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Mannose‐binding lectin and l ‐ficolin polymorphisms in patients with community‐acquired pneumonia caused by intracellular pathogens
Author(s) -
Kempen Gijs,
Meijvis Sabine,
Endeman Henrik,
Vlaminckx Bart,
Meek Bob,
Jong Ben,
Rijkers Ger,
Bos Willem Jan
Publication year - 2017
Publication title -
immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.297
H-Index - 133
eISSN - 1365-2567
pISSN - 0019-2805
DOI - 10.1111/imm.12705
Subject(s) - mannan binding lectin , biology , immunology , mycoplasma pneumoniae , single nucleotide polymorphism , legionella pneumophila , genotype , community acquired pneumonia , atypical pneumonia , microbiology and biotechnology , coxiella burnetii , haplotype , pneumonia , q fever , surfactant protein d , chlamydia , gene , lectin , bacteria , genetics , medicine , innate immune system , immune system
Summary Community‐acquired pneumonia ( CAP ) is the leading infectious disease requiring hospitalization in the western world. Genetic variability affecting the host response to infection may play a role in susceptibility and outcome in patients with CAP . Mannose‐binding lectin ( MBL ) and l ‐ficolin ( l ‐ FCN ) are two important activators of the complement system and they can enhance phagocytosis by opsonization. In a prospective cohort of 505 Dutch patients with CAP and 227 control participants we studied whether polymorphisms in the MBL ( MBL 2 ) and FCN ( FCN 2 ) genes influenced susceptibility and outcome. No difference in frequency of these genotypes was found between patients with CAP in general and controls. However, the +6424G>T single nucleotide polymorphism ( SNP ) in FCN 2 was more common in patients with a Coxiella burnetii pneumonia ( P = 0·014). Moreover, the haplotypes coding for the highest MBL serum levels ( YA / YA and YA / XA ) predisposed to atypical pneumonia ( C. burnetii , Legionella or Chlamydia species or Mycoplasma pneumoniae ) compared with controls ( P = 0·016). Furthermore, patients with these haplotypes were more often bacteraemic ( P = 0·019). It can therefore be concluded that MBL 2 and FCN 2 polymorphisms are not major risk factors for CAP in general, but that the +6424G>T SNP in the FCN 2 gene predisposes to C. burnetii pneumonia. In addition, patients with genotypes corresponding with high serum MBL levels are at risk for atypical pneumonia, possibly caused by enhanced phagocytosis, thereby promoting cell entry of these intracellular bacteria.