Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 0 0 2026 02 07 1 14 Hongyi Shao Department of Emergency Intensive Care Medicine, The Central Hospital Affiliated to Shaoxing University, Shaoxing, Zhejiang, China Jianfeng Zhang Department of Emergency Intensive Care Medicine, The Central Hospital Affiliated to Shaoxing University, Shaoxing, Zhejiang, China Dayong Wu Department of Emergency Intensive Care Medicine, The Central Hospital Affiliated to Shaoxing University, Shaoxing, Zhejiang, China Xiaoyang Zhang Department of Emergency Intensive Care Medicine, The Central Hospital Affiliated to Shaoxing University, Shaoxing, Zhejiang, China Chunqiong Hu Department of Emergency Intensive Care Medicine, The Central Hospital Affiliated to Shaoxing University, Shaoxing, Zhejiang, China 2025 07 04 2025 09 04 Mannose-binding lectin (MBL) is a critical component of the innate immune system, serving a vital role in the body’s initial defense against pathogens. Sepsis, a severe condition triggered by an excessive immune response to infection, has been linked to variations in the MBL2 gene that affect MBL levels and functionality. Numerous studies across various populations have examined the role of MBL-2 promoter polymorphisms (H>L and Y>X), but their results have been conflicting. This study aims to investigate the genetic connection between MBL promoter polymorphisms and susceptibility to sepsis through a meta-analysis of previously published articles. A thorough literature search was conducted using PubMed, Scopus, and ScienceDirect to locate relevant articles for the meta-analysis. Rigorous inclusion and exclusion criteria were implemented to ensure data accuracy. All analyses were performed using Comprehensive Meta-Analysis Software v4. Seven studies were included, examining the role of MBL-2 promoter genetic variants in sepsis (H>L: n=3, sepsis cases: 449, control: 687; Y>X: n=6, sepsis cases: 1211, control: 1694). Egger’s regression analysis and funnel plots suggested no publication bias. Heterogeneity analysis indicated homogeneity among the data. The meta-analysis showed no association between MBL-2 promoter variants and susceptibility to sepsis. The trial sequential analysis highlighted the need for further studies on MBL-2 promoter variants in sepsis to draw a definitive conclusion. The promoter variants of the MBL-2 gene (H>L and Y>X) do not appear to increase the risk of sepsis. Further investigation is needed to confirm this conclusion, including more participants from diverse populations and larger sample sizes. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/4509 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/4509/2298