Baixos níveis de lectina ligante de manose podem estar associados a uma maior predisposição à doença pelo vírus respiratório sincicial sem interferir na ativação de linfócitos T

Abstract

Respiratory syncytial virus (RSV) is a major cause of serious lower respiratory tract disease among infants and young children worldwide, and understanding the immune response to its infection is essential for intervention strategies. The innate-response serum mannose-binding lectin (MBL), which recognizes a broad range of pathogens and subsequently activates the complement system, has an essential role in the early phase of infection contributing to the development of an acquired immune response. In this study, 82 children <5 years old with confirmed acute RSV infection and 70 controls had MBL levels measured by an indirect ELISA and PBMC phenotypes characterized by flow cytometry. Samples were distributed in four groups: serum/case (81), serum/control (40), PBMC/case (33), PBMC/control (58). Thirty eight cases were <6 months old and most of them had been interned (33/38). The MBL concentrations from all children presented a wide range of values, however, the greater percentage of cases, i.e. 67.9% (55/81) had <500 ng/mL (low/intermediate) MBL levels compared to 40% (16/40) for control subjects. Case and control MBL levels from children <1 month old were not statistically different, but were substantially lower in cases >24 months old (p=0.034). The CD4+ T cells percentage was lower (p<0.001) in children >6 months old compared to controls, while, the CD8+ T cells percentage in cases and controls was similar except for lower frequency in the 6 12 months old cases (p=0,003). T cell activation (CD3+HLA-II+) was significantly higher in cases compared to controls (p<0,001), in contrast to natural killer cells which were generally decreased (p<0,001). These results suggest that acute RSV infection in these children seems to be associated with low MBL levels, but not interfering in T cell activation.