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a Hôpital Robert
Debré, INSERM U458, 48 Boulevard Sérurier, 75019 Paris, France, b Hôpital
Cochin, Service de Pneumo-phtisiologie, 75979 Paris cedex 14, France, c Faculté de Médecine Bichat,
INSERM U408, 75018 Paris, France, d Hôpital
Nord, Service de Pédiatrie, 80054 Amiens cedex 1, France, e Hôpital Necker-Enfants Malades,
INSERM U393, 75743 Paris cedex 15, France
Correspondence to: Dr Besmond, besmond{at}infobiogen.fr
Revised version received 6 February 2001;
Accepted for publication 15
February 2001
Chronic liver disease is a major complication of cystic
fibrosis. Its incidence and severity show marked heterogeneity, even among the homogeneous group of homozygous
F508 patients, suggesting that environmental or genetic factors other than the deletion
F508
may influence the development of cystic fibrosis related liver disease.
We investigated whether the allelic variants of mannose binding lectin,
an important protein of the immune system, could be associated with the
presence of cirrhosis in a population of 216 homogeneous homozygous
F508 patients. Analysis of the data shows that the presence of
cirrhosis in cystic fibrosis patients is significantly associated with
a mutated mannose binding lectin genotype (homozygous or compound
heterozygous for mannose binding lectin variants). The modulating role
of mannose binding lectin in the occurrence of cirrhosis in cystic
fibrosis could be explained by the fact that hepatotoxic damage from
viruses or bacteria might be increased by the immunodeficiency
associated with mannose binding lectin variants and might facilitate
the degradation of liver status. These data highlight the crucial role
of mannose binding lectin in the clinical outcome of cystic fibrosis,
as it has recently been shown that the mannose binding lectin gene is a
modulating gene of the respiratory involvement in cystic fibrosis patients.
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