Université Lille Nord de France, Lille Cedex, France.
J Clin Immunol. 2012 Dec;32(6):1317-23. doi: 10.1007/s10875-012-9748-2. Epub 2012 Jul 26.
The high morbi-mortality associated with invasive candidiasis (IC) is a persistent problem in hospitals. Mannose-binding lectin (MBL) plays a role in innate immunity through its interaction with mannosylated molecules of Candida albicans. A correlation between MBL deficiency and vulvovaginal candidiasis or peritonitis has been reported. We investigated circulating MBL levels and their evolution during the course of IC. Sixty-eight patients with proven IC, 82 hospitalized patients (HP) without evidence of infection, and 70 healthy subjects (HS) were studied in order to examine the relationship between serum MBL and IC. Serum MBL levels were measured by enzyme-linked immunosorbent assay (ELISA). MBL levels were significantly higher in IC patients than in HP and HS (p < 0.0001, p < 0.0055, respectively). A change in MBL concentrations was observed during the course of IC, with a dramatic decrease during the 2 days before positive blood culture sampling. This decrease was concomitant with the presence of high levels of circulating mannan (Mn). Like MBL levels, anti-mannan antibodies (AMn) increased after the mannanemia/blood culture period. These findings suggest a possible role of MBL during the early stage of IC. The mechanisms that regulate these observations in terms of effect and consequences on innate and adaptive immunity and the prognosis of IC require further investigation.
侵袭性念珠菌病（IC）相关的高病死率一直是医院面临的一个问题。甘露聚糖结合凝集素（MBL）通过与白色念珠菌的甘露糖化分子相互作用，在固有免疫中发挥作用。已有研究报道 MBL 缺乏与外阴阴道念珠菌病或腹膜炎之间存在相关性。我们研究了循环 MBL 水平及其在 IC 病程中的变化。为了研究血清 MBL 与 IC 之间的关系，我们对 68 例确诊为 IC 的患者、82 例无感染证据的住院患者（HP）和 70 例健康对照者（HS）进行了研究。采用酶联免疫吸附试验（ELISA）测定血清 MBL 水平。IC 患者的 MBL 水平明显高于 HP 和 HS（p<0.0001，p<0.0055）。在 IC 病程中观察到 MBL 浓度的变化，在血培养阳性前的 2 天内明显下降。这种下降与循环甘露聚糖（Mn）水平升高同时发生。与 MBL 水平一样，抗甘露聚糖抗体（AMn）在甘露聚糖血症/血培养期后增加。这些发现提示 MBL 在 IC 的早期阶段可能发挥作用。需要进一步研究调节这些观察结果的机制，包括其对固有和适应性免疫的影响和后果，以及 IC 的预后。
