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Association of mannose-binding lectin-2 genotype and serum levels with prognosis of sepsis

Jin W Huh1, Kyuyoung Song2, Jung-Sun Yum3, Sang-Bum Hong4, Chae-Man Lim4 and Younsuck Koh4*

Author Affiliations

1 Department of Pulmonary and Critical Care Medicine, Inje University Ilsan Paik Hospital, 2240 Daehwa-dong, Goyang-si, 411-706, Korea

2 Department of Biochemistry and Molecular Biology, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Seoul, 138-736, Korea

3 Dobeel Corporation, Byoksan Techonopia 407, 434-6 Sandaewon-dong, Seongnam-si, 462-716, Korea

4 Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Seoul, 138-736, Korea

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Critical Care 2009, 13:R176 doi:10.1186/cc8157

Published: 5 November 2009

Abstract

Introduction

Individuals deficient in mannose-binding lectin (MBL), an important component of the innate immune system, show increased susceptibility to infection. We investigated whether polymorphisms in the MBL2 gene and the serum level are associated with the severity and prognosis of sepsis.

Methods

A total of 266 patients with sepsis and 398 healthy controls were enrolled. We analyzed the three single nucleotide polymorphisms (Gly54Asp, -550, and +4) in the MBL2 gene. Serum samples collected on day 1 were analyzed for the levels of MBL.

Results

Patients who were heterozygous (A/B) or homozygous (B/B) at codon 54 (adjusted odds ratio (OR), 0.370; 95% confidence interval (CI), 0.207-0.661, P = 0.001) and who were heterozygous (H/L) or homozygous (L/L) at -550 (adjusted OR, 0.476; 95% CI, 0.249-0.910, P = 0.025) were less likely to have septic shock in the sepsis group. Using Cox regression analysis for 28-day mortality, an MBL level ≥ 1.3 microg/mL showed significantly lower 28-day mortality (P = 0.020; hazard ratio, 0.571; 95% CI, 0.355-0.916) in the septic shock group.

Conclusions

Homozygosity at codons 54 (A/A) and -550 (H/H) appears to be associated with the severity, but not the outcome, of sepsis, whereas a low MBL level may be an independent risk factor for mortality. These findings suggest that the genotype and serum level for MBL2 may have different clinical implications.