Mannose-binding lectin as a risk factor for acute coronary syndromes.
BACKGROUND
Mannose-binding lectin (MBL) is a multifunctional protein involved in innate immunity. We tested whether MBL and elevated viral and bacterial antibodies were risk factors for acute coronary events.


METHODS
Controlled cohort study.


METHODS
A total of 354 patients with unstable angina pectoris (UA) or acute myocardial infarction (AMI) were compared with 334 paired controls.


RESULTS
Enterovirus titres were associated with increased risk of UA (odds ratio 10.04, P<0.001) and AMI (odds ratio 3.18, P=0.003), but titres did not correlate with either MBL concentration or genotype. Chlamydia pneumoniae heat shock protein 60 IgG concentrations were also associated with increased risk of UA (odds ratio 1.63, P=0.049). Compared to asymptomatic controls, patients had lower complement C3 serum concentrations (P<0.001), higher MBL serum concentration, and more frequently had MBL genotypes that determined high MBL levels (P<0.001). High MBL genotypes had odds ratios of 1.16 (P=0.010) for UA and 1.12 (P=0.007) for AMI. The elevation of MBL concentrations in the acute phase correlated with MBL concentrations after recovery (r=0.85, P<0.001).


CONCLUSIONS
Elevated microbial titres, indicating an on-going inflammation, were associated with cardiovascular events. MBL might have a dual role both decreasing susceptibility to infections and increasing the risk of acute coronary syndromes.
Pesonen
Erkki
E
Department of Pediatric Cardiology, University Hospital of Lund, Sweden. erkki.pesonen@skane.se
Hallman
Mikko
M
Sarna
Seppo
S
Andsberg
Eva
E
Haataja
Ritva
R
Meri
Seppo
S
Persson
Kenneth
K
Puolakkainen
Mirja
M
Ohlin
Hans
H
Truedsson
Lennart
L
D000789:Angina, Unstable / Q000209:etiology* / Q000235:genetics / Q000382:microbiology; D000907:Antibodies, Bacterial / Q000032:analysis; D000914:Antibodies, Viral / Q000032:analysis; D016022:Case-Control Studies; D018834:Chaperonin 60 / Q000276:immunology; D016993:Chlamydophila pneumoniae / Q000276:immunology; D015331:Cohort Studies; D003176:Complement C3 / Q000378:metabolism; D004770:Enterovirus / Q000276:immunology; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000382:microbiology; D008297:Male; D037601:Mannose-Binding Lectin / Q000097:blood* / Q000235:genetics; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology* / Q000235:genetics / Q000382:microbiology; D012307:Risk Factors
D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D018834:Chaperonin 60; D003176:Complement C3; D037601:Mannose-Binding Lectin