Polymorphisms in the mannose-binding lectin and in the MBL-associated serine protease genes in intensive care unit patients with systemic inflammatory response syndrome
Abstract number: P758
Smithson A., Perello R., Garcia-Segarra G., Espinosa G., Tassies D., Freire C., Castro P., Suarez B., Lozano F., Nicolas J.
Background: Polymorphisms in the mannose-binding lectin (MBL2) and in the MBL-associated serine protease (MASP2) genes have been associated with an increased risk of infections. The aim of the study is to asses the possible association between polymorphisms in these genes and the frequency of infections and death among intensive care unit (ICU) patients with systemic inflammatory response syndrome (SIRS).
Methods: Blood samples from 243 consecutive UCI patients with SIRS (mean age 62.75±15.69 years; 63% men) admitted in our hospital from January 2003 to January 2004 were prospectively collected. For further comparison samples from 104 blood donors were also included in the study. At entry, 94 patients exhibited septic shock, 29 severe sepsis, 49 had sepsis and 71 had a noninfectious SIRS. Mean APACHE II, SAPS II and SOFA score at ICU entry were 17.4 + 6.3, 36.5 + 11.8, 8.7 + 3.1, respectively. In-hospital rate mortality was 30%. Six single nucleotide polymorphism's (-550 G/C, -221 C/G, +4 C/T, codon 52 CGT/TGT, codon 54 GGC/GAC and codon 57 GGA/GAA) in the promoter and the exon 1 of the MBL2 gene and the Asp 105 Gly single nucleotide polymorphism's in the MASP2 gene were genotyped using a sequence-based typing technique.
Results: No significant differences were observed in the frequencies for low expression MBL2 genotypes and for the wild type MASP2 genotype between patients with SIRS (13.02% and 94.4%, respectively) and the healthy controls (15.3% and 97.1%, respectively) (P= 0.86 and P= 0.6, respectively; Chi square test). Although patients with an infectious cause of SIRS had a higher incidence for low expression MBL2 genotypes (15.7%) compared to those with a non infectious SIRS (6.5%), these differences were not statistically significant (P= 0.064; Chi2 test). No differences were found regarding the frequency for low MBL2 among patients with septic shock or with severe sepsis or among non-survivor ICU patients. The presence of polymorphism's in the MASP2 gene was not associated with a higher rate of infections or mortality.
Conclusions: Although patients with MBL2 genetic polymorphisms causing low MBL2 levels have a tendency to present a higher incidence of an infectious cause of SIRS, the presence of MBL2 or MASP2 genetic polymorphism's do not seem to have a significant impact neither in mortality nor in the severity of infections in ICU patients with SIRS.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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