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甘露糖结合凝集素基因多态性与早产儿早期新生儿结局的关系。

Mannose-binding lectin gene polymorphism and early neonatal outcome in preterm infants.

机构信息

Division of Neonatology, Department of Pediatrics, Ege University Faculty of Medicine, Bornova/Izmir, Turkey. ozgekoroglu @ mail.ege.edu.tr

出版信息

Neonatology. 2010;98(4):305-12. doi: 10.1159/000291487. Epub 2010 May 4.

Abstract

BACKGROUND

Mannose-binding lectin (MBL) as a component of innate immunity plays an important role in preterm infants in whom adaptive immunity is not sufficiently developed. Polymorphisms in immunoregulatory genes influence the response to infection and subsequent inflammation. Infection and inflammation have been implicated in the mechanisms responsible for many of the diseases in the preterm newborns.

OBJECTIVES

The aim of the study was to investigate the relationship between MBL gene polymorphism and early neonatal outcome in preterm infants.

METHODS

Codon 54 and 57 polymorphisms in MBL2 gene were genotyped in 99 preterm infants admitted to the Neonatal Intensive Care Unit at Ege University Children's Hospital.

RESULTS

Overall frequencies of sepsis and early-onset sepsis were higher in the group of infants with MBL polymorphism when compared to infants with wild-type MBL genotype (p = 0.008, 0.009, respectively). Maximum Tollner sepsis score in the first 3 days of life was higher for the infants with variant MBL genotype (p = 0.0278). More infants in the variant MBL group had significant patent ductus arteriosus when compared to infants with wild-type MBL (27.8 vs. 9.5% respectively, p = 0.037).

CONCLUSION

MBL gene polymorphism was associated with increased frequency of clinical sepsis particularly with early neonatal sepsis and also with higher Tollner sepsis scores and increased frequency of patent ductus arteriosus in infants. Overall mortality and incidence of culture proven sepsis, respiratory distress syndrome, bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leukomalacia and necrotizing enterocolitis were not found to be related to MBL genotype.

摘要

背景

甘露聚糖结合凝集素(MBL)作为先天免疫系统的一部分,在适应性免疫系统尚未充分发育的早产儿中发挥着重要作用。免疫调节基因的多态性影响对感染的反应以及随后的炎症。感染和炎症与许多早产儿疾病的发病机制有关。

目的

本研究旨在探讨 MBL 基因多态性与早产儿早期新生儿结局的关系。

方法

在 99 名入住 Ege 大学儿童医院新生儿重症监护病房的早产儿中,对 MBL2 基因的第 54 和 57 位密码子多态性进行了基因分型。

结果

与野生型 MBL 基因型的婴儿相比,MBL 多态性婴儿的败血症和早发性败血症的总体发生率更高(分别为 p = 0.008、0.009)。出生后前 3 天的最大 Tollner 败血症评分在变异型 MBL 基因型的婴儿中更高(p = 0.0278)。与野生型 MBL 相比,变异型 MBL 组中有更多的婴儿出现显著的动脉导管未闭(分别为 27.8%和 9.5%,p = 0.037)。

结论

MBL 基因多态性与临床败血症的发生率增加有关,特别是与新生儿早期败血症有关,还与 Tollner 败血症评分升高和动脉导管未闭的发生率增加有关。总体死亡率和培养证实的败血症、呼吸窘迫综合征、支气管肺发育不良、脑室内出血、脑室周围白质软化和坏死性小肠结肠炎的发生率与 MBL 基因型无关。

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