title: The pattern recognition molecule collectin-L1 in critically ill children.
abstract: Critically ill children are prone to nosocomial infections, which may lead to adverse outcome. Low serum concentrations upon admission to the pediatric intensive care unit (PICU) of the mannan-binding lectin (MBL)-associated serine protease (MASP)-3 protein of the lectin pathway of complement activation have been associated with risk of infection and prolonged need for intensive care. We hypothesized that also a low upon-admission concentration of collectin-L1 (CL-L1), a novel member of this pathway, is independently associated with these adverse outcomes.
  
  
  
  We quantified the serum concentrations of CL-L1 in 81 healthy children and in 700 critically ill children upon PICU admission.
  
  
  
  CL-L1 concentrations were significantly lower in the critically ill children as compared with the healthy children. However, corrected for baseline characteristics, risk factors and several lectin pathway proteins, a higher CL-L1 concentration upon PICU admission was independently associated with an increased risk of acquiring a new infection and with a prolonged time to PICU discharge. In contrast, a low MASP-3 concentration remained independently associated with these adverse outcomes.
  
  
  
  A high serum CL-L1 concentration in critically ill children upon PICU admission is associated with an increased risk of infection and prolonged need of intensive care, and counteracts the protective effect of having a high MASP-3 concentration.
authors.affiliation: Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, Leuven, Belgium.
authors.forename: Catherine
authors.initials: C
authors.lastname: Ingels
authors.affiliation: Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, Leuven, Belgium.
authors.forename: Ilse
authors.initials: I
authors.lastname: Vanhorebeek
authors.affiliation: Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, Leuven, Belgium.
authors.forename: Inge
authors.initials: I
authors.lastname: Derese
authors.affiliation: Department of Biomedicine, Aarhus University, Aarhus C, Denmark.
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Jensen
authors.affiliation: Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, Leuven, Belgium.
authors.forename: Pieter J
authors.initials: PJ
authors.lastname: Wouters
authors.affiliation: Department of Biomedicine, Aarhus University, Aarhus C, Denmark.
authors.forename: Steffen
authors.initials: S
authors.lastname: Thiel
authors.affiliation: Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, Leuven, Belgium.
authors.forename: Greet
authors.initials: G
authors.lastname: Van den Berghe
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D037222:Collectins / Q000097:blood*; D016638:Critical Illness; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D007223:Infant; D007362:Intensive Care Units; D008297:Male; D037601:Mannose-Binding Lectin / Q000737:chemistry; D050606:Mannose-Binding Protein-Associated Serine Proteases / Q000378:metabolism; D015999:Multivariate Analysis; D010372:Pediatrics; D016016:Proportional Hazards Models; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: C445459:COLEC10 protein, human; D037222:Collectins; D037601:Mannose-Binding Lectin; C084067:MASP1 protein, human; D050606:Mannose-Binding Protein-Associated Serine Proteases