Original Article
  

Mannose-binding Lectin Deficiency in Patients with a History of Recurrent Infections

Abstract

Mannose-binding lectin (MBL) is a protein of innate immune system that is involved in opsonization and complement activation. MBL deficiency is associated with predisposition to infectious diseases; however subnormal levels are also seen in healthy subjects. The aim of this study was to investigate the prevalence and clinical manifestation of MBL deficiency in patients with increased susceptibility to infection. We studied the MBL serum concentration of 104 patients with a history of recurrent and/or severe infections referred to Immunology, Asthma and Allergy Research Institute (IAARI) in order to evaluate the primary immunodeficiency (PID). The distribution of MBL deficiency in these patients and 593 healthy subjects of previous study were analyzed. The frequency of individuals with MBL deficiency was significantly higher in patients with recurrent and/or severe infections (13.5% [14/104]) compared with healthy subjects (4.7% [28/593]; p=0.001; OR 3.1, 95% CI 1.5-6.1). However, in 10.9% (7/64) of patients with recurrent infections without any immunodeficiency background, the MBL deficiency was detected. On the whole, our findings indicate an association between MBL deficiency and increased susceptibility to infections.

1. Aittoniemi J, Baer M, Soppi E, Vesikari T, Miettinen A.Mannan binding lectin deficiency and concomitant immunodefects. Arch Dis Child 1998; 78(3):245-8.

2. Minchinton R, Dean M, Clark T, Heatley S, Mullighan CG. Analysis of the relationship between Mannose- Binding lectin (MBL) Genotype, MBL levels and functional in an Australian blood donor Population. Scand J Immunol 2002; 56(6):630-41.

3. Trevisiol SC, Boniotto M, Giglio L, Poli F, Morgutti M, Crovella S. MBL2 polymorphism screening in a regional Italian CF center. J Cyst Fibros 2005; 4(3):189-91.

4. Heitzeneder S, Seidel M, Forster-Waldl E, Heitger A. Mannan-binding lectin deficiency _ Good news, bad news, doesn’t matter? Clin Immunl 2012; 143(1):22-38.

5. Miller ME, Seals J, Kaye R, Levitsky LC. A famlial, plasma-associated defect of phagocytosis: A new cause of recurrent bacterial infections. Lancet, 1968; 2: 60-3.

6. Turner MW, Hamvas RM. Mannose-binding lectin: structure, function, genetics, and disease associations. Rev Immunogenet 2000; 2(3):305-22.

7. Soltani A, RahmatiRad S, Pourpak Z, Alizadeh Z, Saghafi S, HajiBeigi B, et al. Polymorphisms and serum level of mannose-binding lectin: An Iranian survey. Iran J Allergy Asthma Immunol 2014; 13(6):428-32.

8. Summerfield JA. Clinical potential of mannose-binding lectin-replacement therapy. Biochem Soc Trans,2003;31(4):770-3.

9. Turner MW, Dinan L, Heatley S, Jack DL, Boettcher B, Lester S, et l. Restricted polymorphism of the mannosebinding lectin gene of indigenous Australians. Hum Mol Genet 2000; 9(10):1481–6.

10. Sullivan K, Winkelstein J. Deficiency of the complement system. In: Stiehm ER, Ochs HD, Winkelstein JA. Immunologic disorders in infants and children. 5th ed. Philadelphia: Elsevier Saunders 2004; 652-84.

11. Gupta K, Gupta RK, Hajela K. Disease associations of mannose-binding lectin & potential of replacement therapy. Indian J Med Res 2008; 127(5):431-40.

12. Bronkhorst MW, Bouwman LH, Stiehm ER, TePas E.Mannose-binding lectin deficiency. 2015 Nov. Available from: http://www.uptodate.com/contents/mannose- binding-lectin-deficiency.

13. Zahedifard S, Rashidi E, Shams S, Saghafi S, Fazlollahi MR, Talebzadeh A, et al. Mannan-binding lectin serum levels in 593 healthy Iranian children and adults. Iran J Allergy Asthma Immunol 2014; 13(2):120-4.

14. Potlukova E, Jiskra J, Freiberger T, Limanova Z, Zivorova D, Malickova K, et al. The production of mannan-binding lectin is dependent upon thyroid hormones regardless of the genotype: A cohort study of 95 patients with autoimmune thyroid disorders. Clin Immunol 2010; 136(1):123-29.

15. Hoeflich C, Unterwalder n, Schuett S, Schmolk K, Boenisch O, Hammer M, et al. Clinical manifestation of mannose-binding lectin deficiency in adults independent of concomitant immunodeficiency. Human Immunol 2009; 70(10):809-812.

16. Garred P, Madsen HO, Hofmann B, Svejgaard A.Increased frequency of homozygosity of abnormal mannan- binding- protein alleles in patients with suspected immunodeficiency. Lancet 1995;346(8980):941-3.

17. Rantala A, Lajunen T, Juvonen R, Bloigu A, Silvennoinen-Kassinen S, Peitso A, et al. Mannose- Binding Lectin Concentrations, MBL2 Polymorphisms, and Susceptibility to Respiratory Tract Infections in Young Men. J Infect Dis 2008; 198(8):1247-53.

18. Summerfield JA, Ryder S, Sumiya M, Thursz M, Gorchein A, Montei MA, et al. Mannose binding protein gene mutations associated with unusual and severe infections in adults. Lancet 1995; 345(8954):886-9.

19. Lotz DR, Knutsen AP. Conomitant selective antibody deficiency in pediatric patients with mannose-binding lectin deficiency. Pediatric Allergy, Immunology, and Pulmonology 2010; 23:265.

20. Peterslund NA, Koch C, Jensenius JC, Thiel S.Association between deficiency of mannose-binding lectin and severe infections after chemotherapy. Lancet 2001; 358(9282):637-8.

21. Verschuren JJ, Roos A, Schaapherder AF, Mallat MJ, Daha MR, de Fijter JW, et al. Infectious complications after simultaneous pancreas-kidney transplantation: a role for the lectin pathway of complement activation. Transplantation 2008; 85(1):75-80.

22. Kilpatrick DC. therapeutic applications of mannan- binding lectin. Biochem Soc Trans 2003; 31(pt4):745-7.

Files
IssueVol 15, No 1 (2016) QRcode
SectionOriginal Article(s)
Keywords
Deficiency Mannose-binding lectin Recurrent infections
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Rashidi E, Fazlollahi MR, Zahedifard S, Talebzadeh A, Kazemnejad A, Saghafi S, Pourpak Z. Mannose-binding Lectin Deficiency in Patients with a History of Recurrent Infections. Iran J Allergy Asthma Immunol. 2016;15(1):69-74.