Маннозосвязывающий лектин имеет отношение к недостаточности подкласса IgG
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By LabMedica International staff writers Posted on 01 Aug 2019 |
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Маннозосвязывающий лектин (MBL; маннансвязывающий белок или лектин) участвует во врожденной иммунной защите, продуцируется в основном гепатоцитами и кодируется MBL2 (хромосома 10q21.1). MBL способствует уничтожению микроорганизмов путем активации комплемента через путь лектина и путем опсонизации.
Иммуноглобулин G (IgG), синтезируемый плазматическими клетками, является преобладающим из пяти классов иммуноглобулинов у людей. Недостаточность подкласса IgG (IgG subclass deficiency - IgGSD) у взрослых характеризуется следующими факторами: уровнями подклассов IgG1–3 более чем на два стандартных отклонения (СО) ниже среднего по популяции, частой или тяжелой инфекцией дыхательных путей, субоптимальными ответами IgG на пневмококковые полисахариды и увеличенной распространенностью аутоиммунных состояний.
Ученые, в сотрудничестве с Университетом Алабамы в Бирмингеме (University of Alabama at Birmingham; Бирмингем, штат Алабама, США), последовательно изучили не связанных между собой, неиспаноязычных белых взрослых людей (в возрасте ≥18 лет) в рамках одной амбулаторной практики, которые сообщили о наличии частых или тяжелых инфекций верхних или нижних дыхательных путей. У данных людей IgGSD была диагностирована до 2 октября 2018 года и измерены уровни MBL в сыворотке. Частая инфекция была определена как четыре или более эпизодов в год, которые требовали антибактериальной терапии. Тяжелая инфекция определялась как любая инфекция, которая требовала стационарного лечения.
Инфекцию верхних дыхательных путей определяли на основании сообщений о гайморите, отите, мастоидите, фарингите и тонзиллите. Инфекция нижних дыхательных путей определялась на основании сообщений о бронхите, пневмонии и бронхоэктазии. Уровни сывороточного Ig были измерены с использованием стандартных методов до начала заместительной терапии IgG, а уровни MBL в сыворотке измерялись с помощью иммуноферментного анализа, о конкретных уровнях MBL ≤50 нг/мл не сообщалось.
Команда сообщила о 219 пациентах (средний возраст 51±13 лет, 82,5% женщин). Тридцать шесть пациентов (16,4%) имели MBL ≤50 нг/мл. Два измерения MBL были доступны у 14 пациентов. Средний интервал между первым и вторым измерениями составлял 125 дней (диапазон 18–1031). Средние уровни MBL у пациентов в возрасте ≤52 лет против пациентов в возрасте >52 лет при постановке диагноза достоверно не различались. Средние уровни MBL у мужчин были выше, чем у женщин, но разница не была значительной. Тридцать шесть из 219 пациентов (16,4%) имели MBL ≤50 нг/мл. Характеристики пациентов с MBL ≤50 нг/мл и без него достоверно не различались в одномерных сравнениях. Пропорции иммунофенотипов подкласса IgG у пациентов с и без MBL ≤50 нг/мл существенно не различались.
Авторы пришли к выводу, что доля пациентов с IgGSD с сывороточным MBL ≤50 нг/мл сходна с таковой у здоровых взрослых европейцев. MBL ≤50 нг/мл не был достоверно связан с независимыми переменными, которые они изучали. Исследование было опубликовано 22 мая 2019 года в журнале BMC Immunology.
Ссылки по теме:
Университет Алабамы в Бирмингеме
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