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Open Access Research article

Mannose-binding lectin gene variants and infections in patients receiving autologous stem cell transplantation

Ana Moreto15, Concepción Fariñas-Alvarez2, Maria Puente15, Javier Gonzalo Ocejo-Vinyals3, Pablo Sánchez-Velasco3, Juan Pablo Horcajada46, Ana Batlle1, Carmen Montes1, Francisca Santos4, Eulogio Conde1 and Maria-Carmen Fariñas4*

Author Affiliations

1 Department of Hematology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IFIMAV, Santander, Spain

2 Health Care Quality Unit, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IFIMAV, Santander, Spain

3 Department of Immunology, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IFIMAV, Santander, Spain

4 Infectious Diseases Unit, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IFIMAV, Santander, Spain

5 Current address: Department of Hematology, Hospital Universitario de Cruces, Bilbao, Spain

6 Current address: Department of Infectious Diseases, Hospital Universitari del Mar, Barcelona, Spain

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BMC Immunology 2014, 15:17  doi:10.1186/1471-2172-15-17

Published: 3 May 2014

Abstract

Background

Serious infections are common in patients undergoing autologous stem cell transplantation (ASCT) mainly because of the effects of immunosuppression. The innate immune system plays an important role in the defense against different infections. Mannose binding lectin (MBL) is a central molecule of the innate immune system. There are several promoter polymorphisms and structural variants of the MBL2 gene that encodes for this protein. These variants produce low levels of MBL and have been associated with an increased risk for infections.

Methods

Prospective cohort study. The incidence, severity of infections and mortality in 72 consecutive patients with hematologic diseases who underwent ASCT between February 2006 and June 2008 in a tertiary referral center were analyzed according to their MBL2 genotype. INNO-LiPA MBL2 was used for MBL2 gene amplification and genotyping. Relative risks (RR) (IC95%) as measure of association were calculated. Multivariate analysis was performed using logistic regression.

Results

A statistically significant higher number of fungal infections was found in patients with MBL2 variants causing low MBL levels (21.1%versus1.9%, p=0.016). In this MBL2 variant group infection was more frequently the cause of mortality than in the MBL2 wild-type group (p=0.05). Although not statistically significant, there was a higher incidence of major infections in the MBL2 variant group as well as a higher number of infections caused by gram-positive bacteria.

Conclusions

Low-producer MBL2 genotypes were associated with an increased number of fungal infections in ASCT patients, which would suggest that MBL has a protective role against such infections. ASCT patients with MBL2 variant genotypes are more likely to die as a result of an infection.

Keywords:
MBL; Gene variant; Polymorphism; Infection; Autologous stem cell transplant