Abstract
We investigated MBL2 and MASP2 genotypes, serum MBL (mannose-binding lectin) levels and activities of its complexes with associated serine proteases (MASP-1, MASP -2), in relation to complications following cardiac surgery in 195 children. The incidence of SIRS was lower in patients carrying MBL2 A/O and O/O genotypes (p=0.024). Children with MBL levels <500ng/ml had a lower risk of SIRS (p=0.014) and fever (p=0.044). Median MBL concentration was higher in patients who developed SIRS (p=0.048) but lower in those with post-operative infections (p=0.046). MBL-MASP-2 activities <100mU/ml protected from SIRS (p=0.007), low cardiac output syndrome (p=0.03) and multiorgan failure (p=0.012). In contrast, MBL2 YA/YA genotypes were associated with SIRS (p=0.018), low cardiac output syndrome (p=0.018), fever (p=0.018) and high inotropic score (VIS>30) (p=0.021). Thus, low MBL concentrations and associated genotypes may protect patients from systemic inflammation while high MBL serum levels and corresponding genotypes are risk factors of postoperative complications.
Keywords:
Cardiopulmonary bypass (CPB); Complement; Congenital heart disease; Mannan-binding lectin; Mannose-binding lectin (MBL); SIRS.
Copyright © 2015 Elsevier GmbH. All rights reserved.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Adolescent
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Cardiac Output / physiology
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Cardiac Output, Low / etiology
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Cardiac Output, Low / genetics
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Cardiac Output, Low / immunology*
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Cardiac Output, Low / pathology
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Cardiopulmonary Bypass / adverse effects
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Child
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Child, Preschool
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Female
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Gene Expression
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Genotype
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Hereditary Complement Deficiency Diseases
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Humans
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Immunologic Deficiency Syndromes / blood
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Immunologic Deficiency Syndromes / genetics
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Immunologic Deficiency Syndromes / immunology*
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Infant
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Male
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Mannose-Binding Lectin / blood
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Mannose-Binding Lectin / deficiency*
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Mannose-Binding Lectin / genetics
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Mannose-Binding Lectin / immunology
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Mannose-Binding Protein-Associated Serine Proteases / deficiency*
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Mannose-Binding Protein-Associated Serine Proteases / genetics
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Mannose-Binding Protein-Associated Serine Proteases / immunology
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Mannose-Binding Protein-Associated Serine Proteases / metabolism
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Metabolism, Inborn Errors / blood
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Metabolism, Inborn Errors / genetics
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Metabolism, Inborn Errors / immunology*
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Postoperative Complications / etiology
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Postoperative Complications / genetics
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Postoperative Complications / immunology*
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Postoperative Complications / pathology
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Prospective Studies
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Protective Factors
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Risk Factors
Substances
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MBL2 protein, human
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Mannose-Binding Lectin
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MASP1 protein, human
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MASP2 protein, human
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Mannose-Binding Protein-Associated Serine Proteases
Supplementary concepts
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MASP2 Deficiency
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Mannose-Binding Protein Deficiency