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Mannan-binding lectin deficiency is associated with unexplained recurrent miscarriage
O B Christiansen1, D C Kilpatrick, V Souter
1Department of Obstetrics and Gynaecology, University of Aarhus, Denmark.
Abstract:
Mannan-binding lectin (MBL) is a plasma protein which, upon binding to microbial carbohydrate structures, elicits activation of the complement system. The level of MBL is genetically determined. It has been reported that the frequency of low plasma levels of MBL is increased in patients with unexplained recurrent miscarriages (RM). In the present study plasma MBL levels were determined in 146 Danish women with RM and 41 of their husbands together with 49 Scottish RM women and 41 of their husbands. In both countries MBL levels were also investigated in a total of 444 controls. Based on the control data, a cut-off MBL level < 50 ng/ml was selected to define MBL deficiency. The typical odds ratio for MBL deficiency among female patients in the two populations was 1.68 (95% confidence limits 1.01-2.80, P<0.05) whereas it was 1.57 (95% confidence limits 0.72-3.42, not significant) for the male partners of the patients. There was a significant correlation between the frequency of MBL deficiency in RM women and the number of previous miscarriages (P < 0.01), whereas no such correlation was found in the husbands. The results indicate that maternal MBL deficiency is associated with RM. Maternal MBL deficiency might impair the immune defence against microorganisms at the feto-maternal interface.
Insights
Maternal Mannan-binding lectin (MBL) deficiency is linked to recurrent miscarriages (RM). This deficiency may weaken immune defenses at the crucial feto-maternal interface, impacting pregnancy outcomes.
Area of Science:
- Immunology
- Reproductive Medicine
- Genetics
Background:
- Mannan-binding lectin (MBL) is a key plasma protein in the complement system's activation.
- MBL levels are genetically determined, with low levels observed more frequently in recurrent miscarriage (RM) patients.
- The role of MBL deficiency in RM requires further investigation.
Purpose of the Study:
- To investigate the association between MBL levels and recurrent miscarriages (RM) in Danish and Scottish populations.
- To determine if MBL deficiency is a risk factor for RM in women and their male partners.
- To explore the correlation between MBL deficiency and the number of previous miscarriages.
Main Methods:
- Plasma MBL levels were measured in 146 Danish women with RM and their partners, and 49 Scottish women with RM and their partners.
- MBL levels were also assessed in 444 control individuals from both countries.
- MBL deficiency was defined as a level < 50 ng/ml based on control data.
Main Results:
- MBL deficiency was significantly more frequent in women with RM (odds ratio 1.68, P<0.05).
- No significant association was found for male partners (odds ratio 1.57, P>0.05).
- A significant correlation existed between maternal MBL deficiency and the number of prior miscarriages (P < 0.01).
Conclusions:
- Maternal MBL deficiency is associated with an increased risk of recurrent miscarriages.
- This deficiency may compromise the maternal immune system at the feto-maternal interface, potentially increasing susceptibility to infections.
- Further research is warranted to elucidate the precise mechanisms linking MBL deficiency to RM.