Serum Mannose-Binding lectin concentration, but not genotype, is associated with Clostridium difficile infection recurrence: a prospective cohort study
Authors
Swale, AndrewMiyajima, Fabio
Kolamunnage-Dona, Ruwanthi
Roberts, Paul

Little, Margaret
Beeching, Nicholas
Beadsworth, Mike BJ
Liloglou, Triantafillos
Pirmohamed, Munir
Issue Date
2014-11-15
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Low mannose-binding lectin concentration, but not genotype, was associated with disease recurrence in a large prospective cohort of patients with Clostridium difficile infection. Background. Mannose-binding lectin (MBL) plays a key role in the activation of the lectin-complement pathway of innate immunity, and its deficiency has been linked with several acute infections. However, its role in predisposing to, or modulating disease severity in, Clostridium difficile infection (CDI) has not been investigated. Methods. We prospectively recruited 308 CDI case patients and 145 control patients with antibiotic-associated diarrhea (AAD). CDI outcome measures were disease severity, duration of symptoms, 30-day mortality, and 90-day recurrence. Serum concentrations of MBL were determined using a commercial enzyme-linked immunosorbent assay transferred to an electrochemiluminescence–based platform. MBL2 polymorphisms were typed using a combination of pyrosequencing and TaqMan genotyping assays. Results. The frequency of the MBL2 genetic variants was similar to that reported in other white populations. MBL serum concentrations in CDI and AAD subjects were determined by MBL2 exonic variants B, C, and D and the haplotypes (LYPB, LYQC, and HYPD). There was no difference in either MBL concentrations or genotypes between cases and controls. MBL concentration, but not genotype, was a determinant of CDI recurrence (odds ratios, 3.18 [95% confidence interval {CI}, 1.40–7.24] and 2.61 [95% CI, 1.35–5.04] at the <50 ng/mL and <100 ng/mL cutoff points, respectively; P < .001). However, neither MBL concentration nor MBL2 genotype was linked with the other CDI outcomes. Conclusions. Serum MBL concentration did not differentiate between CDI cases and AAD controls, but among CDI cases, MBL concentration, but not genotype, was associated with CDI recurrence, indicating that MBL acts as a modulator of disease, rather than a predisposing factor.Citation
Swale, A., Miyajima, F., Kolamunnage-Dona, R., Roberts, P. et al. (2014) Serum Mannose-Binding lectin concentration, but not genotype, is associated with Clostridium difficile infection recurrence: a prospective cohort study, Clinical Infectious Diseases, 59(10), pp. 1429-1436Publisher
Oxford University Press (OUP)Journal
Clinical Infectious DiseasesAdditional Links
https://academic.oup.com/cid/article/59/10/1429/2895675Type
Journal articleLanguage
enDescription
© 2014 The Authors. Published by Oxford University Press. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1093/cid/ciu666ISSN
1058-4838EISSN
1537-6591Sponsors
This work was funded by the National Institute for Health Research (NIHR) Biomedical Research Centre in microbial diseases in Liverpool, and by the Medical Research Council (MR/K000551/1). We would also like to thank the NIHR for PhD student funding for Andrew Swale (BRF-2011-028). M. P. is an NIHR Senior Investigator.ae974a485f413a2113503eed53cd6c53
10.1093/cid/ciu666
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Except where otherwise noted, this item's license is described as http://creativecommons.org/licenses/by/4.0/