Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
권호 표지
DOI QR코드

DOI QR Code

Serial Changes in Mannose-Binding Lectin in Patients with Sepsis

  • Huh, Jin Won (Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song, Kyuyoung (Department of Biochemistry and Molecular Biology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Hwa Jung (Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yum, Jung-Sun (R&D Center, CHA Vaccine Institute) ;
  • Hong, Sang-Bum (Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lim, Chae-Man (Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Koh, Younsuck (Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2017.05.13
  • Accepted : 2017.12.28
  • Published : 2018.10.31
Download PDF
⟨ Previous Next ⟩

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 (< $1.3{\mu}g/mL$ or ${\geq}1.3{\mu}g/mL$) 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)-$1{\beta}$, IL-6, IL-8, interferon-${\gamma}$, 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.

Keywords

References

  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;29:1303-10. https://doi.org/10.1097/00003246-200107000-00002
  2. Moreno R, Afonso S, Fevereiro T. Incidence of sepsis in hospitalized patients. Curr Infect Dis Rep 2006;8:346-50. https://doi.org/10.1007/s11908-006-0044-2
  3. Annane D, Aegerter P, Jars-Guincestre MC, Guidet B; CUBRea Network. Current epidemiology of septic shock: the CUBRea Network. Am J Respir Crit Care Med 2003;168:165-72. https://doi.org/10.1164/rccm.2201087
  4. Kwiatkowski D. Genetic dissection of the molecular pathogenesis of severe infection. Intensive Care Med 2000;26 Suppl 1:S89-97. https://doi.org/10.1007/s001340051124
  5. Sorensen TI, Nielsen GG, Andersen PK, Teasdale TW. Genetic and environmental influences on premature death in adult adoptees. N Engl J Med 1988;318:727-32. https://doi.org/10.1056/NEJM198803243181202
  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. https://doi.org/10.1038/352595a0
  7. Turner MW, Hamvas RM. Mannose-binding lectin: structure, function, genetics and disease associations. Rev Immunogenet 2000;2:305-22.
  8. Moine P, Abraham E. Immunomodulation and sepsis: impact of the pathogen. Shock 2004;22:297-308. https://doi.org/10.1097/01.shk.0000140663.80530.73
  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;6:183-91. https://doi.org/10.2174/187153006777442350
  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;188:1394-403. https://doi.org/10.1086/379044
  11. Koch A, Melbye M, Sorensen P, Homoe P, Madsen HO, Molbak K, et al. Acute respiratory tract infections and mannosebinding lectin insufficiency during early childhood. JAMA 2001;285:1316-21. https://doi.org/10.1001/jama.285.10.1316
  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 mannosebinding lectin. Intensive Care Med 2004;30:1438-45.
  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;5:319-21.
  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;345:886-9. https://doi.org/10.1016/S0140-6736(95)90009-8
  15. Cohen J. The immunopathogenesis of sepsis. Nature 2002;420:885-91. https://doi.org/10.1038/nature01326
  16. Fraser IP, Koziel H, Ezekowitz RA. The serum mannosebinding protein and the macrophage mannose receptor are pattern recognition molecules that link innate and adaptive immunity. Semin Immunol 1998;10:363-72. https://doi.org/10.1006/smim.1998.0141
  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;101:1644-55. https://doi.org/10.1378/chest.101.6.1644
  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. https://doi.org/10.1186/cc8157
  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;42:969-77. https://doi.org/10.1016/j.molimm.2004.09.036
  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;337:1569-70. https://doi.org/10.1016/0140-6736(91)93263-9
  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;1:709-15. https://doi.org/10.1093/hmg/1.9.709
  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. https://doi.org/10.1007/BF00163962
  23. Serbina NV, Jia T, Hohl TM, Pamer EG. Monocyte-mediated defense against microbial pathogens. Annu Rev Immunol 2008;26:421-52. https://doi.org/10.1146/annurev.immunol.26.021607.090326
  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;26:457-63. https://doi.org/10.1097/01.shk.0000228801.56223.92
  25. Mukaida N. Pathophysiological roles of interleukin-8/CXCL8 in pulmonary diseases. Am J Physiol Lung Cell Mol Physiol 2003;284:L566-77. https://doi.org/10.1152/ajplung.00233.2002