Gene polymorphisms leading to lower serum levels of MBL, have been associated with an increased risk of infection. This study evaluates for the first time the correlation between functionally relevant MBL2 gene polymorphisms and serum MBL concentration in a cohort of heart recipients and risk of development of CMV infection after transplantation.
160 adult heart recipients were evaluated. Universal prophylaxis with gancyclovir was administered. CMV antigenemia and viral load were prospectively evaluated at distinct times after transplantation during the first year. Genotyping of MBL was done by a polymerase chain reaction/sequence-based typing technique. MBL serum concentration was evaluated by ELISA.
During follow-up 30 patients (18.8%) developed CMV infection. Frequencies of the MBL genotypes in our patients was similar than that described in Spanish population. There was a good correlation between the MBL genotype and pre transplant serum concentrations of MBL. Patients with low and intermediate expressing MBL genotype were at higher risk of developing CMV infection during the first year after transplantation as compared with patients with the high-expressing genotype (RH 3.02, 95% CI 1.24-7.34, p=0.0146). After transplantation, patients with CMV infections showed significantly lower serum levels of MBL at day 30 as compared with recipients who did not developed CMV infection (559±443 vs 1233±920 ng/mL, p<0.001; T-2-tailed test). Pre-transplant and day 7 serum MBL tended to be lower in heart recipients who developed CMV infection.
Under the immunosuppressive clinical setting of heart transplantation MBL genotype and MBL serum levels were associated with high risk for development of CMV infection.