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Mannose-Binding Lectin Levels Could Predict Prognosis in IgA Nephropathy.

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Mannose-binding lectin (MBL) deficiency is linked to more infections and poor kidney outcomes in IgA nephropathy (IgAN). Both MBL deficiency and excess may harm IgAN progression, suggesting MBL

Keywords:
IgA nephropathyMBLrenal outcome

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Area of Science:

  • Immunology
  • Nephrology
  • Genetics

Background:

  • IgA nephropathy (IgAN) often follows infections and is linked to episodic hematuria.
  • The role of mannose-binding lectin (MBL) in IgAN pathogenesis is debated.
  • MBL deficiency is associated with recurrent infections in various diseases.

Purpose of the Study:

  • To investigate the association between MBL2 variants, MBL levels, and clinical outcomes in IgA nephropathy.
  • To determine if MBL deficiency or excess impacts IgAN progression and renal outcomes.

Main Methods:

  • Measured MBL2 variants and serum MBL levels in 749 IgAN patients and 489 controls.
  • Analyzed the association between MBL levels and IgAN outcomes, including infections, hematuria, proteinuria, and renal progression.
  • Utilized multivariable adjustments to assess independent associations.

Main Results:

  • 5.2% of IgAN patients had MBL deficiency (<100 ng/ml), predominantly with LYPB/LYPB and LXPA/LYPB MBL2 haplotypes.
  • MBL deficiency was associated with increased infections and gross hematuria.
  • MBL deficiency independently predicted poor renal outcome (HR, 5.18; P<0.001).
  • High MBL levels (>3540 ng/ml) correlated with more severe proteinuria and crescents, but not significantly with progression after adjustments.

Conclusions:

  • MBL deficiency is a significant risk factor for poor renal outcomes in IgA nephropathy.
  • Both MBL deficiency and excess may negatively impact IgAN progression.
  • MBL likely contributes to IgAN pathogenesis through diverse mechanisms.