Tuberc Respir Dis.  2018 Oct;81(4):305-310. 10.4046/trd.2017.0060.

Serial Changes in Mannose-Binding Lectin in Patients with Sepsis

• Huh JW
• Song K
• Kim HJ
• Yum JS
• Hong SB
• Lim CM
• Koh Y

• KMID: 2420564
• DOI: http://doi.org/10.4046/trd.2017.0060

Abstract

BACKGROUND
Mannose-binding lectin (MBL) deficiency leads to increased susceptibility to infection. We investigated whether serial changes in MBL levels are associated with the prognosis of patients diagnosed with septic shock, and correlated with cytokine levels.
METHODS
We enrolled 131 patients with septic shock in the study. We analyzed the serum samples for MBL and cytokine levels at baseline and 7 days later. Samples on day 7 were available in 73 patients.
RESULTS
We divided the patients with septic shock into four groups according to serum MBL levels ( < 1.3 µg/mL or ≥1.3 µg/mL) on days 1 and 7. Patients with low MBL levels on day 1 and high MBL levels on day 7 showed a favorable prognosis for 28-day survival (odds ratio, 1.96, 95% confidence interval, 1.10-2.87; p=0.087). The high MBL group on day 7 showed a significant decrease in monocyte chemoattractant protein 1, interleukin (IL)-1β, IL-6, IL-8, interferon-γ, and granulocyte macrophage colony-stimulating factor levels compared with the low MBL group on day 7.
CONCLUSION
The increase in MBL levels of patients with septic shock may suggest a favorable prognosis and attenuate pro-inflammatory and anti-inflammatory responses.

Keyword

Mannose-Binding Lectin; Cytokines; Shock, Septic; Prognosis

MeSH Terms

Chemokine CCL2
Cytokines
Granulocytes
Humans
Interleukin-6
Interleukin-8
Interleukins
Macrophage Colony-Stimulating Factor
Mannose-Binding Lectin*
Prognosis
Sepsis*
Shock, Septic
Chemokine CCL2
Cytokines
Interleukin-6
Interleukin-8
Interleukins
Macrophage Colony-Stimulating Factor
Mannose-Binding Lectin

Figure

• 

  Figure 1 Correlation between the level of monocyte chemoattractant protein 1 (MCP-1) and serum mannose-binding lectin (MBL) levels at day 1. There was a significant negative correlation between the level of MCP-1 and MBL level.

Reference

1. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001; 29:1303–1310. PMID: 11445675.

2. Moreno R, Afonso S, Fevereiro T. Incidence of sepsis in hospitalized patients. Curr Infect Dis Rep. 2006; 8:346–350. PMID: 16934192.

3. Annane D, Aegerter P, Jars-Guincestre MC, Guidet B. CUB-Réa Network. Current epidemiology of septic shock: the CUB-Rea Network. Am J Respir Crit Care Med. 2003; 168:165–172. PMID: 12851245.

4. Kwiatkowski D. Genetic dissection of the molecular pathogenesis of severe infection. Intensive Care Med. 2000; 26(Suppl 1):S89–S97. PMID: 10786964.

5. Sorensen TI, Nielsen GG, Andersen PK, Teasdale TW. Genetic and environmental influences on premature death in adult adoptees. N Engl J Med. 1988; 318:727–732. PMID: 3347221.

6. Hill AV, Allsopp CE, Kwiatkowski D, Anstey NM, Twumasi P, Rowe PA, et al. Common west African HLA antigens are associated with protection from severe malaria. Nature. 1991; 352:595–600. PMID: 1865923.

7. Turner MW, Hamvas RM. Mannose-binding lectin: structure, function, genetics and disease associations. Rev Immunogenet. 2000; 2:305–322. PMID: 11256742.

8. Moine P, Abraham E. Immunomodulation and sepsis: impact of the pathogen. Shock. 2004; 22:297–308. PMID: 15377883.

9. Martins PS, Brunialti MK, da Luz Fernandes M, Martos LS, Gomes NE, Rigato O, et al. Bacterial recognition and induced cell activation in sepsis. Endocr Metab Immune Disord Drug Targets. 2006; 6:183–191. PMID: 16787293.

10. Garred P, Strom JJ, Quist L, Taaning E, Madsen HO. Association of mannose-binding lectin polymorphisms with sepsis and fatal outcome, in patients with systemic inflammatory response syndrome. J Infect Dis. 2003; 188:1394–1403. PMID: 14593599.

11. Koch A, Melbye M, Sorensen P, Homoe P, Madsen HO, Molbak K, et al. Acute respiratory tract infections and mannose-binding lectin insufficiency during early childhood. JAMA. 2001; 285:1316–1321. PMID: 11255386.

12. Fidler KJ, Wilson P, Davies JC, Turner MW, Peters MJ, Klein NJ. Increased incidence and severity of the systemic inflammatory response syndrome in patients deficient in mannose-binding lectin. Intensive Care Med. 2004; 30:1438–1445. PMID: 15127191.

13. Kakkanaiah VN, Shen GQ, Ojo-Amaize EA, Peter JB. Association of low concentrations of serum mannose-binding protein with recurrent infections in adults. Clin Diagn Lab Immunol. 1998; 5:319–321. PMID: 9605984.

14. Summerfield JA, Ryder S, Sumiya M, Thursz M, Gorchein A, Monteil MA, et al. Mannose binding protein gene mutations associated with unusual and severe infections in adults. Lancet. 1995; 345:886–889. PMID: 7707811.

15. Cohen J. The immunopathogenesis of sepsis. Nature. 2002; 420:885–891. PMID: 12490963.

16. Fraser IP, Koziel H, Ezekowitz RA. The serum mannose-binding protein and the macrophage mannose receptor are pattern recognition molecules that link innate and adaptive immunity. Semin Immunol. 1998; 10:363–372. PMID: 9799711.

17. Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis The ACCP/SCCM Consensus Conference Committee American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992; 101:1644–1655. PMID: 1303622.

18. Huh JW, Song K, Yum JS, Hong SB, Lim CM, Koh Y. Association of mannose-binding lectin-2 genotype and serum levels with prognosis of sepsis. Crit Care. 2009; 13:R176. PMID: 19891773.

19. Lee SG, Yum JS, Moon HM, Kim HJ, Yang YJ, Kim HL, et al. Analysis of mannose-binding lectin 2 (MBL2) genotype and the serum protein levels in the Korean population. Mol Immunol. 2005; 42:969–977. PMID: 15829288.

20. Sumiya M, Super M, Tabona P, Levinsky RJ, Arai T, Turner MW, et al. Molecular basis of opsonic defect in immunodeficient children. Lancet. 1991; 337:1569–1570. PMID: 1675710.

21. Lipscombe RJ, Sumiya M, Hill AV, Lau YL, Levinsky RJ, Summerfield JA, et al. High frequencies in African and non-African populations of independent mutations in the mannose binding protein gene. Hum Mol Genet. 1992; 1:709–715. PMID: 1304173.

22. Madsen HO, Garred P, Kurtzhals JA, Lamm LU, Ryder LP, Thiel S, et al. A new frequent allele is the missing link in the structural polymorphism of the human mannan-binding protein. Immunogenetics. 1994; 40:37–44. PMID: 8206524.

23. Serbina NV, Jia T, Hohl TM, Pamer EG. Monocyte-mediated defense against microbial pathogens. Annu Rev Immunol. 2008; 26:421–452. PMID: 18303997.

24. Gomes RN, Figueiredo RT, Bozza FA, Pacheco P, Amancio RT, Laranjeira AP, et al. Increased susceptibility to septic and endotoxic shock in monocyte chemoattractant protein 1/cc chemokine ligand 2-deficient mice correlates with reduced interleukin 10 and enhanced macrophage migration inhibitory factor production. Shock. 2006; 26:457–463. PMID: 17047515.

25. Mukaida N. Pathophysiological roles of interleukin-8/CXCL8 in pulmonary diseases. Am J Physiol Lung Cell Mol Physiol. 2003; 284:L566–L577. PMID: 12618418.