Lectin pathway of complement activation and relation with clinical complications in critically ill children.
Pediatr Res
; 75(1-1): 99-108, 2014 Jan.
Article
en En
| MEDLINE
| ID: mdl-24129551
ABSTRACT
BACKGROUND:
Critically ill children are susceptible to nosocomial infections, which contribute to adverse outcomes. Deficiencies in the innate immunity lectin pathway of complement activation are implicated in a child's vulnerability to infections in conditions such as cancer, but the role during critical illness remains unclear. We hypothesized that low on-admission levels of the pathway proteins are, in part, genetically determined and associated with susceptibility to infectious complications and adverse outcomes.METHODS:
We studied protein levels of mannose-binding lectin (MBL), H-ficolin and M-ficolin, three MBL-associated-serine proteases (MASPs) and MBL-associated protein (MAp44), and relation with functional genetic polymorphisms, in 130 healthy children and upon intensive care unit (ICU) admission in 700 critically ill children of a randomized study on glycemic control.RESULTS:
Levels of MASP-1, MASP-2, MASP-3, and MAp-44 were lower and the levels of M-ficolin were higher in ICU patients on admission than those in matched healthy controls. Only a low on-admission MASP-3 level was independently associated with risk of new ICU infections and prolonged ICU stay, after correcting for other risk factors. On-admission MASP-3 varied with age, illness severity, and genetic variation.CONCLUSION:
Low on-admission MASP-3 levels in critically ill children were independently associated with subsequent acquisition of infection and prolonged ICU stay. The biological explanation needs further investigation.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Enfermedad Crítica
/
Activación de Complemento
/
Lectinas
Tipo de estudio:
Clinical_trials
/
Risk_factors_studies
Límite:
Child
/
Humans
Idioma:
En
Revista:
Pediatr Res
Año:
2014
Tipo del documento:
Article
País de afiliación:
Bélgica