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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Immunology 1/2014

Mannose-binding lectin gene variants and infections in patients receiving autologous stem cell transplantation

Zeitschrift:
BMC Immunology > Ausgabe 1/2014
Autoren:
Ana Moreto, Concepción Fariñas-Alvarez, Maria Puente, Javier Gonzalo Ocejo-Vinyals, Pablo Sánchez-Velasco, Juan Pablo Horcajada, Ana Batlle, Carmen Montes, Francisca Santos, Eulogio Conde, Maria-Carmen Fariñas
Wichtige Hinweise

Competing interest

The authors declare that they have no competing interests.

Authors’ contributions

AM participated in data collection and manuscript preparation. CF-A participated in the design of the study, performed the statistical analysis and reviewed and revised the manuscript. MP participated in collection of data and manuscript preparation. JGO-V carried out part of the MBL2 genotyping, and revised the manuscript. PS-V carried out part of the MBL2 genotyping and revised the manuscript. JPH participated in the design of the study and reviewed and revised the manuscript. AB participated in collection of data. CM participated in collection of data and manuscript preparation. FS participated in collection of data and manuscript preparation. EC reviewed and revised the manuscript. MCF: participated in the design of the study, data analysis and reviewed and revised the manuscript. All authors read and approved the final manuscript.

Abstract

Background

Serious infections are common in patients undergoing autologous stem cell transplantation (ASCT) mainly because of the effects of immunosuppression. The innate immune system plays an important role in the defense against different infections. Mannose binding lectin (MBL) is a central molecule of the innate immune system. There are several promoter polymorphisms and structural variants of the MBL2 gene that encodes for this protein. These variants produce low levels of MBL and have been associated with an increased risk for infections.

Methods

Prospective cohort study. The incidence, severity of infections and mortality in 72 consecutive patients with hematologic diseases who underwent ASCT between February 2006 and June 2008 in a tertiary referral center were analyzed according to their MBL2 genotype. INNO-LiPA MBL2 was used for MBL2 gene amplification and genotyping. Relative risks (RR) (IC95%) as measure of association were calculated. Multivariate analysis was performed using logistic regression.

Results

A statistically significant higher number of fungal infections was found in patients with MBL2 variants causing low MBL levels (21.1%versus1.9%, p=0.016). In this MBL2 variant group infection was more frequently the cause of mortality than in the MBL2 wild-type group (p=0.05). Although not statistically significant, there was a higher incidence of major infections in the MBL2 variant group as well as a higher number of infections caused by gram-positive bacteria.

Conclusions

Low-producer MBL2 genotypes were associated with an increased number of fungal infections in ASCT patients, which would suggest that MBL has a protective role against such infections. ASCT patients with MBL2 variant genotypes are more likely to die as a result of an infection.
Literatur
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