title: Mannose-binding lectin (MBL) insufficiency protects against the development of systemic inflammatory response after pediatric cardiac surgery.
abstract: We investigated MBL2 and MASP2 genotypes, serum MBL (mannose-binding lectin) levels and activities of its complexes with associated serine proteases (MASP-1, MASP -2), in relation to complications following cardiac surgery in 195 children. The incidence of SIRS was lower in patients carrying MBL2 A/O and O/O genotypes (p=0.024). Children with MBL levels <500ng/ml had a lower risk of SIRS (p=0.014) and fever (p=0.044). Median MBL concentration was higher in patients who developed SIRS (p=0.048) but lower in those with post-operative infections (p=0.046). MBL-MASP-2 activities <100mU/ml protected from SIRS (p=0.007), low cardiac output syndrome (p=0.03) and multiorgan failure (p=0.012). In contrast, MBL2 YA/YA genotypes were associated with SIRS (p=0.018), low cardiac output syndrome (p=0.018), fever (p=0.018) and high inotropic score (VIS>30) (p=0.021). Thus, low MBL concentrations and associated genotypes may protect patients from systemic inflammation while high MBL serum levels and corresponding genotypes are risk factors of postoperative complications.
authors.affiliation: Department of Anesthesiology and Intensive Care, Polish Mother's Memorial Hospital Research Institute, Rzgowska 281/289, 93-338 Lodz, Poland.
authors.forename: Izabela
authors.initials: I
authors.lastname: Pągowska-Klimek
authors.affiliation: Laboratory of Immunobiology of Infections, Institute of Medical Biology, Polish Academy of Sciences, Lodowa 106, 93-232 Lodz, Poland.
authors.forename: Anna S
authors.initials: AS
authors.lastname: Świerzko
authors.affiliation: Laboratory of Immunobiology of Infections, Institute of Medical Biology, Polish Academy of Sciences, Lodowa 106, 93-232 Lodz, Poland.
authors.forename: Mateusz
authors.initials: M
authors.lastname: Michalski
authors.affiliation: Department of Cardiac Surgery, Polish Mothers's Memorial Hospital Research Institute, Rzgowska 281/289, 93-338 Lodz, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Moll
authors.affiliation: Laboratory of Immunobiology of Infections, Institute of Medical Biology, Polish Academy of Sciences, Lodowa 106, 93-232 Lodz, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Szala-Poździej
authors.affiliation: Laboratory of Immunobiology of Infections, Institute of Medical Biology, Polish Academy of Sciences, Lodowa 106, 93-232 Lodz, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Sokołowska
authors.affiliation: Department of Anesthesiology and Intensive Care, Polish Mother's Memorial Hospital Research Institute, Rzgowska 281/289, 93-338 Lodz, Poland.
authors.forename: Wojciech R
authors.initials: WR
authors.lastname: Krajewski
authors.affiliation: Laboratory of Immunobiology of Infections, Institute of Medical Biology, Polish Academy of Sciences, Lodowa 106, 93-232 Lodz, Poland. Electronic address: mcedzynski@cbm.pan.pl.
authors.forename: Maciej
authors.initials: M
authors.lastname: Cedzyński
mesh_terms: D000293:Adolescent; D002302:Cardiac Output / Q000502:physiology; D002303:Cardiac Output, Low / Q000209:etiology / Q000235:genetics / Q000276:immunology* / Q000473:pathology; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D015870:Gene Expression; D005838:Genotype; D000081208:Hereditary Complement Deficiency Diseases; D006801:Humans; D007153:Immunologic Deficiency Syndromes / Q000097:blood / Q000235:genetics / Q000276:immunology*; D007223:Infant; D008297:Male; D037601:Mannose-Binding Lectin / Q000097:blood / Q000172:deficiency* / Q000235:genetics / Q000276:immunology; D050606:Mannose-Binding Protein-Associated Serine Proteases / Q000172:deficiency* / Q000235:genetics / Q000276:immunology / Q000378:metabolism; D008661:Metabolism, Inborn Errors / Q000097:blood / Q000235:genetics / Q000276:immunology*; D011183:Postoperative Complications / Q000209:etiology / Q000235:genetics / Q000276:immunology* / Q000473:pathology; D011446:Prospective Studies; D065840:Protective Factors; D012307:Risk Factors
chemical_list: C445619:MBL2 protein, human; D037601:Mannose-Binding Lectin; C084067:MASP1 protein, human; C105296:MASP2 protein, human; D050606:Mannose-Binding Protein-Associated Serine Proteases
keywords: Cardiopulmonary bypass (CPB); Complement; Congenital heart disease; Mannan-binding lectin; Mannose-binding lectin (MBL); SIRS