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The Lectin Complement Pathway in Patients with Necrotizing Soft Tissue Infection

Marco B Hansen1, Lars S Rasmussen, Katrine Pilely

  • 1Department of Anesthesia, Center of Head and Orthopedics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

Journal of Innate Immunity
|June 30, 2016
PubMed
Abstract

Insights

Lower plasma Ficolin-2 levels in patients with necrotizing soft tissue infection (NSTI) indicate increased mortality risk. High Ficolin-2 levels predict a 94% survival rate within 28 days for NSTI patients.

Area of Science:

  • Immunology
  • Infectious Diseases

Background:

  • Mannose-binding lectin (MBL) and ficolins are pattern recognition molecules (PRMs) crucial for activating the lectin complement pathway during infections.
  • Necrotizing soft tissue infection (NSTI) is a severe condition where understanding host immune responses is vital.

Purpose of the Study:

  • To investigate the association between plasma levels of PRMs (MBL and ficolins) and mortality in patients diagnosed with NSTI.
  • To determine if specific PRM levels can serve as predictive biomarkers for NSTI patient outcomes.

Main Methods:

  • A prospective, observational study was conducted over 25 months with 135 NSTI patients.
  • Plasma samples were collected upon admission for PRM level analysis.
  • Non-infected individuals were included as controls.

Main Results:

  • Plasma PRM levels were significantly lower in NSTI patients compared to controls.
  • A Ficolin-2 level below the median was significantly associated with both short-term and long-term mortality.
  • A low Ficolin-2 level demonstrated a high negative predictive value (0.94) for 28-day mortality and was an independent predictor of mortality in NSTI patients.

Conclusions:

  • Plasma PRM levels, particularly Ficolin-2, are significantly reduced in patients with NSTI.
  • Baseline Ficolin-2 levels are a significant predictor of mortality in NSTI patients.
  • Elevated Ficolin-2 levels are associated with a favorable prognosis, indicating a high likelihood of survival in the initial 28 days post-admission.

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