Differential role of the lectin pathway of complement activation in susceptibility to neonatal sepsis

Schlapbach, Luregn J., Mattmann, Maika, Thiel, Steffen, Boillat, Colette, Otth, Margrith, Nelle, Mathias, Wagner, Bendicht, Jensenius, Jens C. and Aebi, Christoph (2010) Differential role of the lectin pathway of complement activation in susceptibility to neonatal sepsis. Clinical Infectious Diseases, 51 2: 153-162. doi:10.1086/653531

Author Schlapbach, Luregn J.
Mattmann, Maika
Thiel, Steffen
Boillat, Colette
Otth, Margrith
Nelle, Mathias
Wagner, Bendicht
Jensenius, Jens C.
Aebi, Christoph
Title Differential role of the lectin pathway of complement activation in susceptibility to neonatal sepsis
Journal name Clinical Infectious Diseases   Check publisher's open access policy
ISSN 1058-4838
Publication date 2010-07-15
Year available 2010
Sub-type Article (original research)
DOI 10.1086/653531
Open Access Status Not yet assessed
Volume 51
Issue 2
Start page 153
End page 162
Total pages 10
Place of publication Cary, NC, United States
Publisher Oxford University Press
Language eng
Formatted abstract
Background: The incidence of bacterial sepsis during the neonatal period is high. Mannan-binding lectin (MBL), L-ficolin, and H-ficolin recognize microorganisms and activate the complement system viaMBL-associated serine proteases (MASPs). This study investigated whether cord blood concentrations of the lectin pathway proteins are associated with neonatal sepsis.

Methods: This was a case-control study including 47 infants with culture-proven sepsis during the first month of life and 94 matched controls. MBL, L-ficolin, H-ficolin, MASP-2, and MASP-3 levels were measured in cord blood with use of enzyme-linked immunosorbent assay and time-resolved immunofluorometric assay. Multivariate logistic regression was performed.

Results: Infants with gram-positive sepsis had significantly lower H-ficolin cord blood concentrations than controls (multivariate odds ratio [OR], 4.00; 95% confidence interval [CI], 1.51-10.56; ), whereas infants with gram-negative sepsis had lower MBL cord blood concentrations (OR, 2.99; 95% CI, 0.86-10.33; Pp.084). When excluding patients with postoperative sepsis, multivariate analysis confirmed that low H-ficolin was associated with a significantly higher risk of gram-positive sepsis (OR, 3.71; 95% CI, 1.26-10.92; Pp.017) and late-onset sepsis (OR, 3.14; 95% CI, 1.07-9.21; Pp.037). In contrast, low MBL was associated with a significantly higher risk of gram-negative sepsis (OR, 4.39; 95% CI, 1.10-17.45; Pp.036) and early-onset sepsis (OR, 3.87; 95% CI, 1.05-14.29; Pp.042). The concentrations of all the lectin pathway proteins increased with gestational age (P<.01).

Conclusions: These preliminary results indicate that low MBL concentrations are a susceptibility factor for gram-negative sepsis, and low H-ficolin concentrations indicate susceptibility to gram-positive sepsis. The decreased expression of lectin pathway proteins in neonates must be considered to be an additional form of neonatal immunodeficiency. 
Keyword Immunology
Infectious Diseases
Infectious Diseases
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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