Mannose-Binding Lectin Deficiency is Associated with Smaller Infarction Size and Favorable Outcome in Ischemic Stroke Patients

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Mannose-Binding Lectin Deficiency is Associated with Smaller Infarction Size and Favorable Outcome in Ischemic Stroke Patients

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dc.contributor.author Osthoff, Michael
dc.contributor.author Katan, Mira
dc.contributor.author Fluri, Felix
dc.contributor.author Bingisser, Roland
dc.contributor.author Kappos, Ludwig
dc.contributor.author Steck, Andreas J.
dc.contributor.author Engelter, Stefan T.
dc.contributor.author Mueller, Beat
dc.contributor.author Christ-Crain, Mirjam
dc.contributor.author Trendelenburg, Marten
dc.contributor.author Schuetz, Philipp
dc.date.accessioned 2011-09-29T14:59:03Z
dc.date.issued 2011
dc.identifier.citation Osthoff, Michael, Mira Katan, Felix Fluri, Philipp Schuetz, Roland Bingisser, Ludwig Kappos, Andreas J. Steck, et al. 2011. Mannose-Binding lectin deficiency is associated with smaller infarction size and favorable outcome in ischemic stroke patients. PLoS ONE 6(6): e21338. en_US
dc.identifier.issn 1932-6203 en_US
dc.identifier.uri http://nrs.harvard.edu/urn-3:HUL.InstRepos:5146968
dc.description.abstract Background: The Mannose-binding lectin (MBL) pathway of complement plays a pivotal role in the pathogenesis of ischemia/reperfusion (I/R) injury after experimental ischemic stroke. As comparable data in human ischemic stroke are limited, we investigated in more detail the association of MBL deficiency with infarction volume and functional outcome in a large cohort of patients receiving intravenous thrombolysis or conservative treatment. Methodology/Principal Findings: In a post hoc analysis of a prospective cohort study, admission MBL concentrations were determined in 353 consecutive patients with an acute ischemic stroke of whom 287 and 66 patients received conservative and thrombolytic treatment, respectively. Stroke severity, infarction volume, and functional outcome were studied in relation to MBL concentrations at presentation to the emergency department. MBL levels on admission were not influenced by the time from symptom onset to presentation (p = 0.53). In the conservative treatment group patients with mild strokes at presentation, small infarction volumes or favorable outcomes after three months demonstrated 1.5 to 2.6-fold lower median MBL levels (p = 0.025, p = 0.0027 and p = 0.046, respectively) compared to patients with more severe strokes. Moreover, MBL deficient patients (,100 ng/ml) were subject to a considerably decreased risk of an unfavorable outcome three months after ischemic stroke (adjusted odds ratio 0.38, p,0.05) and showed smaller lesion volumes (mean size 0.6 vs. 18.4 ml, p = 0.0025). In contrast, no association of MBL concentration with infarction volume or functional outcome was found in the thrombolysis group. However, the small sample size limits the significance of this observation. Conclusions: MBL deficiency is associated with smaller cerebral infarcts and favorable outcome in patients receiving conservative treatment. Our data suggest an important role of the lectin pathway in the pathophysiology of cerebral I/R injury and might pave the way for new therapeutic interventions. en_US
dc.language.iso en_US en_US
dc.publisher Public Library of Science en_US
dc.relation.isversionof doi:10.1371/journal.pone.0021338 en_US
dc.relation.hasversion http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3119675/pdf/ en_US
dash.license LAA
dc.subject acute cardiovascular problems en_US
dc.subject clinical immunology en_US
dc.subject genetics of the immune system en_US
dc.subject immune activation en_US
dc.subject immune deficiency en_US
dc.subject stroke en_US
dc.subject inflammation en_US
dc.subject innate immunity en_US
dc.title Mannose-Binding Lectin Deficiency is Associated with Smaller Infarction Size and Favorable Outcome in Ischemic Stroke Patients en_US
dc.type Journal Article en_US
dc.description.version Version of Record en_US
dc.relation.journal PLoS ONE en_US
dash.depositing.author Schuetz, Philipp
dc.date.available 2011-09-29T14:59:03Z
dash.affiliation.other 100176 en_US

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