Association of mannose-binding lectin polymorphisms with sepsis and fatal outcome in patients with systemic inflammatory response syndrome

Genetic factors may predispose to increased risk for sepsis in critically ill patients. Mannose-binding lectin (MBL) is an important factor in innate immune defence. Accordingly, we investigated whether MBL gene polymorphisms causing low levels of functional MBL in the the blood are associated with the development and progression of sepsis in adult intensive care patients. In 272 patients with systemic inflammatory response syndrome followed prospectively, different MBL genotypes were compared with respect to microbiology, sepsis development, and survival. The presence of MBL variant alleles was highly significantly associated with development of sepsis, severe sepsis and septic shock in a gene dose-dependent fashion. An increased risk of death was observed in variant allele carriers. These data show that a genetic factor such as MBL insufficiency plays an important role in the susceptibility of critically ill patients for development and progression of sepsis, and confer a substantial risk for fatal outcome.