Influence of mannose-binding lectin genotypes and serostatus in allo-SCT: analysis of 131 recipients and donors.
Mannan-binding lectin (MBL) deficiency is determined by MBL gene polymorphisms and is associated with an increased infection risk. To clarify the role of MBL in Allo-SCT, 131 recipients-donors were analysed. MBL genotypes were determined by PCR and heteroduplex analyses, MBL serum levels by ELISA, and MBL oligomers by western blotting. MBL levels <400 ng/ml were associated with increased susceptibility to fungal pneumonia (7/12 vs 35/111; P=0.04, adjusted P=0.002), HSV/VZV (7/12 vs 26/111; P=0.03), CMV reactivation and acute GVHD. Donor genotypes had no influence. Pre-SCT MBL levels corresponded to recipients' genotypes (P<0.001), changed significantly post-SCT, but were not influenced by donors' genotypes. MBL oligomer profiles were similar pre-/post-SCT. Cultured CD34+ cells were found not to synthesise MBL. In conclusion, low MBL levels pre-transplant predisposed patients to sepsis, fungal and viral infection. Donors' MBL genotypes did not influence infection rates. Prospective studies should clarify the importance of MBL as a prelude for MBL replacement after SCT.
Infectious Diseases and Microbiology Unit, Institute of Child Health and Great Ormond Street Hospital, London, UK. olafw.neth.sspa@juntadeandalucia.es
O W
OW
Neth
U
U
Bacher
P
P
Das
T
T
Zabelina
H
H
Kabisch
N
N
Kroeger
F
F
Ayuk
M
M
Lioznov
O
O
Waschke
B
B
Fehse
R
R
Thiébaut
R M
RM
Haston
N
N
Klein
A R
AR
Zander
D000293:Adolescent; D000328:Adult; D000368:Aged; D004198:Disease Susceptibility; D005260:Female; D005838:Genotype; D006086:Graft vs Host Disease / Q000209:etiology / Q000235:genetics; D006801:Humans; D008297:Male; D037601:Mannose-Binding Lectin / Q000097:blood / Q000235:genetics*; D008875:Middle Aged; D009181:Mycoses / Q000209:etiology; D010641:Phenotype; D011446:Prospective Studies; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology; D033581:Stem Cell Transplantation / Q000009:adverse effects* / Q000401:mortality; D014019:Tissue Donors; D014184:Transplantation, Homologous
D037601:Mannose-Binding Lectin