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Mannose-binding lectin genotypes in susceptibility to community acquired pneumonia

Departments of Internal Medicine, Pulmonary Medicine and Medical Microbiology and Immunology, St. Antonius Ziekenhuis Nieuwegein, PB 2500, 3430 EM Nieuwegein, the Netherlands, Henrik Endeman and Bjorn L. Herpers attributed equally to this manuscript

henrik.endeman{at}planet.nl

b.herpers{at}antonius.net

b.jong{at}antonius.net

p.voorn{at}antoniusmesosgroep.nl

j.grutters{at}antonius.net

h.vvelzenb{at}antonius.net

d.h.biesma{at}umcutrecht.nl

Abstract

BackgroundCommunity 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.

MethodsAll 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 exon1 (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 controls.

ResultsIn 199 patients and 223 controls 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 controls. The frequency of sufficient MBL genotypes was non-significantly higher in patients with pneumonia with L. species and M. pneumoniae. In L. species, the sufficient YA/YA genotype was significantly more frequent than in controls (OR 5.43; CI 1.32-22.41; p = 0.02). The frequency of the MBL deficient genotype was significantly higher in patients with viral (co-)infections (OR 2.36: CI 1.06-5.26; p = 0.03) and non-significantly higher in patients with pneumococcal pneumonia and viral (co-)infections. MBL genotypes had no effect on outcome.

ConclusionsMBL 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.

Key Words: Pneumonia • mannose-binding lectin, Streptococcus pneumoniae • viral pneumonia • Legionella • Mycoplasma