title: Higher cord blood levels of mannose-binding lectin-associated serine protease-2 in infants with necrotising enterocolitis.
abstract: Necrotising enterocolitis (NEC) causes significant morbidity and mortality in premature infants. The role of innate immunity in the pathogenesis of NEC remains unclear. Mannose-binding lectin (MBL) recognizes microorganisms and activates the complement system via MBL-associated serine protease-2 (MASP-2). The aim of this study was to investigate whether MBL and MASP-2 are associated with NEC. This observational case-control study included 32 infants with radiologically confirmed NEC and 64 controls. MBL and MASP-2 were measured in cord blood using ELISA. Multivariate logistic regression was performed. Of the 32 NEC cases (median gestational age, 30.5 wk), 13 (41%) were operated and 5 (16%) died. MASP-2 cord blood concentration ranged from undetectable (<10 ng/mL) to 277 ng/mL. Eighteen of 32 (56%) NEC cases had higher MASP-2 levels (> or =30 ng/mL) compared with 22 of 64 (34%) controls (univariate OR 2.46; 95% CI 1.03-5.85; p = 0.043). Higher cord blood MASP-2 levels were significantly associated with an increased risk of NEC in multivariate analysis (OR 3.00; 95% CI 1.17-7.93; p = 0.027). MBL levels were not associated with NEC (p = 0.64). In conclusion, infants later developing NEC had significantly higher MASP-2 cord blood levels compared with controls. Higher MASP-2 may favor complement-mediated inflammation and could thereby predispose to NEC.
authors.affiliation: Department of Pediatrics, University of Bern, 3010 Bern, Switzerland.
authors.forename: Luregn J
authors.initials: LJ
authors.lastname: Schlapbach
authors.forename: Christoph
authors.initials: C
authors.lastname: Aebi
authors.forename: Urs
authors.initials: U
authors.lastname: Fisch
authors.forename: Roland A
authors.initials: RA
authors.lastname: Ammann
authors.forename: Margrith
authors.initials: M
authors.lastname: Otth
authors.forename: Susanne
authors.initials: S
authors.lastname: Bigler
authors.forename: Mathias
authors.initials: M
authors.lastname: Nelle
authors.forename: Steffen
authors.initials: S
authors.lastname: Berger
authors.forename: Ulf
authors.initials: U
authors.lastname: Kessler
mesh_terms: D016022:Case-Control Studies; D003167:Complement Activation; D020345:Enterocolitis, Necrotizing / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000276:immunology / Q000401:mortality / Q000601:surgery; D005312:Fetal Blood / Q000201:enzymology*; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D037601:Mannose-Binding Lectin / Q000097:blood*; D050606:Mannose-Binding Protein-Associated Serine Proteases / Q000032:analysis*; D011859:Radiography; D012307:Risk Factors; D015854:Up-Regulation
chemical_list: D037601:Mannose-Binding Lectin; C105296:MASP2 protein, human; D050606:Mannose-Binding Protein-Associated Serine Proteases