INTRODUÇÃO: A premissa da relação entre o processo aterosclerótico da doença arterial coronária e a doença periodontal é o processo imunoinflamatório, que provoca aumento significativo da concentração sérica de lectina ligadora de manose. Essa proteína é parte da imunidade inata e possui a capacidade de ligar-se aos resíduos de manose comuns a vários patógenos. Estudos em animais também mostraram que o aumento da concentração sérica de sirtuína-1 associou-se com redução da inflamação. Evidências indicam que a sirtuína-1 desempenha um importante papel na proteção vascular e está associada ao envelhecimento. OBJETIVOS: Esse estudo analisou a influência do tratamento não cirúrgico da doença periodontal na concentração sérica de lectina ligadora de manose e de sirtuína-1 em pacientes com doença periodontal e doença arterial coronária. MÉTODOS: Foram avaliados 78 pacientes, 38 mulheres e 40 homens, média de idade de 58 ± 8 anos, distribuídos em 4 grupos: 20 indivíduos saudáveis (grupo 1), 18 pacientes com doença aterosclerótica e isentos da doença periodontal (grupo 2), 20 pacientes com doença periodontal e isentos de doença arterial coronária (grupo 3) e 20 pacientes com doença aterosclerótica e doença periodontal (grupo 4). Foi realizada coleta de sangue periférico no início e no final do tratamento da doença periodontal. RESULTADOS: Observou-se uma correlação negativa entre a variação de concentração de lectina ligadora de manose e a concentração de sirtuína-1 (r = -0,30; p = 0,006). Os pacientes que receberam tratamento para a doença periodontal tiveram aumento da concentração sérica de sirtuína-1 (1,06 ± 1,03 vs. 1,66 ± 1,64 ng/mL; p < 0,001) e redução da concentração sérica da lectina ligadora de manose (1099,35 ± 916,59 vs. 861,42 ± 724,82 ng/mL; p < 0,001) quando comparamos os momentos inicial e final do estudo. Observou-se redução na concentração sérica da lectina ligadora de manose e aumento da sirtuína-1 nos grupos 3 e 4. A lectina ligadora de manose reduziu no grupo 3 de 886,27 ± 906,72 ng/mL para 689,94 ± 808,36 ng/mL (p = 0,003) e no grupo 4 de 1.312,43 ± 898,21 ng/mL para 1.032,90 ± 602,52 ng/mL (p = 0,010). A sirtuína-1 aumentou no grupo 3 de 0,80 ± 1,01 ng/mL para 1,49 ± 1,55 ng/mL (p = 0,005) e no grupo 4 de 1,32 ± 1,00 ng/mL para 1,82 ± 1,75 ng/mL (p = 0,044). CONCLUSÃO: O tratamento periodontal, além da redução de processos infecciosos locais, promove a redução da concentração sérica de lectina ligadora de manose e aumento da concentração sérica da sirtuína-1. Porém, estudos prospectivos serão necessários para avaliar o impacto das alterações séricas dessas proteínas como biomarcadores na incidência e no prognóstigo da doença arterial coronária / BACKGROUND: The premise of the relationship between the atherosclerotic process of coronary artery disease and periodontal disease is the immunoinflammatory process, which causes a significant increase in serum concentration of mannose-binding lectin. This protein is part of the innate immunity and has the ability to bind to the mannose residues common to various pathogens. Animal studies also showed that increased serum concentration of sirtuin-1 was associated with reduced inflammation. Evidence indicates that sirtuin-1 plays an important role in vascular protection and is associated with aging. OBJECTIVES: This study examined the influence of nonsurgical treatment of periodontal disease on the serum concentration of mannose-binding lectin and sirtuin-1 in patients with periodontal disease and coronary artery disease. METHODS: Seventy-eight patients, 38 women and 40 men, mean age 58 ± 8 years old, were divided into 4 groups: 20 healthy subjects (group 1), 18 patients with coronary artery disease and without periodontal disease (group 2), 20 patients with periodontal disease and without coronary artery disease (group 3) and 20 patients with coronary artery disease and periodontal disease (group 4). Peripheral blood samples were collected at the beginning and at the end of the treatment of periodontal disease. RESULTS: A negative correlation was observed between the concentration of mannose-binding lectin and the concentration of sirtuin-1 (r = -0.30; p = 0.006). Patients receiving treatment for periodontal disease had increased serum sirtuin-1 concentration (1.06 ± 1.03 vs. 1.66 ± 1.64 ng/mL, p < 0.001) and decreased serum mannose-binding lectin concentration (1099.35 ± 916.59 vs. 861.42 ± 724.82 ng/mL, p <0.001) when we compared the initial and final moments of the study. Reduction in serum concentration of mannose-binding lectin and increase of sirtuin-1 were observed in groups 3 and 4. Mannosebinding lectin reduced in group 3 from 886.27 ± 906.72 ng/mL to 689.94 ± 808 (P = 0.010), and in group 4 from 1312.43 ± 898.21 ng / mL to 1032.90 ± 602.52 ng/mL (p = 0.010). Sirtuin-1 increased in group 3 from 0.80 ± 1.01 ng/mL to 1.49 ± 1.55 ng/mL (p = 0.005) and in group 4 of 1.32 ± 1.00 ng/mL to 1.82 ± 1.75 ng/mL (p = 0.044). CONCLUSION: The periodontal treatment, in addition to the reduction of local infectious processes, promoted the reduction of serum concentration of mannose-binding lectin and increased serum concentration of sirtuin-1. However, prospective studies will be needed to evaluate the impact of serum changes of these proteins as biomarkers on the incidence and prognosis of coronary artery disease

Chronic granulomatous disease (CGD) is associated with defective function of the NADPH-oxidase system in conjunction with phagocytic defects which leads to granuloma formation and serious infectious complications. This is often associated with significant morbidity and mortality. The association of defective phagocyte function with other coincidental immune defects is unknown. Defects in innate pathways seen with CGD, including complement systems, and toll-like and dectin receptor pathways, have not been described before. We present the case of a 2-year old male patient hospitalized with recurrent pneumonia, a non-healing skin ulcer, necrotizing lung granulomas, and epididymo-orchitis. Defective neutrophil chemiluminescence was detected by dihydrorhodamine (DHR) testing. Further evaluation demonstrated characteristic molecular mutations of CYBB consistent with CGD. Immune evaluation demonstrated polyclonal hyperglobulinemia, but a greatly reduced mannose binding lectin (MBL) level. Six biallelic polymorphisms in MBL gene and its promoter were analyzed using Light Cycler™ Real-time PCR assay. The LXPA/LYPB haplotype of MBL was detected in our patient; the latter is the defective haplotype associated with low MBL levels. Due to the implications for innate immunity and the protection against bacterial, viral, and fungal infections provided by MBL, a deficiency of this protein may have disastrous consequences on the long term outcomes of CGD. MBL deficiency can also complicate other disorders affecting the immune system, significantly increasing the risk of infection in such patients. Further studies looking at the frequency and implications of MBL deficiency in CGD are needed. © 2012 Bentham Science Publishers.

Chronic granulomatous disease (CGD) is associated with defective function of the NADPH-oxidase system in conjunction with phagocytic defects which leads to granuloma formation and serious infectious complications. This is often associated with significant morbidity and mortality. The association of defective phagocyte function with other coincidental immune defects is unknown. Defects in innate pathways seen with CGD, including complement systems, and toll-like and dectin receptor pathways, have not been described before. We present the case of a 2-year old male patient hospitalized with recurrent pneumonia, a non-healing skin ulcer, necrotizing lung granulomas, and epididymo-orchitis. Defective neutrophil chemiluminescence was detected by dihydrorhodamine (DHR) testing. Further evaluation demonstrated characteristic molecular mutations of CYBB consistent with CGD. Immune evaluation demonstrated polyclonal hyperglobulinemia, but a greatly reduced mannose binding lectin (MBL) level. Six biallelic polymorphisms in MBL gene and its promoter were analyzed using Light Cycler™ Real-time PCR assay. The LXPA/LYPB haplotype of MBL was detected in our patient; the latter is the defective haplotype associated with low MBL levels. Due to the implications for innate immunity and the protection against bacterial, viral, and fungal infections provided by MBL, a deficiency of this protein may have disastrous consequences on the long term outcomes of CGD. MBL deficiency can also complicate other disorders affecting the immune system, significantly increasing the risk of infection in such patients. Further studies looking at the frequency and implications of MBL deficiency in CGD are needed.

A Lectina Ligadora de Manose (MBL) é uma proteína que reconhece carboidratos na superfície microbiana levando à ativação do sistema complemento. Este processo é mediado por Serino Proteases tal como a MASP-2. O complexo MBL/MASP-2 é responsável pela formação da C3 convertase C4bC2b. Os níveis séricos de MBL e a MASP-2 (genes MBL2 e MASP-2, respectivamente) são geneticamente determinados, e podem ser influenciados pela presença de polimorfismos em um único nucleotídeo SNPs em genes codificadores destas proteínas. OBJETIVO: Determinar os níveis séricos e polimorfismos gênicos da MBL e MASP-2 em uma amostra da população brasileira. MÉTODOS: 294 amostras de doadores de sangue [mediana = 36,51 ± 10,56; 18-63 anos; 91/294 (30,95%) sexo feminino, 203/294 (69,05%) sexo masculino] foram genotipadas para os SNPs do éxon 1 (MBL2): SNPs localizados nos códons 52 (ArgCys), 54 (GlyAsp) e 57 (GlyGlu) e SNP Asp371Tyr (D371Y, A>C ) do gene da MASP-2 (éxon 9). Foi utilizado o ensaio de temperatura de dissociação para éxon 1 (MBL2) e sequenciamento direto dos promoters (H/L, X/Y e P/Q, nas posições -550, -221 e +4, respectivamente). A combinação das variantes do éxon 1 MBL2 foram agrupadas e denominadas alelo O e o genótipo selvagem foi denominado A. O éxon 9 da MASP-2 foi genotipado através da plataforma TaqMan. RESULTADOS: MBL2: 58,5% A/A, 36,39% A/O e 5,1% O/O; promoters: 13% H/H, 39% H/L, 48% L/L; 2% X/X, 26% X/Y, 72% Y/Y; 52% P/P, 37% P/Q, 11% Q/Q; haplótipos encontrados: 15% LXPA, 28% HYPA, 8% LYQO, 12% LYPO, 11% LYPA, 22% LYQA e 4% HYPO. Quanto à produção, 56,12% produziram altos níveis de MBL, 30,61% níveis médios e 13,27% níveis baixos ou insuficientes de MBL. Para MASP-2: 38,78% A/A, 44,56% A/C e 16,67% C/C. CONCLUSÃO: A prevalência (5,1%) SNP O/O do éxon 1 (MBL2) está de acordo com a literatura brasileira, é semelhante à européia (4%) e japonesa (5%), menor que a africana (10-14%). Níveis séricos de MBL corresponderam aos genótipos determinados. Esta é a primeira avaliação da frequência do SNP D371Y do gene MASP-2 em uma população brasileira. Os resultados deste trabalho fornecem subsídios para estudos sobre repercussão de MBL e MASP-2 em situações clínicas / BACKGROUND: Mannose-binding lectin (MBL) is a protein that recognizes carbohydrates on microbial surface leading to complement activation. This process is mediated by MBL-associated serine proteases, such as MASP-2. MBL/MASP-2 complex is responsible for generating the C3 convertase C4bC2b. Both MBL and MASP-2 levels are genetically determined, and can be influenced by the presence of single nucleotide polymorphisms (SNPs) in the genes encoding for these proteins (namely MBL2 and MASP-2). OBJTECTIVE: to determine MBL and MASP-2 serum levels and the frequencies of MBL2 and MASP-2 gene polymorphisms in a Brazilian population sample. METHODS: 294 blood donor samples [median age = 36.51 ± 10.56 years, range 18-63, 91/294 (31%) females and 203/294 (69%) males] were genotyped for MBL2 exon 1 SNPs: single point mutation in codon 52 (ArgCys), 54 (GlyAsp) and 57 (GlyGlu), and MASP-2 polymorphism Asp371Tyr (D371Y, A>C) (exon 9). A melting temperature assay was used to perform the genotyping of MBL2 SNPs. The combination of variants of MBL2 were grouped together as allele O, wild types were indicated as A. Exon 1 promoters were evaluated by direct genotype sequencing- alleles H/L, X/Y and P/Q (positions -550, -221 and +4, respectively). MASP-2 exon 9 genotyping was performed by using TaqMan pre-developed assay. RESULTS: MBL2: 58.5% A/A, 36.39% A/O, 5.1% O/O; promoters: 13% H/H, 39% H/L, 48% L/L; 2% X/X, 26% X/Y, 72% Y/Y; 52% P/P, 37% P/Q, 11% Q/Q; haplotypes: 15% LXPA, 28% HYPA, 8% LYQO, 12% LYPO, 11% LYPA, 22% LYQA and 4% HYPO. MASP-2: 38.78% A/A, 44.56% A/C and 16.67% C/C. CONCLUSION: The prevalence (5.1%) of O/O genotype of MBL2 exon 1 SNPs in our population is in accordance with Brazilian reports, similar to European (4%) and Japanese (5%); lower than Africans (10-14%). There is a correlation between MBL serum levels and genotyping. Moreover, this is the first report of D371Y MASP-2 polymorphism frequency in a Brazilian population. Our data may contribute to new insights on the role of MBL and MASP-2 in clinical conditions

A Lectina Ligadora de Manose (MBL) é uma proteína que reconhece carboidratos na superfície microbiana levando à ativação do sistema complemento. Este processo é mediado por Serino Proteases tal como a MASP-2. O complexo MBL/MASP-2 é responsável pela formação da C3 convertase C4bC2b. Os níveis séricos de MBL e a MASP-2 (genes MBL2 e MASP-2, respectivamente) são geneticamente determinados, e podem ser influenciados pela presença de polimorfismos em um único nucleotídeo SNPs em genes codificadores destas proteínas. OBJETIVO: Determinar os níveis séricos e polimorfismos gênicos da MBL e MASP-2 em uma amostra da população brasileira. MÉTODOS: 294 amostras de doadores de sangue [mediana = 36,51 ± 10,56; 18-63 anos; 91/294 (30,95%) sexo feminino, 203/294 (69,05%) sexo masculino] foram genotipadas para os SNPs do éxon 1 (MBL2): SNPs localizados nos códons 52 (ArgCys), 54 (GlyAsp) e 57 (GlyGlu) e SNP Asp371Tyr (D371Y, A>C ) do gene da MASP-2 (éxon 9). Foi utilizado o ensaio de temperatura de dissociação para éxon 1 (MBL2) e sequenciamento direto dos promoters (H/L, X/Y e P/Q, nas posições -550, -221 e +4, respectivamente). A combinação das variantes do éxon 1 MBL2 foram agrupadas e denominadas alelo O e o genótipo selvagem foi denominado A. O éxon 9 da MASP-2 foi genotipado através da plataforma TaqMan. RESULTADOS: MBL2: 58,5% A/A, 36,39% A/O e 5,1% O/O; promoters: 13% H/H, 39% H/L, 48% L/L; 2% X/X, 26% X/Y, 72% Y/Y; 52% P/P, 37% P/Q, 11% Q/Q; haplótipos encontrados: 15% LXPA, 28% HYPA, 8% LYQO, 12% LYPO, 11% LYPA, 22% LYQA e 4% HYPO. Quanto à produção, 56,12% produziram altos níveis de MBL, 30,61% níveis médios e 13,27% níveis baixos ou insuficientes de MBL. Para MASP-2: 38,78% A/A, 44,56% A/C e 16,67% C/C. CONCLUSÃO: A prevalência (5,1%) SNP O/O do éxon 1 (MBL2) está de acordo com a literatura brasileira, é semelhante à européia (4%) e japonesa (5%), menor que a africana (10-14%). Níveis séricos de MBL corresponderam aos genótipos determinados. Esta é a primeira avaliação da frequência do SNP D371Y do gene MASP-2 em uma população brasileira. Os resultados deste trabalho fornecem subsídios para estudos sobre repercussão de MBL e MASP-2 em situações clínicas / BACKGROUND: Mannose-binding lectin (MBL) is a protein that recognizes carbohydrates on microbial surface leading to complement activation. This process is mediated by MBL-associated serine proteases, such as MASP-2. MBL/MASP-2 complex is responsible for generating the C3 convertase C4bC2b. Both MBL and MASP-2 levels are genetically determined, and can be influenced by the presence of single nucleotide polymorphisms (SNPs) in the genes encoding for these proteins (namely MBL2 and MASP-2). OBJTECTIVE: to determine MBL and MASP-2 serum levels and the frequencies of MBL2 and MASP-2 gene polymorphisms in a Brazilian population sample. METHODS: 294 blood donor samples [median age = 36.51 ± 10.56 years, range 18-63, 91/294 (31%) females and 203/294 (69%) males] were genotyped for MBL2 exon 1 SNPs: single point mutation in codon 52 (ArgCys), 54 (GlyAsp) and 57 (GlyGlu), and MASP-2 polymorphism Asp371Tyr (D371Y, A>C) (exon 9). A melting temperature assay was used to perform the genotyping of MBL2 SNPs. The combination of variants of MBL2 were grouped together as allele O, wild types were indicated as A. Exon 1 promoters were evaluated by direct genotype sequencing- alleles H/L, X/Y and P/Q (positions -550, -221 and +4, respectively). MASP-2 exon 9 genotyping was performed by using TaqMan pre-developed assay. RESULTS: MBL2: 58.5% A/A, 36.39% A/O, 5.1% O/O; promoters: 13% H/H, 39% H/L, 48% L/L; 2% X/X, 26% X/Y, 72% Y/Y; 52% P/P, 37% P/Q, 11% Q/Q; haplotypes: 15% LXPA, 28% HYPA, 8% LYQO, 12% LYPO, 11% LYPA, 22% LYQA and 4% HYPO. MASP-2: 38.78% A/A, 44.56% A/C and 16.67% C/C. CONCLUSION: The prevalence (5.1%) of O/O genotype of MBL2 exon 1 SNPs in our population is in accordance with Brazilian reports, similar to European (4%) and Japanese (5%); lower than Africans (10-14%). There is a correlation between MBL serum levels and genotyping. Moreover, this is the first report of D371Y MASP-2 polymorphism frequency in a Brazilian population. Our data may contribute to new insights on the role of MBL and MASP-2 in clinical conditions