No strong relationship between mannan binding lectin or plasma ficolins and chemotherapy-related infections

被引:65
作者
Kilpatrick, DC
Mclintock, LA
Allan, EK
Copland, M
Fujita, T
Jordanides, NE
Koch, C
Matsushita, M
Shiraki, H
Stewart, K
Tsujimura, M
Turner, ML
Franklin, IM
Holyoake, TL
机构
[1] SNBTS Natl Sci Lab, Edinburgh EH17 7QT, Midlothian, Scotland
[2] Univ Edinburgh, Acad Transfus Med Unit, Edinburgh EH8 9YL, Midlothian, Scotland
[3] Glasgow Royal Infirm, Acad Transfus Med Unit, Glasgow, Lanark, Scotland
[4] Fukushima Med Univ Sch Med, Dept Biochem, Fukushima, Japan
[5] State Serum Inst, Copenhagen, Denmark
[6] Tokai Univ, Inst Glycotechnol, Kanagawa 2591100, Japan
[7] Fukuoka Red Cross Blood Ctr, Fukuoka, Japan
关键词
chemotherapy; ficolins; mannan-binding lectin; mannose-binding lectin;
D O I
10.1046/j.1365-2249.2003.02284.x
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Chemotherapy causes neutropenia and an increased susceptibility to infection. Recent reports indicate that mannan-binding lectin (MBL) insufficiency is associated with an increased duration of febrile neutropenia and incidence of serious infections following chemotherapy for haematological malignancies. We aimed to confirm or refute this finding and to extend the investigation to the plasma ficolins, P35 (L-ficolin) and the Hakata antigen (H-ficolin). MBL, L-ficolin and H-ficolin were measured in 128 patients with haematological malignancies treated by chemotherapy alone or combined with bone marrow transplantation. Protein concentrations were related to clinical data retrieved from medical records. MBL concentrations were elevated compared with healthy controls in patients who received chemotherapy, while L-ficolin concentrations were decreased and H-ficolin levels were unchanged. There was no correlation between MBL, L-ficolin or H-ficolin concentration and febrile neutropenia expressed as the proportion of neutropenic periods in which patients experienced fever, and there was no relation between abnormally low (deficiency) levels of MBL, L-ficolin or H-ficolin and febrile neutropenia so expressed. Patients with MBL less than or equal to 0.1 mug/ml had significantly more major infections than no infections within the follow-up period (P < 0.05), but overall most patients had signs or symptoms of minor infections irrespective of MBL concentration. Neither L-ficolin nor H-ficolin deficiencies were associated with infections individually, in combination or in combination with MBL deficiency. MBL, L-ficolin and H-ficolin, independently or in combination, did not have a major influence on susceptibility to infection in these patients rendered neutropenic by chemotherapy. These results cast doubt on the potential value of MBL replacement therapy in this clinical context.
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收藏
页码:279 / 284
页数:6
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