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* Department of Neurology and
Department of Immunology, Erasmus Medical Center, Rotterdam, The Netherlands;
Departments of Nephrology and Clinical Chemistry and
Departments of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Leiden, The Netherlands
In Guillain-Barré syndrome (GBS), complement activation plays a crucial role in the induction and extent of the postinfectious immune-mediated peripheral nerve damage. Mannose-binding lectin (MBL) activates the complement system via the lectin pathway after recognition of repetitive sugar groups on pathogens. We investigated whether the MBL2 genotype, serum MBL level, and MBL complex activity are associated with the development and severity of GBS. Single nucleotide polymorphisms in the promoter region (–550 H/L and –221 X/Y) and exon 1 (A/O) of the MBL2 gene were determined in 271 GBS patients and 212 healthy controls. The frequencies of the H allele, HY promoter haplotype, and HYA haplotype, which are related to high MBL activity, were all increased in GBS patients compared with healthy controls (p 
0.03), particularly in severely affected GBS patients (MRC-sum score <40) (p 0.02). Severe weakness was also associated with high MBL concentrations and MBL complex activity in sera from GBS patients (p < 0.01). The MBL2 B allele was associated with functional deficiency and relatively mild weakness. These results support the hypothesis that complement activation mediated by MBL contributes to the extent of nerve damage in GBS, which is codetermined by the MBL2 haplotype.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
1 This work was supported by the Netherlands Organization for Scientific Research (NWO Project Number 940/38/009; to K.G. and W.v.R.) and the Dutch Kidney Foundation (C03–6014; to A.R.).
2 Address correspondence and reprint requests to Dr. Bart C. Jacobs, Department of Neurology, Erasmus Medical Center, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. E-mail address: b.jacobs{at}erasmusmc.nl
3 Abbreviations used in this paper: GBS, Guillain-Barré syndrome; IVIg, i.v. Ig; MBL, mannose-binding lectin; SNP, single nucleotide polymorphism; OR, odds ratio; CI, confidence interval.
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