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Increased incidence and severity of the systemic inflammatory response syndrome in patients deficient in

Katy J Fidler1, Peter Wilson, Jane C Davies

  • 1Infectious Diseases and Microbiology Unit, Institute of Child Health, 30 Guilford Street, London, WC1 N 1EH, UK.

Intensive Care Medicine
|May 6, 2004
PubMed

Insights

Children with specific mannose-binding lectin (MBL) gene variants face a higher risk of systemic inflammatory response syndrome (SIRS) and sepsis. Low MBL protein levels significantly increase this risk in pediatric intensive care unit patients.

Area of Science:

  • Immunogenetics
  • Pediatric Critical Care
  • Infectious Diseases

Background:

  • Mannose-binding lectin (MBL) plays a crucial role in innate immunity.
  • MBL deficiency, often due to gene polymorphisms, can impair pathogen recognition.
  • The association between MBL gene variants and severe outcomes in pediatric intensive care unit (PICU) patients remains under investigation.

Purpose of the Study:

  • To investigate the association between MBL gene polymorphisms and the risk of developing sepsis and SIRS in pediatric PICU patients.
  • To determine if MBL gene variants linked to low functional MBL protein levels increase susceptibility to severe inflammatory responses.

Main Methods:

  • Prospective, observational cohort study of 100 consecutive PICU admissions.
  • Patients classified by infectious or non-infectious primary insults.
  • Genotyping for MBL-2 gene polymorphisms and measurement of MBL serum levels.
  • Follow-up to identify development of sepsis or SIRS using standard criteria.

Main Results:

  • 42% of patients carried variant MBL alleles.
  • Variant MBL alleles were significantly over-represented in the 59 patients who developed SIRS.
  • Low MBL serum levels (<1000 ng/ml) were strongly associated with an increased risk of SIRS.
  • In infected patients, variant MBL alleles correlated with increased severity, from localized infection to septic shock.

Conclusions:

  • MBL-2 gene polymorphisms associated with low serum MBL protein levels significantly increase the risk of SIRS in pediatric ICU patients.
  • These MBL variants are linked to an increased risk of progression from infection to sepsis and septic shock.
  • MBL genotyping and serum level assessment may aid in identifying high-risk pediatric patients.
Abstract

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