The Lectin Complement Pathway in Patients with Necrotizing Soft Tissue Infection.

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.