Mannan-binding lectin is a determinant of survival in infective endocarditis

C. T. Tran*, K. Kjeldsen, S. Haunsø, N. Høiby, H. K. Johansen, M. Christiansen

*Corresponding author af dette arbejde

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    Abstrakt

    Mannan-binding lectin (MBL) is a collectin plasma protein activating the lectin pathway of the complement system, enhancing opsonophagocytosis and modulating the cytokine response to inflammation. Deficiency of MBL, caused by structural mutations or promoter polymorphisms in the MBL2 gene, has been associated with increased susceptibility to infection and autoimmune disease. Thus, as infective endocarditis remains a severe disease requiring intensive and long-term treatment with antibiotics, we examined whether there was an association between MBL and clinical outcome in 39 well-characterized patients with infective endocarditis. Five patients (13%) had MBL concentrations < 100 μg/l and were considered MBL-deficient. This proportion was similar to that in a healthy control group of blood donors. Mortality 3 months after diagnosis was 20% in patients with MBL-deficiency and 9% in patients with normal MBL. The 5-year mortality was 80% and 25%, respectively. MBL-deficiency was on univariate survival statistics associated with significantly higher mortality on follow-up (P = 0.03). In conclusion, this is the first report of an association between MBL-deficiency and survival in infective endocarditis. The present observation is important, as replacement therapy in MBL-deficient patients is possible. For certain high-risk subgroups, it opens new perspectives for improvement of treatment and outcome in infective endocarditis.

    OriginalsprogEngelsk
    Sider (fra-til)101-105
    Antal sider5
    TidsskriftClinical and Experimental Immunology
    Vol/bind148
    Udgave nummer1
    DOI
    StatusUdgivet - 1 apr. 2007

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