The pattern recognition molecule collectin-L1 in critically ill children

TY - JOUR

T1 - The pattern recognition molecule collectin-L1 in critically ill children

AU - Ingels, Catherine

AU - Vanhorebeek, Ilse

AU - Derese, Inge

AU - Jensen, Lisbeth

AU - Wouters, Pieter J

AU - Thiel, Steffen

AU - Van den Berghe, Greet

PY - 2016/8/1

Y1 - 2016/8/1

N2 - BACKGROUND: Critically ill children are prone to nosocomial infections, which may lead to adverse outcome. Low serum concentrations upon admission to the pediatric intensive care unit (PICU) of the mannan-binding lectin (MBL)-associated serine protease (MASP)-3 protein of the lectin pathway of complement activation have been associated with risk of infection and prolonged need for intensive care. We hypothesized that also a low upon-admission concentration of collectin-L1 (CL-L1), a novel member of this pathway, is independently associated with these adverse outcomes.METHODS: We quantified the serum concentrations of CL-L1 in 81 healthy children and in 700 critically ill children upon PICU admission.RESULTS: CL-L1 concentrations were significantly lower in the critically ill children as compared with the healthy children. However, corrected for baseline characteristics, risk factors and several lectin pathway proteins, a higher CL-L1 concentration upon PICU admission was independently associated with an increased risk of acquiring a new infection and with a prolonged time to PICU discharge. In contrast, a low MASP-3 concentration remained independently associated with these adverse outcomes.CONCLUSION: A high serum CL-L1 concentration in critically ill children upon PICU admission is associated with an increased risk of infection and prolonged need of intensive care, and counteracts the protective effect of having a high MASP-3 concentration.

AB - BACKGROUND: Critically ill children are prone to nosocomial infections, which may lead to adverse outcome. Low serum concentrations upon admission to the pediatric intensive care unit (PICU) of the mannan-binding lectin (MBL)-associated serine protease (MASP)-3 protein of the lectin pathway of complement activation have been associated with risk of infection and prolonged need for intensive care. We hypothesized that also a low upon-admission concentration of collectin-L1 (CL-L1), a novel member of this pathway, is independently associated with these adverse outcomes.METHODS: We quantified the serum concentrations of CL-L1 in 81 healthy children and in 700 critically ill children upon PICU admission.RESULTS: CL-L1 concentrations were significantly lower in the critically ill children as compared with the healthy children. However, corrected for baseline characteristics, risk factors and several lectin pathway proteins, a higher CL-L1 concentration upon PICU admission was independently associated with an increased risk of acquiring a new infection and with a prolonged time to PICU discharge. In contrast, a low MASP-3 concentration remained independently associated with these adverse outcomes.CONCLUSION: A high serum CL-L1 concentration in critically ill children upon PICU admission is associated with an increased risk of infection and prolonged need of intensive care, and counteracts the protective effect of having a high MASP-3 concentration.

KW - Journal Article

UR - https://www.scopus.com/pages/publications/84983329276

U2 - 10.1038/pr.2016.76

DO - 10.1038/pr.2016.76

M3 - Journal article

C2 - 27057739

SN - 0031-3998

VL - 80

SP - 237

EP - 243

JO - Pediatric Research

JF - Pediatric Research

IS - 2

ER -