Schafranski M D, Stier A, Nisihara R, Messias-Reason I J T
Laboratory of Immunopathology, Department of Clinical Pathology, Hospital de Clinicas, Federal University of Paraná, Curitiba, Brazil.
Clin Exp Immunol. 2004 Dec;138(3):521-5. doi: 10.1111/j.1365-2249.2004.02645.x.
Although mannose-binding lectin (MBL) is known to be involved in the primary defense against microorganisms, there are emerging lines of evidence for an active proinflammatory role for MBL in different chronic diseases. In this study we determined the circulating levels of MBL in patients with rheumatic heart disease (RHD). A total of 100 patients (77 women, 23 men; mean age 45.8 +/- 11 years, range 19-76 years) with chronic RHD, and a previous diagnosis of rheumatic fever, were studied. Transthoracic echocardiography was performed in all patients to evaluate valvular heart disease. Ninety-nine healthy individuals matched for age, sex and ethnic origin were included as controls. MBL concentration was measured by enzyme-linked immunosorbent assay and C3 and C4 levels by turbidimetry. MBL levels were significantly higher in patients with RHD than in healthy subjects (mean +/- SEM: 3036.2 +/- 298.9 ng/ml versus 1942.6 +/- 185.5 ng/ml, P <0.003). In addition, MBL deficiency was more prevalent in controls (17.1%) than in patients (9% P <0.09). Concentrations of C4 were within the normal range (22.7 +/- 0.8 mg/dl, normal: 10.0-40.0 mg/dl), while C3 concentrations were found to be elevated (109.2 +/- 3.6 mg/dl, normal: 50.0-90.0 mg/dl). No correlation was observed between serum MBL levels and valve area or the type of surgical procedure. The significantly elevated circulating MBL levels in patients with RHD together with the greater prevalence of MBL deficiency in controls suggest that MBL may cause undesirable complement activation contributing to the pathogenesis of RHD.
虽然已知甘露糖结合凝集素（MBL）参与针对微生物的初级防御，但越来越多的证据表明MBL在不同慢性疾病中具有积极的促炎作用。在本研究中，我们测定了风湿性心脏病（RHD）患者的循环MBL水平。共研究了100例慢性RHD患者（77例女性，23例男性；平均年龄45.8±11岁，范围19 - 76岁），这些患者既往有风湿热诊断。对所有患者进行经胸超声心动图检查以评估瓣膜性心脏病。纳入99名年龄、性别和种族匹配的健康个体作为对照。通过酶联免疫吸附测定法测量MBL浓度，通过比浊法测量C3和C4水平。RHD患者的MBL水平显著高于健康受试者（平均值±标准误：3036.2±298.9 ng/ml对1942.6±185.5 ng/ml，P<0.003）。此外，MBL缺乏在对照组（17.1%）中比在患者组（9%，P<0.09）中更普遍。C4浓度在正常范围内（22.7±0.8 mg/dl，正常：10.0 - 40.0 mg/dl），而C3浓度升高（109.2±3.6 mg/dl，正常：50.0 - 90.0 mg/dl）。未观察到血清MBL水平与瓣膜面积或手术类型之间的相关性。RHD患者循环MBL水平显著升高以及对照组中MBL缺乏患病率更高，表明MBL可能导致不良的补体激活，从而促进RHD的发病机制。
