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Original Research: COPD |

Mannose-Binding Lectin Gene Polymorphism Contributes to Recurrence of Infective Exacerbation in Patients With COPD

Chii-Lan Lin, MD; Leung-Kei Siu, PhD; Jung-Chung Lin, MD, PhD; Chien-Ying Liu, MD; Chih-Feng Chian, MD; Chun-Nin Lee, MD; Feng-Yee Chang, MD, PhD
Author and Funding Information

From the Graduate Institute of Medical Sciences (Dr C.-L. Lin), Division of Infectious Diseases and Tropical Medicine (Drs Siu, J.-C. Lin, and Chang), and Division of Pulmonary and Critical Care Medicine (Dr Chian), Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei; Division of Clinical Research (Dr Siu), National Health Research Institutes, Miaoli; Department of Thoracic Medicine (Dr Liu), Chang-Gung Memorial Hospital and Chang-Gung University, Taipei; and Division of Pulmonary Medicine (Dr Lee), Department of Medicine, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan.

Correspondence to: Feng-Yee Chang, MD, PhD, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei; No. 161, Section 6, Min-Chuan East Rd, Taipei 114, Taiwan; e-mail: fychang@ndmctsgh.edu.tw


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).

Funding/Support: This study was partly supported by the Teh-Tzer Study Group for Human Medical Research Foundation (A951102).


© 2011 American College of Chest Physicians


Chest. 2011;139(1):43-51. doi:10.1378/chest.10-0375
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Background:  Mannose-binding lectin (MBL) deficiency is associated with susceptibility to respiratory infections. We investigated the impact of MBL2 gene polymorphisms and MBL deficiency on the recurrence of infective exacerbation in patients with COPD.

Methods:  A prospective study was conducted among 215 patients with COPD and 137 healthy subjects. MBL deficiency was determined by the MBL2 gene polymorphisms and serum levels of MBL.

Results:  The average frequency of infective exacerbations over 3 years in the 215 patients with COPD was 2.5 ± 1.3 episodes. The COPD group with three or more episodes of infective exacerbation (recurrent exacerbators) included 96 patients, and the remaining 119 patients had two or fewer episodes (less-frequent exacerbators). Among the 96 recurrent exacerbators, 12 (12.50%) had the MBL deficiency genotype compared with 5 (4.20%) among the less-frequent exacerbators (OR, 3.25; 95% CI, 1.01-11.07; P = .0253). In recurrent exacerbators, the frequency of infective exacerbation was significantly higher in patients with MBL-deficient genotypes than in those with non-MBL-deficient genotypes (4.75 ± 1.22 vs 3.52 ± 0.78, respectively; P < .0001). In addition, mortality was significantly increased in recurrent exacerbators with MBL-deficient genotypes compared with those with non-MBL-deficient genotypes (66.7% vs 31.0%, respectively; P = .0153).

Conclusions:  MBL deficiency due to MBL2 polymorphisms increases the risk of recurrent infective exacerbation and worsens its outcome in patients with COPD.

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