Genetic and/or developmental variations in the innate immune response could play a role in modulating the predisposition
to severe infections and to ischemia reperfusion related pathologies, as NEC, in critically ill neonates with the same risk
We prospectively investigated the association of mannose-b
inding lectin (MBL) serum levels with nosocomial sepsis (NS),
their changes overtime during infection, the MBL2 genotype and their relationship with mortality in 365 critically ill neonat
42 of them underwent major surgery. Th
e median MBL serum concentration on admission, was signifi
cantly lower in infected
than in uninfected neonates (p<0.001), without signifi
erences between not surgical and surgical neonates. Low MBL
serum levels on admission independently increased the risk of infection. Th
e median peak MBL level during infection was
higher than the median level on admission (p < 0.001) and was correlated with it (r
= 0.83, p<0.001), also dividing the neonates
into surgical and not surgical neonates. MBL levels on admission and peak levels during infections were not associated with
death ( p=0.57). We did not fi
erence in the frequencies of MBL2 genotypes between infected and uninfected
neonates. Moreover, no association was found between MBL2 genotypes and death.
e pathogenesis of NEC is still unclear and the local pro-infl
ammatory response of the host could play an important role.
To identify subsets of neonates at high risk of NEC is a challenge.
To evaluate the association between Mannose Binding Le
ctin (MBL) genotype, MBL serum level on admission to the
Hospital and NEC in preterm infants we performed a retrospective study on 107 neonates (41 with NEC and 66 controls). MBL-
2 genotyping was assessed by PCR and RFLP. Th
e main outcome of the analysis was severe NEC (II-III Bell�s stages).
MBL2 genotypes, related to high MBL expression, were more frequent in neonates with severe NEC than in controls.
Neonates with NEC showed MBL level on admission > 400 ng/ml more frequently than controls (p=0.043) and among neonates
with severe NEC, all deceased neonates were carriers of high or intermediate producing
-2 haplotypes (p=0.035).
genotypes associated to high MBL serum levels could represent a risk factor for NEC.
In conclusion Mannose Binding Lectin pla
ys a crucial role in innate immunity against pathogens but we still don�t fully
understand the clinical value of the MBL response during infections and NEC.
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