Customize your JAMA Network experience by selecting one or more topics from the list below.
Koch A, Melbye M, Sørensen P, et al. Acute Respiratory Tract Infections and Mannose-Binding Lectin Insufficiency During Early Childhood. JAMA. 2001;285(10):1316–1321. doi:10.1001/jama.285.10.1316
Author Affiliations: Department of Epidemiology Research, Statens Serum Institut (Drs Koch, Melbye, Sørensen, and Mølbak and Messrs Hansen and Andersen, and Ms Hahn); Departments of Otolaryngology, Head and Neck Surgery (Dr Homøe) and Clinical Immunology, Rigshospitalet, National University Hospital (Drs Madsen and Garred), Copenhagen, Denmark.
Context Hospital-based studies have found that increased susceptibility to certain
infections is associated with low serum levels of mannose-binding lectin (MBL)
due to MBL variant alleles. However, the contribution of MBL insufficiency
to incidence of common childhood infections at a population level is unknown.
Objective To investigate the effect of MBL insufficiency on risk for acute respiratory
tract infection (ARI) in unselected children younger than 2 years.
Design and Setting Population-based, prospective, cohort study conducted in Sisimiut, Greenland.
Participants Two hundred fifty-two children younger than 2 years who were followed
up weekly between August 1996 and August 1998 for morbidity surveillance.
Main Outcome Measure Risk of ARI, based on medical history and clinical examination, compared
by MBL genotype, determined from blood samples based on presence of structural
and promoter alleles.
Results A 2.08-fold (95% confidence interval [CI], 1.41-3.06) increased relative
risk (RR) of ARI was found in MBL-insufficient children (n = 13) compared
with MBL-sufficient children (n = 239; P<.001).
The risk association was largely restricted to children aged 6 to 17 months
(RR, 2.92; 95% CI, 1.78-4.79) while less effect (RR, 1.47; 95% CI, 0.45-4.82)
and no effect (RR, 1.00; 95% CI, 0.42-2.37) was shown among children aged
0 to 5 months and 18 to 23 months, respectively.
Conclusion These data suggest that genetic factors such as MBL insufficiency play
an important role in host defense, particularly during the vulnerable period
of childhood from age 6 through 17 months, when the adaptive immune system
Create a personal account or sign in to: