Mannose-binding lectin (MBL) insufficiency protects against the development of systemic inflammatory response after pediatric cardiac surgery

Immunobiology. 2016 Feb;221(2):175-81. doi: 10.1016/j.imbio.2015.09.010. Epub 2015 Sep 8.


We investigated MBL2 and MASP2 genotypes, serum MBL (mannose-binding lectin) levels and activities of its complexes with associated serine proteases (MASP-1, MASP -2), in relation to complications following cardiac surgery in 195 children. The incidence of SIRS was lower in patients carrying MBL2 A/O and O/O genotypes (p=0.024). Children with MBL levels <500ng/ml had a lower risk of SIRS (p=0.014) and fever (p=0.044). Median MBL concentration was higher in patients who developed SIRS (p=0.048) but lower in those with post-operative infections (p=0.046). MBL-MASP-2 activities <100mU/ml protected from SIRS (p=0.007), low cardiac output syndrome (p=0.03) and multiorgan failure (p=0.012). In contrast, MBL2 YA/YA genotypes were associated with SIRS (p=0.018), low cardiac output syndrome (p=0.018), fever (p=0.018) and high inotropic score (VIS>30) (p=0.021). Thus, low MBL concentrations and associated genotypes may protect patients from systemic inflammation while high MBL serum levels and corresponding genotypes are risk factors of postoperative complications.

Keywords: Cardiopulmonary bypass (CPB); Complement; Congenital heart disease; Mannan-binding lectin; Mannose-binding lectin (MBL); SIRS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Cardiac Output / physiology
  • Cardiac Output, Low / etiology
  • Cardiac Output, Low / genetics
  • Cardiac Output, Low / immunology*
  • Cardiac Output, Low / pathology
  • Cardiopulmonary Bypass / adverse effects
  • Child
  • Child, Preschool
  • Female
  • Gene Expression
  • Genotype
  • Hereditary Complement Deficiency Diseases
  • Humans
  • Immunologic Deficiency Syndromes / blood
  • Immunologic Deficiency Syndromes / genetics
  • Immunologic Deficiency Syndromes / immunology*
  • Infant
  • Male
  • Mannose-Binding Lectin / blood
  • Mannose-Binding Lectin / deficiency*
  • Mannose-Binding Lectin / genetics
  • Mannose-Binding Lectin / immunology
  • Mannose-Binding Protein-Associated Serine Proteases / deficiency*
  • Mannose-Binding Protein-Associated Serine Proteases / genetics
  • Mannose-Binding Protein-Associated Serine Proteases / immunology
  • Mannose-Binding Protein-Associated Serine Proteases / metabolism
  • Metabolism, Inborn Errors / blood
  • Metabolism, Inborn Errors / genetics
  • Metabolism, Inborn Errors / immunology*
  • Postoperative Complications / etiology
  • Postoperative Complications / genetics
  • Postoperative Complications / immunology*
  • Postoperative Complications / pathology
  • Prospective Studies
  • Protective Factors
  • Risk Factors


  • MBL2 protein, human
  • Mannose-Binding Lectin
  • MASP1 protein, human
  • MASP2 protein, human
  • Mannose-Binding Protein-Associated Serine Proteases

Supplementary concepts

  • MASP2 Deficiency
  • Mannose-Binding Protein Deficiency