MBL deficiency in preterm and very light neonates
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. Even neonates with a wild-type MBL-2 genotype may be deficient in MBL at birth. Therefore, detection of MBL-deficiency at birth should be based on actual MBL plasma levels rather than on MBL-2 genotype.
Mannose-binding lectin (MBL) is a circulating pattern recognition molecule playing an important role in the innate immune defense. It activates the lectin pathway of the complement system. Circulating MBL plasma levels vary between 0 and 10 µg/ml. These variations are correlated with mutations in the structural and promoter regions of the MBL-2 gene that lead to reduced MBL concentrations.
Babies with MBL levels below 400 ng/ml are more likely to suffer from sepsis, regardless of their genotype. In neonates, regardless of their MBL-2 gene genotype, a very low birth weight (less than 1000g) or gestation of less than 28 weeks increased the risk of sepsis to 70%. Whereas, in neonates with MBL levels above 400 ng/ml, the risk of sepsis was less than 50%.
References:
1. Dzwonek, A et al; The role of mannose-binding lectin in susceptibility to infection in preterm neonates. Pediatr Res 2008, 63: 680
2. Frakking, F et al; Low mannose-binding lectin (MBL) levels in neonates with pneumonia and sepsis. Clin Exp Immunol 2007, 150: 255
3. Frakking, F et al; High prevalence of mannose-binding lectin (MBL) deficiency in premature neonates. Clin Exp Immunol 2006, 145: 5
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