Affiliation:
1. Departments of Clinical Immunology
2. Blood Cell Research, Sanquin Research and Landsteiner Laboratory, University of Amsterdam, Amsterdam, the Netherlands
3. Paediatric Clinical Epidemiology
4. Department of Neonatology, Emma Children's Hospital, Academic Medical Center
Abstract
Summary
We investigated whether deficiency of mannose-binding lectin (MBL), a component of innate immunity, is associated with neonatal pneumonia and sepsis during the first 72 h, i.e. early onset, and during the first month after birth. In 88 neonatal intensive care patients (71 premature), MBL2 genotype and MBL plasma levels at birth were determined prospectively by Taqman analysis and enzyme-linked immunosorbent assay, respectively. Thirty-five neonates (40%) had low, i.e. ≤ 0·7 µg/ml, MBL plasma levels at birth. Median (interquartile range) MBL plasma levels in 32 no early-onset sepsis (EOS) cases, 44 possible EOS cases and 11 EOS cases were 1·57 (0·57–2·67) µg/ml, 1·05 (0·41–1·70) µg/ml and 0·20 (0·10–0·77) µg/ml, respectively (P < 0·01). During the first month, 28 neonates (32%) had no infection, 49 (55%) had suspected infection, five (6%) had pneumonia and six (7%) had culture-proven sepsis. Low MBL levels at birth were associated both with an increased risk of developing pneumonia (OR: 12·0; 95% CI: 1·1–126·1; P = 0·04) and culture-proven sepsis (OR: 15·0; 95% CI: 1·5–151·3; P = 0·02). These results were confirmed by genetic analysis of MBL deficiency. Low MBL levels at birth are associated with an increased risk of early-onset sepsis, culture-proven sepsis and pneumonia during the first month of life.
Publisher
Oxford University Press (OUP)
Subject
Immunology,Immunology and Allergy
Cited by
78 articles.
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