Predisposition to Disease / Q000453:epidemiology / Q000209:etiology*; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D037601:Mannose-Binding Lectin / Q000235:genetics*; D008875:Middle Aged; D017720:Molecular Epidemiology; D011110:Polymorphism, Genetic / Q000235:genetics*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000378:metabolism / Q000401:mortality; D012307:Risk Factors; D018805:Sepsis / Q000150:complications; D065227:Transfusion Reaction; D014947:Wounds and Injuries / Q000150:complications
chemical_list: C445619:MBL2 protein, human; D037601:Mannose-Binding Lectin