Mannose‐binding lectin (MBL) and the risk for febrile neutropenia and infection in pediatric oncology patients with chemotherapy

Frakking, Florine N. J.; Israëls, Joël; Kremer, Leontien C. M.; Kuijpers, Taco W.; Caron, Huib N.; Wetering, Marianne D. van de

doi:10.1002/pbc.22901

Cited by 20 publications

(16 citation statements)

References 32 publications

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“…In the review by Frakking et al [22] investigating the correlation of infection in pediatric oncology patients with MBL deficiency and/or severity of infection, no relationship was found between low MBL levels and presence of sepsis, bacteremia, or fungal infection in 3 of the 5 studies, while the results of the other 2 studies were to the contrary. Although there are a variety of studies with different results in the literature [23,24,25,26,27], Peterslund et al [28] showed a significant correlation between low levels of MBL and the development of bacteremia in adult patients with hematological malignancies.…”

Section: Discussionmentioning

confidence: 99%

“…The dramatic differences reported in the studies of Peterslund et al [28], Neth et al [29], and Schlapbach et al [23] in median MBL concentrations were virtually identical to those of the other patient categories. The studies of Klostergaard et al [27], Frakking et al [22], and Schlapbach et al [23] revealed that infections due to gram-positive bacteria were more commonly observed in cases with low MBL levels.…”

Section: Discussionmentioning

confidence: 99%

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Early Changes of Mannose-Binding Lectin, H-Ficolin, and Procalcitonin in Patients with Febrile Neutropenia: A Prospective Observational Study

S¹,

Saltoğlu²,

Balkan

et al. 2016

Tjh

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Objective:The significance of mannose-binding lectin (MBL) and H-ficolin deficiency in febrile neutropenic (FN) patients and the correlation of these markers along with consecutive C-reactive protein (CRP) and procalcitonin (PCT) levels during the infectious process are investigated.Materials and Methods:Patients with any hematological malignancies who were defined to have “microbiologically confirmed infection”, “clinically documented infection”, or “fever of unknown origin” were included in this single-center prospective observational study. Serum levels of CRP, PCT, MBL, and H-ficolin were determined on 3 separate occasions: at baseline (between hospital admission and chemotherapy), at the onset of fever, and at the 72nd hour of fever.Results:Forty-six patients (54% male, mean age 41.7 years) with 61 separate episodes of FN were evaluated. Eleven patients (23.9%) had “microbiologically confirmed infection”, 17 (37%) had “clinically documented infection”, and 18 (39.1%) had “fever of unknown origin”. Fourteen (30.4%) patients had low (<500 ng/mL) initial MBL levels and 7 (15.21%) had low (<12,000 ng/mL) H-ficolin levels. Baseline MBL and H-ficolin levels did not significantly change on the first and third days of fever (p=0.076). Gram-negative bacteremia more frequently occurred in those with low initial MBL levels (p=0.006). PCT levels were significantly higher in those with microbiologically documented infections. Mean and median PCT levels were significantly higher in cases with bacteremia. There was no significant difference between hemoculture-positive and-negative patients in terms of CRP levels.Conclusion:Monitoring serum H-ficolin levels was shown to be of no benefit in terms of predicting severe infection. Low baseline MBL levels were correlated with high risk of gram-negative bacteremia; however, no significant correlation was shown in the follow-up. Close monitoring of PCT levels is warranted to provide more accurate and specific data while monitoring cases of bacteremia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Early Changes of Mannose-Binding Lectin, H-Ficolin, and Procalcitonin in Patients with Febrile Neutropenia: A Prospective Observational Study

S¹,

Saltoğlu²,

Balkan

et al. 2016

Tjh

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“…Cellular viral sensors have long been recognized as crucial mediators of innate antiviral defense with important effects on the magnitude and quality of both innate and adaptive immune responses. Important antiviral factors and pathways, such as the retinoic acid-inducible gene I protein/DEAD (Asp-Glu-Ala-Asp) box polypeptide 58 (RIG-I/DDX58), Toll-like receptors (TLRs), mannose-binding lectin (encoded by MBL2 ), and dendritic cell−specific intercellular adhesion molecule-3−grabbing non-integrin (DC-SIGN, also known as CD209) play a role in viral sensing, control, pathogenesis, and outcome of viral infections (Thompson and Iwasaki 2008; Nakhaei et al 2009; Faure and Rabourdin-Combe 2011; Frakking et al 2011; Clingan et al 2012). …”

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confidence: 99%

Genetic Polymorphisms in Host Innate Immune Sensor Genes and the Risk of Nasopharyngeal Carcinoma in North Africa

Moumad

Lascorz

Bevier

et al. 2013

G3 Genes|Genomes|Genetics

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Nasopharyngeal carcinoma (NPC) is a rare malignancy in most parts of the world. It is an Epstein-Barr virus−associated malignancy with an unusual racial and geographical distribution. The host innate immune sensor genes play an important role in infection recognition and immune response against viruses. Therefore, we examined the association between polymorphisms in genes within a group of pattern recognition receptors (including families of Toll-like receptors, C-type lectin receptors, and retinoic acid−inducible gene I−like receptors) and NPC susceptibility. Twenty-six single-nucleotide polymorphisms (SNPs) in five pattern-recognition genes were genotyped in 492 North African NPC cases and 373 frequency-matched controls. TLR3_rs3775291 was the most significantly associated SNP (odds ratio [OR] 1.49; 95% confidence interval [95% CI] 1.11−2.00; P = 0.008; dominant model). The analysis showed also that CD209_rs7248637 (OR 0.69; 95% CI 0.52−0.93; P = 0.02; dominant model) and DDX58_rs56309110 (OR 0.70; 95% CI 0.51−0.98; P = 0.04) were associated with the risk of NPC. An 18% increased risk per allele was observed for the five most significantly associated SNPs, TLR3_rs3775291, CD209_rs7248637, DDX58_rs56309110, CD209_rs4804800, and MBL2_rs10824792, (ptrend = 8.2 × 10−4). Our results suggest that genetic variation in pattern-recognition genes is associated with the risk of NPC. These preliminary findings require replication in larger studies.

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“…(4, 11, 12, 16, 19, 33–38) We did find that MBL levels were diluted in patients that received extremely high volumes of fluid in the first 24 hours; a common occurrence in patients with severe sepsis that could possibly confound the relationship between MBL levels and infection-related critical illness. MBL levels were strongly genetically influenced by the combination of high, intermediate and low producing haplotypes.…”

Section: Discussionmentioning

confidence: 88%

Mannose-Binding Lectin Levels in Critically Ill Children With Severe Infections*

Madsen

Levy

Madden

et al. 2017

Pediatric Critical Care Medicine

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Objective Low mannose-binding lectin (MBL) levels and haplotypes associated with low MBL production have been associated with infection and severe sepsis. We tested the hypothesis that MBL levels would be associated with severe infection in a large cohort of critically ill children. Design Prospective cohort study Setting Medical and Surgical Pediatric Intensive Care Units (PICUs), Boston Children’s Hospital Patients Children < 21 years of age admitted to the intensive care units from November 2009 to November 2010. Interventions None Measurements and Main Results We measured MBL levels in 479/520 (92%) consecutively admitted children with severe or life-threatening illness. We genotyped 213 Caucasian children for MBL haplotype tagging variants and assigned haplotypes. In the univariate analyses of MBL levels with pre-admission characteristics, levels were higher in patients with pre-existing renal disease. Patients who received >100 ml/kg of fluids in the first 24 hours after admission had markedly lower MBL, as did patients post-spinal fusion surgery. MBL levels had no association with infection status on admission, or with progression from systemic inflammatory response syndrome to sepsis or septic shock. Although MBL haplotypes strongly influenced MBL levels in the predicted relationship, low MBL-producing haplotypes were not associated with increased risk of infection. Conclusions Mannose-binding lectin levels are largely genetically determined. This relationship was preserved in children during critical illness, despite the effect of large-volume fluid administration on MBL levels. Previous literature evaluating an association between MBL levels and severe infection is inconsistent; we found no relationship in our PICU cohort. We found that MBL levels were lower after aggressive fluid resuscitation, and suggest that studies of MBL in critically ill patients should assess MBL haplotypes to reflect pre-illness levels.

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Mannose‐binding lectin (MBL) and the risk for febrile neutropenia and infection in pediatric oncology patients with chemotherapy

Cited by 20 publications

References 32 publications

Early Changes of Mannose-Binding Lectin, H-Ficolin, and Procalcitonin in Patients with Febrile Neutropenia: A Prospective Observational Study

Early Changes of Mannose-Binding Lectin, H-Ficolin, and Procalcitonin in Patients with Febrile Neutropenia: A Prospective Observational Study

Genetic Polymorphisms in Host Innate Immune Sensor Genes and the Risk of Nasopharyngeal Carcinoma in North Africa

Mannose-Binding Lectin Levels in Critically Ill Children With Severe Infections*

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