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Chest. 2008 Dec;134(6):1135-1140. doi: 10.1378/chest.08-0642. Epub 2008 Jul 18.

Mannose-binding lectin genotypes in susceptibility to community-acquired pneumonia.

Author information

1
Department of Intensive Care Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam. Electronic address: henrik.endeman@planet.nl.
2
Medical Microbiology and Immunology, St. Antonius Ziekenhuis Nieuwegein, Nieuwegein, the Netherlands.
3
Departments of Pulmonary Medicine, St. Antonius Ziekenhuis Nieuwegein, Nieuwegein, the Netherlands.
4
Department of Internal Medicine, University Medical Center Utrecht, Utrecht.

Abstract

BACKGROUND:

Community-acquired pneumonia (CAP) is most frequently caused by Streptococcus pneumoniae, Haemophilus influenzae, atypical pathogens, and respiratory viruses. Susceptibility to CAP can be increased by single-nucleotide polymorphisms (SNPs) within the mannose-binding lectin (MBL) gene. We questioned whether MBL polymorphisms are associated with the susceptibility to and outcome of CAP and its most common pathogens.

METHODS:

All adult patients presenting with CAP in a 23-month period were included in this study. Frequencies of SNPs were determined for the promoter X/Y and the three coding SNPs in exon 1 (A/0). Six genotypes were constructed representing patients with sufficient and deficient serum levels of MBL. The results of the patients with CAP were compared with control subjects.

RESULTS:

In 199 patients and 223 control subjects, MBL genotypes were determined. There were no differences in MBL genotype frequencies between patients with CAP in general, pneumonia caused by S pneumoniae or H influenzae, and control subjects. The frequency of sufficient MBL genotypes was nonsignificantly higher in patients with pneumonia with Legionella sp and Mycoplasma pneumoniae. In Legionella spp, the sufficient YA/YA genotype was significantly more frequent than in control subjects (odds ratio [OR], 5.43; confidence interval [CI], 1.32 to 22.41; p = 0.02). The frequency of the MBL-deficient genotype was significantly higher in patients with viral (co)infections (OR, 2.36; CI, 1.06 to 5.26; p = 0.03) and nonsignificantly higher in patients with pneumococcal pneumonia and viral (co)infections. MBL genotypes had no effect on outcome.

CONCLUSIONS:

MBL genotypes play a limited role in pneumococcal pneumonia. Sufficient MBL genotypes were more frequently found in a small group of patients with atypical pneumonia, and MBL-deficient genotypes were more frequently found in patients with viral (co)infections.

PMID:
18641104
DOI:
10.1378/chest.08-0642
[Indexed for MEDLINE]

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