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Mannose-binding lectin (MBL) insufficiency protects against the development of systemic inflammatory response after
Izabela Pągowska-Klimek1, Anna S Świerzko2, Mateusz Michalski2
1Department of Anesthesiology and Intensive Care, Polish Mother's Memorial Hospital Research Institute, Rzgowska 281/289, 93-338 Lodz, Poland.
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.
Insights
Low mannose-binding lectin (MBL) levels and specific MBL2 genotypes may protect children from systemic inflammation and complications after cardiac surgery. Conversely, high MBL levels and certain genotypes are risk factors for adverse outcomes.
Area of Science:
- Immunology
- Pediatric Surgery
- Genetics
Background:
- Mannose-binding lectin (MBL) plays a crucial role in the innate immune system.
- MBL deficiency and genetic variations can influence immune responses.
- Postoperative complications following cardiac surgery in children are a significant clinical concern.
Purpose of the Study:
- To investigate the association between MBL2 and MASP2 genotypes, MBL serum levels, and MBL-MASP complex activities with postoperative complications in pediatric cardiac surgery patients.
- To identify potential protective or risk factors related to MBL in this population.
Main Methods:
- Genotyping of MBL2 and MASP2.
- Measurement of serum MBL levels.
- Assay of MBL-MASP complex activities.
- Correlation analysis with postoperative complications including SIRS, fever, low cardiac output syndrome, and multiorgan failure in 195 children.
Main Results:
- Lower incidence of SIRS in patients with MBL2 A/O and O/O genotypes (p=0.024).
- MBL levels <500 ng/ml were associated with reduced risk of SIRS (p=0.014) and fever (p=0.044).
- MBL-MASP-2 activities <100 mU/ml correlated with protection from SIRS (p=0.007), low cardiac output syndrome (p=0.03), and multiorgan failure (p=0.012).
- Conversely, MBL2 YA/YA genotypes were linked to increased SIRS (p=0.018), low cardiac output syndrome (p=0.018), and fever (p=0.018).
Conclusions:
- Low MBL concentrations and specific MBL2 genotypes (A/O, O/O) may confer protection against systemic inflammation and postoperative complications.
- High MBL serum levels and certain genotypes (YA/YA) are associated with an increased risk of adverse outcomes following pediatric cardiac surgery.
- MBL-MASP-2 complex activity levels are significant indicators for predicting and potentially mitigating postoperative complications.
