Department of Plastic Surgery, Herlev University Hospital, Herlev, Denmark.
J Plast Reconstr Aesthet Surg. 2011 Jun;64(6):e146-8. doi: 10.1016/j.bjps.2011.01.013. Epub 2011 Feb 25.
Mannan-binding lectin is an important component of innate immunity, and insufficiency is associated with several clinical disorders. Recently, experimental replacement therapy with plasma-derived mannan-binding lectin has become an option. The current article presents the case of a patient with an insufficient level of mannan-binding lectin and a chronic radiation-induced ulcer following the treatment of breast cancer. After 15 months of initially conservative treatment and thereafter plastic surgery, the healing was still impaired with necrosis in the periphery of the ulcer. Immunological work-up of the patient revealed pronounced insufficiency of mannan-binding lectin. Following a 6-week experimental intravenous treatment with mannan-binding lectin purified from human plasma, that is, 0.2-0.3 mg mannan-binding lectin per kg body weight twice a week, the defect was completely healed. We suggest that deficiency of mannan-binding lectin can explain cases of otherwise unexplained impaired healing, and that replacement therapy is considered in such cases.
甘露聚糖结合凝集素是先天免疫系统的重要组成部分，其不足与几种临床疾病有关。最近，用血浆衍生的甘露聚糖结合凝集素进行实验性替代治疗已成为一种选择。本文介绍了一例乳腺癌治疗后出现甘露聚糖结合凝集素水平不足和慢性放射性溃疡的患者。在最初的 15 个月保守治疗和此后的整形手术后，溃疡周围仍存在坏死，愈合仍受到影响。对患者的免疫功能检查显示甘露聚糖结合凝集素明显不足。经过 6 周的实验性静脉内治疗，用从人血浆中纯化的甘露聚糖结合凝集素进行治疗，即每周两次，每次每公斤体重 0.2-0.3 毫克甘露聚糖结合凝集素，缺陷完全愈合。我们建议，甘露聚糖结合凝集素缺乏可解释其他原因不明的愈合不良病例，在这种情况下应考虑替代治疗。
