A. Koch et al., Acute respiratory tract infections and mannose-binding lectin insufficiency during early childhood, J AM MED A, 285(10), 2001, pp. 1316-1321
Citations number
33
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
Context Hospital-based studies have found that increased susceptibility to
certain infections is associated with low serum levels of mannose-binding l
ectin (MBL) due to MBL variant alleles, However, the contribution of MBL in
sufficiency to incidence of common childhood infections at a population lev
el is unknown,
Objective To investigate the effect of MBL insufficiency on risk for acute
respiratory tract infection (ARI) in unselected children younger than 2 yea
rs.
Design and Setting Population-based, prospective, cohort study conducted in
Sisimiut, Greenland,
Participants Two hundred fifty-two children younger than 2 years who were f
ollowed up weekly between August 1996 and August 1998 for morbidity surveil
lance.
Main Outcome Measure Risk of ARI, based on medical history and clinical exa
mination, compared by MBL genotype, determined from blood samples based on
presence of structural and promoter alleles.
Results A 2.08-fold (95% confidence interval [CI], 1.41-3.06) increased rel
ative risk (RR) of ARI was found in MBL-insufficient children (n = 13) comp
ared with MBL sufficient children (n = 239; P < .001), The risk association
was largely restricted to children aged 6 to 17 months (RR, 2.92; 95% CI,
1.78-4.79) while less effect (RR, 1.47; 95% CI, 0.45-4.82) and no effect (R
R, 1.00; 95% CI, 0.42-2.37) was shown among children aged 0 to 5 months and
18 to 23 months, respectively,
Conclusion These data suggest that genetic factors such as MBL insufficienc
y play an important role in host defense, particularly during the vulnerabl
e period of childhood from age 6 through 17 months, when the adaptive immun
e system is immature.