We retrospectively studied MBP genotypes in patients with malaria, tuberculosis (TB), and persistent hepatitis B virus (HBV) carriage, in clinics and hospitals in The Gambia. Children under 10 years with cerebral malaria and/or severe malarial anaemia, were compared with children with symptomatic, mild malaria, and controls of the same age and ethnicity. Adult TB cases with smear-positive pulmonary TB were compared with healthy blood donors from the same ethnic groups. Malaria cases and controls were tested for hepatitis B core antibody (anti-HBc) and surface antigen (HBsAg). TB patients were tested for HIV antibodies. Genotyping used sequence-specific oligonucleotide analysis to identify MBP variant alleles. Overall, 46% (944/2041) of patients and controls were homozygous for the wild-type MBP allele, 45% (922/2041) were carriers of a single variant allele and 8.6% (175/2041) had two variant alleles. Neither homozygotes nor heterozygotes for MBP variants were at increased risk of clinical malaria, persistent HBV carriage or TB. The most common mutation in Africans, the codon 57 variant allele, was weakly associated with resistance to TB (221/794 in TB cases and 276/844 in controls, p = 0.037). MBP deficiency is not a significant risk factor for persistent HBV, severe malaria nor pulmonary TB in West Africa.
PIP: Low serum mannose-binding protein (MBP), a calcium-dependent serum lectin that acts as an opsonin to promote phagocytosis, has been characterized as the most common immune deficiency. It has been suggested that MBP acts as a binding protein for mycobacteria and other intracellular pathogens, enabling them to enter host macrophages. The present study investigated the association between variant MBP alleles and malaria, tuberculosis, and hepatitis B virus (HBV) in adults and children in The Gambia. Of the 2041 Gambians screened for MBP mutations, 944 (46%) were homozygous for the wild-type allele, 922 (45%) were carriers of a single variant allele, and 175 (8.6%) possessed 2 mutant alleles. Compared to healthy controls, neither homozygotes nor heterozygotes for MBP genotypes were at increased risk of severe malaria (n = 504), HBV carriage (n = 337), or tuberculosis (n = 397). Stratification of patients by ethnic group did not alter this lack of relationship. However, the most common mutation in Africans--the codon 57 variant allele--was weakly associated with resistance to tuberculosis in both cases and controls. Although MBP deficiency may predispose to recurrent infections, this study failed to provide evidence that such a deficiency is a major risk factor for infectious diseases.