| Chapter.1 Association between MASP-2 gene polymorphism and risk of infection disease: A meta-analysisBackground and Aims: Complement system plays an important role in the prevention and treatment of infectious diseases,the role of MASP-2 is vital in the process of complement activation by the lectin pathway.It is generally believed that the mutation of MASP-2 gene can lead to the change of the protein content and function of the protein,which may affect the occurrence and development of infectious diseases.In the study of MASP-2 gene polymorphism among all the exon 3 of MASP-2 gene(rs72550870)mutations can lead to the serum level of MASP-2 is lower than 200ng/ml,which can make the loss of MASP-2 and MBL binding ability and inhibition of complement activation,resulting in loss of function of the lectin complement pathway.However,these studies are inconsistent with the MASP-2 gene(rs72550870)polymorphism and the risk of infectious disease.So We analyze the association between MASP-2 functional gene(rs72550870)polymorphism and the infection disease risk by a meta-analysis.Method: Relevant case-control studies were identified by searching Cochrane Library,Pub Med,Emabase,DOAJ,CAB Abstracts,CSA,CINAHL,EBSCO,Scopus,Global Health,Index Copernicus,CA,China National Knowledge Infrastructure(CNKI)databases up to 10 th January 2016.The data were extracted and the methodological quality of studies were evaluated.The STATA 12.0 software was used to perform statistical analysis.Results: 9 studies were included.There was no significant association between MASP-2 gene(p.D120 G,rs72550870)polymorphism and the risk of infection disease under the allele model(G vs.A: OR = 0.89,95%CI = 0.66–1.21)(P=0.445>0.05)and the recessive model(AA+GG vs.AA :OR=0.88,95%CI=0.65-1.20)(P=0.428>0.05).Conclusion: This is the first comprehensive meta-analysis indicates that the MASP-2 functional gene(rs72550870)polymorphism is not associated with the infection diseases,and the key functional gene polymorphism of rs72550870 did not increase susceptibility to the infection diseases.Similarly,there were no obvious difference in subgroup analysis based on geographical areas and pathogenic microorganisms.Chapter.2 The serum MASP-2 levels in patients of type 2 diabetes mellitus with pulmonary infectionBackground: With the rapid development of China's economy and the change of people's life style,type 2 diabetes mellitus(T2DM),as a complex metabolic disease,has a significantly higher incidence.Pulmonary infection is the most common complication,which seriously affects the quality of life and prognosis of patients.As a part of innate immunity,complement system plays an important role in the pathogenesis of infection.MASP-2 is a key enzyme in activation of the lectin complement pathway.Our purpose of this study is to detect the serum level of MASP-2 in type 2 diabetes mellitus with pulmonary infection,and to discuss the relationship among MASP-2 content to the occurrence,development and prognosis of type 2 diabetes mellitus with pulmonary infection.so as to provide valuable reference basis for the pathogenesis and auxiliary diagnosis to type 2 diabetes mellitus with pulmonary infection.Aims: To investigate the serum levels of MASP-2,as the key enzyme of complement activation,in patients with type 2 diabetes mellitus with pulmonary infection,and the relationship between MASP-2 and type 2 diabetes mellitus with pulmonary infection,to explore the pathogenesis of type 2 diabetes complicated with infection and to evaluate the diagnostic value of MASP-2 in type 2 diabetes with pulmonary infection.Method: Blood samples were obtained from 45 cases of patients with type 2 diabetes mellitus complicated(with pulmonary infection)as T2DM-WPI group?41 cases of patients with type 2 diabetes(without pulmonary infection)as T2DM-WOPI group and 47 cases of healthy people as C group from October 2015 to November 2016 in Linxia National Hospital.The concentration of MASP-2 in serum was detected by enzyme-linked immunosorbent assay(ELISA),and the concentration of PCT?Hs-CRP?C3 and C4 in serum was detected by Immune enhancement Turbidimetry.The differences were analyzed between T2DM-WPI group(type 2 diabetes mellitus with pulmonary infection)?T2DM-WOPI group(type 2 diabetes mellitus without pulmonary infection)and HC group(healthy controls).The correlation of MASP-2 concentration and the PCT?Hs-CRP of T2DM-WPI group(type 2 diabetes mellitus with pulmonary infection)were further analyzed.Results:1.Serum MASP-2(389.75 ±27.63ng/ml)in T2DM-WPI group compared to HC group was decreased,the difference was no statistically significant(P> 0.05);Complement 3(2.85±0.51g/L)?Complement 4(1.03±0.16mg/L)?PCT(7.51±0.78ug/L)?Hs-CRP(24.44±6.73mg/L)compared to HC group was increased significantly,the difference was statistically significant(P< 0.05).2.Serum MASP-2(389.75 ±27.63ng/ml)in T2DM-WPI group of type 2 diabetic patients with pulmonary infection compared to T2DM-WOPI group was decreased significantly,the difference was statistically significant(P< 0.05);Com Plement 3(2.85±0.51g/L)?PCT(7.51± 0.78ug/L)?Hs-CRP(24.44±6.92mg/L)compared to T2DM-WOPI group was increased significantly,the difference was statistically significant(P<0.05);Complement 4(1.03±0.16mg/L)compared to T2DM-WOPI group was little increased;the difference was no statistically significant(P> 0.05).3.Serum MASP-2(481.84 ±26.82ng/ml)?Complement 3(2.25±0.47g/L)and Complement 4(1.03±0.16mg/L)in T2DM-WOPI group,compared to serum MASP-2(396.43±25.31ng/ml)?Complement 3(1.54±0.47g/L)and Complement 4(0.67±0.16mg/L)in C group,was increased significantly,the difference was statistically significant(P< 0.05).4.By the Spearman rank correlation test in T2DM-WPI group of type 2 diabetes patients with pulmonary infection,correlation between serum MASP-2 level and PCT content(r=0.621,P< 0.01)are high positive correlation;and the Hs-CRP(r=0.654,P< 0.01)are also high positive correlation.5.The ROC curve analysis revealed the area under curve(AUC)of MASP-2 was(0.519,P=0.757> 0.05)?the PCT was(0.997,P<0.001)and the Hs-CRP was(0.961,P<0.001)in T2DM-WPI group of type 2 diabetic patients with pulmonary infection.Conclusion:1.The serum MASP-2 level in T2DM-WPI group compared to HC group was decreased,but it compared to T2DM-WOPI group was increased,showed that the complement system was disorders in type 2 diabetic patients without pulmonary infection,and the MASP-2 is involved in the occurrence of type 2 diabetes mellitus complicated with pulmonary infection.2.The diagnostic value of MASP-2 was lower than the PCT and Hs-CRP in type 2 diabetes patients with pulmonary infection,but the serum MASP-2 level in type 2 diabetes mellitus with pulmonary infection was significantly lower,showed that the detection of the serum MASP-2 level can not be used as a diagnostic marker of effective,the changes of the serum MASP-2 level can help predict the incidence of infection. |
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