Abstract
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.
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Acknowledgements
We thank the pediatric ICU clinical and nursing staff for excellent patient care, protocol compliance, and sample handling.
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Ingels, C., Vanhorebeek, I., Derese, I. et al. The pattern recognition molecule collectin-L1 in critically ill children. Pediatr Res 80, 237–243 (2016). https://doi.org/10.1038/pr.2016.76
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DOI: https://doi.org/10.1038/pr.2016.76
