Low mannose-binding lectin (MBL) levels in neonates with pneumonia and sepsis.
We investigated whether deficiency of mannose-binding lectin (MBL), a component of innate immunity, is associated with neonatal pneumonia and sepsis during the first 72 h, i.e. early onset, and during the first month after birth. In 88 neonatal intensive care patients (71 premature), MBL2 genotype and MBL plasma levels at birth were determined prospectively by Taqman analysis and enzyme-linked immunosorbent assay, respectively. Thirty-five neonates (40%) had low, i.e. </= 0.7 microg/ml, MBL plasma levels at birth. Median (interquartile range) MBL plasma levels in 32 no early-onset sepsis (EOS) cases, 44 possible EOS cases and 11 EOS cases were 1.57 (0.57-2.67) microg/ml, 1.05 (0.41-1.70) microg/ml and 0.20 (0.10-0.77) microg/ml, respectively (P < 0.01). During the first month, 28 neonates (32%) had no infection, 49 (55%) had suspected infection, five (6%) had pneumonia and six (7%) had culture-proven sepsis. Low MBL levels at birth were associated both with an increased risk of developing pneumonia (OR: 12.0; 95% CI: 1.1-126.1; P = 0.04) and culture-proven sepsis (OR: 15.0; 95% CI: 1.5-151.3; P = 0.02). These results were confirmed by genetic analysis of MBL deficiency. Low MBL levels at birth are associated with an increased risk of early-onset sepsis, culture-proven sepsis and pneumonia during the first month of life.
Frakking
F N J
FN
Departments of Clinical Immunology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands. f.n.frakking@amc.uva.nl
Brouwer
N
N
van Eijkelenburg
N K A
NK
Merkus
M P
MP
Kuijpers
T W
TW
Offringa
M
M
Dolman
K M
KM
D003422:Critical Care; D036861:Delivery, Obstetric / Q000379:methods; D004198:Disease Susceptibility; D005260:Female; D005838:Genotype; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000276:immunology; D008297:Male; D037601:Mannose-Binding Lectin / Q000097:blood / Q000172:deficiency* / Q000235:genetics; D018410:Pneumonia, Bacterial / Q000276:immunology*; D011446:Prospective Studies; D018805:Sepsis / Q000276:immunology*
C445619:MBL2 protein, human; D037601:Mannose-Binding Lectin
Pediatr Crit Care Med. 2005 Jan;6(1):2-8
15636651
Pediatr Infect Dis J. 2005 Jul;24(7):635-9
15999007
Acta Paediatr. 2005 Jun;94(6):794-9
16188791
J Hosp Infect. 2005 Dec;61(4):300-11
16221510
Shock. 2006 Jan;25(1):88-93
16369192
Mol Immunol. 2006 May;43(13):2051-60
16499969
Eur J Cancer. 2006 May;42(7):909-16
16517152
Clin Exp Immunol. 2006 Jul;145(1):5-12
16792667
Pediatr Res. 2007 Mar;61(3):325-8
17314691
Eur J Immunogenet. 2000 Jun;27(3):111-7
10940077
Pediatrics. 2001 Jul;108(1):E12
11433091
Lancet. 2001 Aug 25;358(9282):614-8
11530147
J Clin Epidemiol. 2001 Dec;54(12):1251-7
11750194
Pediatr Infect Dis J. 2003 Mar;22(3):244-51
12634586
Ann Intern Med. 2003 Apr 15;138(8):644-50
12693887
Pediatr Infect Dis J. 2003 May;22(5):430-4
12792384
Mol Immunol. 2003 Sep;40(2-4):73-84
12914814
Paediatr Drugs. 2003;5(11):723-40
14580222
J Infect Dis. 2003 Nov 1;188(9):1394-403
14593599
J Clin Pathol. 2003 Dec;56(12):956-9
14645358
Scand J Immunol. 2004 Jan;59(1):97-102
14723627
Pediatr Res. 2004 Apr;55(4):652-6
14739370
Clin Exp Immunol. 2004 May;136(2):304-11
15086395
Intensive Care Med. 2004 Jul;30(7):1438-45
15127191
Lancet. 1989 Nov 25;2(8674):1236-9
2573758
Immunol Lett. 1993 Nov;38(3):185-7
8125525
Immunogenetics. 1994;40(1):37-44
8206524
J Immunol. 1995 Sep 15;155(6):3013-20
7673719
Clin Exp Immunol. 1995 Dec;102(3):649-54
8536386
Immunol Today. 1996 Nov;17(11):532-40
8961631