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Mannose-binding lectin deficiency(MBLD; LCAPD1)

MedGen UID:
482216
Concept ID:
C3280586
Disease or Syndrome
Synonyms: Chronic infections, due to MBL deficiency; LECTIN COMPLEMENT ACTIVATION PATHWAY, DEFECT IN, 1; Mannose-binding protein deficiency; MBL DEFICIENCY; MBL2 DEFICIENCY; MBP DEFICIENCY
SNOMED CT: Mannose-binding protein deficiency (703538003); MBL2 deficiency (703538003); MBP deficiency (703538003); Mannose-binding lectin protein deficiency (703538003); MBL deficiency (703538003); Mannose-binding lectin deficiency (703538003)
 
Gene (location): MBL2 (10q21.1)
 
Monarch Initiative: MONDO:0013714
OMIM®: 614372

Definition

Mannose-binding lectin (MBL) deficiency, defined as MBL protein level of less than 100 ng/ml, is present in about 5% of people of European descent and in about 10% of sub-Saharan Africans. Most MBL-deficient adults appear healthy, but low levels of MBL are associated with increased risk of infection in toddlers, in cancer patients undergoing chemotherapy, and in organ-transplant patients receiving immunosuppressive drugs, particularly recipients of liver transplants (review by Degn et al., 2011). MBL is a soluble molecule that can activate the lectin pathway of the complement system; deficiency may thus lead to defects in the complement system (summary by Garcia-Laorden et al., 2008). Genetic Heterogeneity of Lectin Complement Activation Pathway Defects See also LCAPD2 (613791), caused by variation in the MASP2 gene (605102) on chromosome 1p36, and LCAPD3 (613860), caused by variation in the FCN3 gene (604973) on chromosome 1p36. [from OMIM]

Additional description

From MedlinePlus Genetics
Mannose-binding lectin deficiency is a condition that affects the immune system. People with this condition have low levels (deficiency) of an immune system protein called mannose-binding lectin in their blood. Whether this deficiency makes affected individuals prone to recurrent infections is not clear.

People with mannose-binding lectin deficiency can develop infections of the upper respiratory tract and other body systems. Individuals with this condition may also contract more serious infections such as pneumonia and meningitis. Depending on the type of infection, the symptoms caused by the infections vary in frequency and severity.

Infants and young children with mannose-binding lectin deficiency seem to be more susceptible to infections than affected adults, but adults can also develop recurrent infections. In addition, affected individuals undergoing chemotherapy or taking drugs that suppress the immune system are especially prone to infections.  https://medlineplus.gov/genetics/condition/mannose-binding-lectin-deficiency

Clinical features

From HPO
Failure to thrive
MedGen UID:
746019
Concept ID:
C2315100
Disease or Syndrome
Failure to thrive (FTT) refers to a child whose physical growth is substantially below the norm.
Recurrent skin infections
MedGen UID:
377848
Concept ID:
C1853193
Disease or Syndrome
Infections of the skin that happen multiple times.
Recurrent meningococcal disease
MedGen UID:
369692
Concept ID:
C1970263
Finding
Recurrent infections by Neisseria meningitidis (one of the most common causes of bacterial meningitis), which is also known as meningococcus.
Recurrent Klebsiella infections
MedGen UID:
867386
Concept ID:
C4021751
Finding
Increased susceptibility to Klebsiella infections, as manifested by recurrent episodes of Klebsiella infection.
Recurrent herpes
MedGen UID:
870750
Concept ID:
C4025207
Finding
Increased susceptibility to herpesvirus, as manifested by recurrent episodes of herpesvirus.
Disseminated cryptosporidium infection
MedGen UID:
1643996
Concept ID:
C4703487
Disease or Syndrome
Failure to contain infection by a protozoan of the genus Cryptosporidium, leading to spread to many parts of the body.

Professional guidelines

PubMed

Turley AJ, Gathmann B, Bangs C, Bradbury M, Seneviratne S, Gonzalez-Granado LI, Hackett S, Kutukculer N, Alachkar H, Hambleton S, Ritterbusch H, Kralickova P, Marodi L, Seidel MG, Dueckers G, Roesler J, Huissoon A, Baxendale H, Litzman J, Arkwright PD
J Clin Immunol 2015 Feb;35(2):199-205. Epub 2015 Feb 8 doi: 10.1007/s10875-015-0137-5. PMID: 25663093
Ou XT, Wu JQ, Zhu LP, Guan M, Xu B, Hu XP, Wang X, Weng XH
J Infect Dis 2011 Jun 1;203(11):1686-91. doi: 10.1093/infdis/jir152. PMID: 21592999Free PMC Article

Recent clinical studies

Etiology

Belfrage E, Jinnestål CL, Jönsen A, Bengtsson A, Åkesson A, Schmidtchen A, Sonesson A
Acta Derm Venereol 2023 Mar 30;103:adv2405. doi: 10.2340/actadv.v103.2405. PMID: 36994777Free PMC Article
Cieslinski JZ, Goeldner I, Skare TL, Nisihara R, Andrade FA, Velavan TP, Messias-Reason I, Utiyama SRR
Autoimmunity 2017 Nov;50(7):409-413. Epub 2017 Sep 12 doi: 10.1080/08916934.2017.1373765. PMID: 28898115
Osthoff M, Trendelenburg M
Biomed Res Int 2013;2013:962695. Epub 2013 Dec 10 doi: 10.1155/2013/962695. PMID: 24386641Free PMC Article
Israëls J, Scherpbier HJ, Frakking FN, van de Wetering MD, Kremer LC, Kuijpers TW
Pediatr Infect Dis J 2012 Dec;31(12):1272-8. doi: 10.1097/INF.0b013e3182678bc4. PMID: 22810018
Israëls J, Frakking FN, Kremer LC, Offringa M, Kuijpers TW, van de Wetering MD
Arch Dis Child Fetal Neonatal Ed 2010 Nov;95(6):F452-61. Epub 2010 May 20 doi: 10.1136/adc.2009.172122. PMID: 20488866

Diagnosis

Belfrage E, Jinnestål CL, Jönsen A, Bengtsson A, Åkesson A, Schmidtchen A, Sonesson A
Acta Derm Venereol 2023 Mar 30;103:adv2405. doi: 10.2340/actadv.v103.2405. PMID: 36994777Free PMC Article
Ruffles T, Basu K, Inglis SK, Bremner S, Rabe H, Memon A, Seddon P, Tavendale R, Palmer CNA, Mukhopadhyay S, Fidler K
Pediatr Pulmonol 2022 Nov;57(11):2824-2833. Epub 2022 Aug 30 doi: 10.1002/ppul.26109. PMID: 35949104
Barton JC, Barton JC, Bertoli LF
BMC Immunol 2019 May 22;20(1):15. doi: 10.1186/s12865-019-0296-x. PMID: 31117958Free PMC Article
Nisihara R, Skare T, Maestri V, Alegretti JS, Campos APB, Messias-Reason I
Clin Rheumatol 2018 Feb;37(2):555-558. Epub 2017 Sep 6 doi: 10.1007/s10067-017-3813-4. PMID: 28879439
Rashidi E, Fazlollahi MR, Zahedifard S, Talebzadeh A, Kazemnejad A, Saghafi S, Pourpak Z
Iran J Allergy Asthma Immunol 2016 Feb;15(1):69-74. PMID: 26996114

Therapy

Gupta A, Gupta GS
Mol Cell Biochem 2021 Aug;476(8):2917-2942. Epub 2021 Mar 21 doi: 10.1007/s11010-021-04107-3. PMID: 33745077Free PMC Article
Nisihara R, Skare T, Maestri V, Alegretti JS, Campos APB, Messias-Reason I
Clin Rheumatol 2018 Feb;37(2):555-558. Epub 2017 Sep 6 doi: 10.1007/s10067-017-3813-4. PMID: 28879439
Osthoff M, Trendelenburg M
Biomed Res Int 2013;2013:962695. Epub 2013 Dec 10 doi: 10.1155/2013/962695. PMID: 24386641Free PMC Article
Gupta K, Gupta RK, Hajela K
Indian J Med Res 2008 May;127(5):431-40. PMID: 18653905
Christiansen OB, Nielsen HS, Kolte AM
Semin Fetal Neonatal Med 2006 Oct;11(5):302-8. Epub 2006 May 6 doi: 10.1016/j.siny.2006.03.001. PMID: 16682265

Prognosis

Guo WY, Zhu L, Meng SJ, Shi SF, Liu LJ, Lv JC, Zhang H
J Am Soc Nephrol 2017 Nov;28(11):3175-3181. Epub 2017 Jul 11 doi: 10.1681/ASN.2017010076. PMID: 28698271Free PMC Article
Kwakkel-van Erp JM, Paantjens AW, van Kessel DA, Grutters JC, van den Bosch JM, van de Graaf EA, Otten HG
Clin Exp Immunol 2011 Sep;165(3):410-6. Epub 2011 Jun 27 doi: 10.1111/j.1365-2249.2011.04436.x. PMID: 21707593Free PMC Article
Chalmers JD, Fleming GB, Hill AT, Kilpatrick DC
Glycobiology 2011 Mar;21(3):271-82. Epub 2010 Nov 2 doi: 10.1093/glycob/cwq161. PMID: 21045008
Huh JW, Song K, Yum JS, Hong SB, Lim CM, Koh Y
Crit Care 2009;13(6):R176. Epub 2009 Nov 5 doi: 10.1186/cc8157. PMID: 19891773Free PMC Article
Kilpatrick DC
Transfus Med 2002 Dec;12(6):335-52. doi: 10.1046/j.1365-3148.2002.00408.x. PMID: 12473150

Clinical prediction guides

Barton JC, Barton JC, Bertoli LF
BMC Immunol 2019 May 22;20(1):15. doi: 10.1186/s12865-019-0296-x. PMID: 31117958Free PMC Article
Guo WY, Zhu L, Meng SJ, Shi SF, Liu LJ, Lv JC, Zhang H
J Am Soc Nephrol 2017 Nov;28(11):3175-3181. Epub 2017 Jul 11 doi: 10.1681/ASN.2017010076. PMID: 28698271Free PMC Article
Carroll GJ, Makin K, Garnsey M, Bulsara M, Carroll BV, Curtin SM, Allan EM, McLean-Tooke A, Bundell C, Kemp ML, Deshpande P, Ihdayhid D, Coleman S, Easter T, Triplett J, Disteldorf T, Marsden CH, Lucas M
J Allergy Clin Immunol Pract 2017 Nov-Dec;5(6):1609-1616. Epub 2017 Jun 19 doi: 10.1016/j.jaip.2017.02.025. PMID: 28634103
Skare TL, Nisihara R, Cieslinski JZ, Zeni JO, Rasera HN, Messias-Reason I, Utiyama SR
Immunol Invest 2017 Feb;46(2):183-189. Epub 2016 Dec 2 doi: 10.1080/08820139.2016.1237525. PMID: 27911110
Antony JS, Ojurongbe O, van Tong H, Ouf EA, Engleitner T, Akindele AA, Sina-Agbaje OR, Adeyeba AO, Kremsner PG, Velavan TP
J Infect Dis 2013 Jun 1;207(11):1675-83. Epub 2013 Feb 28 doi: 10.1093/infdis/jit081. PMID: 23448728Free PMC Article

Recent systematic reviews

Israëls J, Scherpbier HJ, Frakking FN, van de Wetering MD, Kremer LC, Kuijpers TW
Pediatr Infect Dis J 2012 Dec;31(12):1272-8. doi: 10.1097/INF.0b013e3182678bc4. PMID: 22810018
Israëls J, Frakking FN, Kremer LC, Offringa M, Kuijpers TW, van de Wetering MD
Arch Dis Child Fetal Neonatal Ed 2010 Nov;95(6):F452-61. Epub 2010 May 20 doi: 10.1136/adc.2009.172122. PMID: 20488866

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