Association of mannose-binding lectin-2 genotype and serum levels with prognosis of sepsis.
BACKGROUND
Individuals deficient in mannose-binding lectin (MBL), an important component of the innate immune system, show increased susceptibility to infection. We investigated whether polymorphisms in the MBL2 gene and the serum level are associated with the severity and prognosis of sepsis.


METHODS
A total of 266 patients with sepsis and 398 healthy controls were enrolled. We analyzed the three single nucleotide polymorphisms (Gly54Asp, -550, and +4) in the MBL2 gene. Serum samples collected on day 1 were analyzed for the levels of MBL.


RESULTS
Patients who were heterozygous (A/B) or homozygous (B/B) at codon 54 (adjusted odds ratio (OR), 0.370; 95% confidence interval (CI), 0.207-0.661, P = 0.001) and who were heterozygous (H/L) or homozygous (L/L) at -550 (adjusted OR, 0.476; 95% CI, 0.249-0.910, P = 0.025) were less likely to have septic shock in the sepsis group. Using Cox regression analysis for 28-day mortality, an MBL level > or = 1.3 microg/mL showed significantly lower 28-day mortality (P = 0.020; hazard ratio, 0.571; 95% CI, 0.355-0.916) in the septic shock group.


CONCLUSIONS
Homozygosity at codons 54 (A/A) and -550 (H/H) appears to be associated with the severity, but not the outcome, of sepsis, whereas a low MBL level may be an independent risk factor for mortality. These findings suggest that the genotype and serum level for MBL2 may have different clinical implications.
Huh
Jin Won
JW
Department of Pulmonary and Critical Care Medicine, Inje University Ilsan Paik Hospital, Goyang-si, 411-706, Korea. jwhuh@paik.ac.kr
Song
Kyuyoung
K
Yum
Jung-Sun
JS
Hong
Sang-Bum
SB
Lim
Chae-Man
CM
Koh
Younsuck
Y
D000368:Aged; D019943:Amino Acid Substitution; D017931:DNA Primers; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005787:Gene Frequency; D005838:Genotype; D006801:Humans; D008297:Male; D037601:Mannose-Binding Lectin / Q000097:blood* / Q000172:deficiency / Q000235:genetics*; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D011379:Prognosis; D012016:Reference Values; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood* / Q000235:genetics*; D012772:Shock, Septic / Q000097:blood / Q000235:genetics; D016896:Treatment Outcome
D017931:DNA Primers; C445619:MBL2 protein, human; D037601:Mannose-Binding Lectin