Hartz Annika, Pagel Julia, Humberg Alexander, Preuss Michael, Schreiter Lena, Rupp Jan, Figge Julia, Karsten Christian M, Nürnberg Peter, Herting Egbert, Göpel Wolfgang, Härtel Christoph
Department of Pediatrics, University Hospital Lübeck, Lübeck, Germany.
Institute of Systemic Inflammation Research, University Hospital Lübeck, Lübeck, Germany.
PLoS One. 2017 May 30;12(5):e0178032. doi: 10.1371/journal.pone.0178032. eCollection 2017.
Studies on the influence of mannose-binding lectin (MBL) deficiency on infection susceptibility in preterm infants have yielded controversial results. We investigated the association of genotype-based MBL levels with outcome in very-low-birth weight infants (VLBWI).
We genotyped 3 genetic variants of MBL2 (rs1800450, rs1800451, rs5030737) in 6878 VLBWI. MBL plasma levels were categorized as normal (wild type, A/A), low (heterozygotes, A/O) or undetectable (homozygotes, O/O). Primary outcome was the effect of genotype-based MBL2 levels on blood-culture proven and clinical sepsis during primary stay in hospital. We also evaluated burden of infection within 24 months after discharge.
We found no association between MBL levels and sepsis risk in the whole cohort. Infants without measurable MBL levels born between 32 0/7 to 36 6/7 weeks of gestation, however, had a higher rate of Gram-negative sepsis than infants with normal or reduced MBL levels. In a follow-up investigation at 24 months (n = 1070 infants), infants without measurable MBL levels suffered more frequently from stomatitis and urinary tract infection.
In a large cohort of VLBWI MBL2 deficiency had no major impact on infection risk unless children were born between 32 0/7 and 36 6/7 weeks of gestation.
关于甘露糖结合凝集素（MBL）缺乏对早产儿感染易感性影响的研究结果存在争议。我们调查了基于基因型的MBL水平与极低出生体重儿（VLBWI）预后的相关性。
我们对6878例VLBWI的MBL2的3个基因变异（rs1800450、rs1800451、rs5030737）进行基因分型。MBL血浆水平分为正常（野生型，A/A）、低（杂合子，A/O）或不可检测（纯合子，O/O）。主要结局是基于基因型的MBL2水平对住院期间血培养证实的和临床败血症的影响。我们还评估了出院后24个月内的感染负担。
我们在整个队列中未发现MBL水平与败血症风险之间存在关联。然而，孕周在32 0/7至36 6/7周之间出生且MBL水平不可测量的婴儿，革兰氏阴性败血症的发生率高于MBL水平正常或降低的婴儿。在24个月的随访调查中（n = 1070例婴儿），MBL水平不可测量的婴儿患口腔炎和尿路感染的频率更高。
在一大群VLBWI中，除非儿童在32 0/7至36 6/7周之间出生，否则MBL2缺乏对感染风险没有重大影响。
