Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Mannose-binding lectin deficiency

Maarten W Bronkhorst, MD, PhD, FEBS, FRCS
Lee H Bouwman, MD, PhD, FEBVS
Section Editor
Luigi D Notarangelo, MD
Deputy Editor
Elizabeth TePas, MD, MS


Mannose-binding lectin (MBL), also known as mannan-binding protein (MBP), is a protein that is involved in complement activation via the lectin pathway (figure 1). The complement system provides immediate defense against infection and has proinflammatory effects.

MBL deficiency has been variously defined as a serum levels either <100 or <500 ng/mL. It is a laboratory finding that does not necessarily equate to a clinical disorder. Numerous case-control studies with widely varying methodologies have reported that MBL deficiency is associated with a large and heterogeneous group of disease processes. However, subnormal levels are also found in healthy people. To date, there is no consensus on the clinical relevance of MBL deficiency or its treatment.

This topic reviews the genetics, epidemiology, diagnosis, and management of MBL deficiency and also reviews diseases associated with both low and high levels of MBL. Genetic defects and polymorphisms of the MBL2 gene, the function of the MBL protein, and other disorders of the complement system are discussed separately. (See "Mannose-binding lectin" and "Inherited disorders of the complement system" and "Acquired deficiencies of the complement system".)


Genetic variants within the mannose-binding lectin 2 (MBL2) gene are extremely common [1,2]. Heterozygosity, or the presence of a DNA variant in one MBL2 allele, is found in more than 30 percent of the population in most ethnic groups evaluated. Thus, up to 40 percent of most populations may have single nucleotide polymorphisms (SNPs) in one or both MBL2 alleles [3,4]. (See "Mannose-binding lectin", section on 'The MBL gene'.)


Genetics — The normal or wild-type MBL2 allele is referred to as "A." Three structural region point mutations have been identified, all in exon 1, designated alleles "B," "C," and "D." As a group, these variant alleles have also been referred to as "O." There is an autosomal pattern of inheritance. However, the MBL serum phenotype is gene-dose dependent, so inheritance cannot be defined as dominant or recessive. The level of functional MBL is decreased by as much as 90 percent, even in heterozygotes. The effect of the D allele in heterozygotes is less dramatic than that of the B or C alleles. (See "Mannose-binding lectin", section on 'The MBL gene'.)

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:

Subscribers log in here

Literature review current through: Nov 2017. | This topic last updated: Jun 13, 2016.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.
  1. Eisen DP, Minchinton RM. Impact of mannose-binding lectin on susceptibility to infectious diseases. Clin Infect Dis 2003; 37:1496.
  2. Garred P, Larsen F, Seyfarth J, et al. Mannose-binding lectin and its genetic variants. Genes Immun 2006; 7:85.
  3. Minchinton RM, Dean MM, Clark TR, et al. Analysis of the relationship between mannose-binding lectin (MBL) genotype, MBL levels and function in an Australian blood donor population. Scand J Immunol 2002; 56:630.
  4. Van Till JW, Boermeester MA, Modderman PW, et al. Variable mannose-binding lectin expression during postoperative acute-phase response. Surg Infect (Larchmt) 2006; 7:443.
  5. Turner MW, Dinan L, Heatley S, et al. Restricted polymorphism of the mannose-binding lectin gene of indigenous Australians. Hum Mol Genet 2000; 9:1481.
  6. Lipscombe RJ, Sumiya M, Hill AV, et al. High frequencies in African and non-African populations of independent mutations in the mannose binding protein gene. Hum Mol Genet 1992; 1:709.
  7. Garred P. Mannose-binding lectin genetics: from A to Z. Biochem Soc Trans 2008; 36:1461.
  8. Thiel S, Frederiksen PD, Jensenius JC. Clinical manifestations of mannan-binding lectin deficiency. Mol Immunol 2006; 43:86.
  9. Dommett RM, Klein N, Turner MW. Mannose-binding lectin in innate immunity: past, present and future. Tissue Antigens 2006; 68:193.
  10. Garred P, Pressler T, Lanng S, et al. Mannose-binding lectin (MBL) therapy in an MBL-deficient patient with severe cystic fibrosis lung disease. Pediatr Pulmonol 2002; 33:201.
  11. Sprong T, van Deuren M. Mannose-binding lectin: ancient molecule, interesting future. Clin Infect Dis 2008; 47:517.
  12. Eisen DP, Osthoff M. If there is an evolutionary selection pressure for the high frequency of MBL2 polymorphisms, what is it? Clin Exp Immunol 2014; 176:165.
  13. van de Geijn FE, Dolhain RJ, van Rijs W, et al. Mannose-binding lectin genotypes are associated with shorter gestational age. An evolutionary advantage of low MBL production genotypes? Mol Immunol 2008; 45:1514.
  14. Oudshoorn AM, van den Dungen FA, Bach KP, et al. Mannose-binding lectin in term newborns and their mothers: genotypic and phenotypic relationship. Hum Immunol 2008; 69:344.
  15. Ip WK, To YF, Cheng SK, Lau YL. Serum mannose-binding lectin levels and mbl2 gene polymorphisms in different age and gender groups of southern Chinese adults. Scand J Immunol 2004; 59:310.
  16. Ytting H, Christensen IJ, Thiel S, et al. Biological variation in circulating levels of mannan-binding lectin (MBL) and MBL-associated serine protease-2 and the influence of age, gender and physical exercise. Scand J Immunol 2007; 66:458.
  17. Thiel S, Holmskov U, Hviid L, et al. The concentration of the C-type lectin, mannan-binding protein, in human plasma increases during an acute phase response. Clin Exp Immunol 1992; 90:31.
  18. Dahl M, Tybjaerg-Hansen A, Schnohr P, Nordestgaard BG. A population-based study of morbidity and mortality in mannose-binding lectin deficiency. J Exp Med 2004; 199:1391.
  19. Bouwman LH. Mannose binding lectin: The Dr. Jekyll and Mr. Hyde of the innate immune system. Thesis. In: Department of surgery, Leiden University, Leiden 2006. p.153.
  20. Super M, Thiel S, Lu J, et al. Association of low levels of mannan-binding protein with a common defect of opsonisation. Lancet 1989; 2:1236.
  21. Miller ME, Seals J, Kaye R, Levitsky LC. A familial, plasma-associated defect of phagocytosis: A new cause of recurrent bacterial infections. Lancet 1968; 292:60.
  22. Soothill JF, Harvey BA. Defective opsonization. A common immunity deficiency. Arch Dis Child 1976; 51:91.
  23. Candy DC, Larcher VF, Tripp JH, et al. Yeast opsonisation in children with chronic diarrhoeal states. Arch Dis Child 1980; 55:189.
  24. Richardson VF, Larcher VF, Price JF. A common congenital immunodeficiency predisposing to infection and atopy in infancy. Arch Dis Child 1983; 58:799.
  25. Turner MW, Mowbray JF, Harvey BA, et al. Defective yeast opsonization and C2 deficiency in atopic patients. Clin Exp Immunol 1978; 34:253.
  26. Koch A, Melbye M, Sørensen P, et al. Acute respiratory tract infections and mannose-binding lectin insufficiency during early childhood. JAMA 2001; 285:1316.
  27. Israëls J, Frakking FN, Kremer LC, et al. Mannose-binding lectin and infection risk in newborns: a systematic review. Arch Dis Child Fetal Neonatal Ed 2010; 95:F452.
  28. Schlapbach LJ, Latzin P, Regamey N, et al. Mannose-binding lectin cord blood levels and respiratory symptoms during infancy: a prospective birth cohort study. Pediatr Allergy Immunol 2009; 20:219.
  29. Lotz DR, Knutsen AP. Concomitant selective antibody deficiency in pediatric patients with mannose-binding lectin deficiency. Pediatric Allergy, Immunology, and Pulmonology 2010; 23:265.
  30. Verschuren JJ, Roos A, Schaapherder AF, et al. Infectious complications after simultaneous pancreas-kidney transplantation: a role for the lectin pathway of complement activation. Transplantation 2008; 85:75.
  31. Worthley DL, Johnson DF, Eisen DP, et al. Donor mannose-binding lectin deficiency increases the likelihood of clinically significant infection after liver transplantation. Clin Infect Dis 2009; 48:410.
  32. Bouwman LH, Roos A, Terpstra OT, et al. Mannose binding lectin gene polymorphisms confer a major risk for severe infections after liver transplantation. Gastroenterology 2005; 129:408.
  33. de Rooij BJ, van Hoek B, ten Hove WR, et al. Lectin complement pathway gene profile of donor and recipient determine the risk of bacterial infections after orthotopic liver transplantation. Hepatology 2010; 52:1100.
  34. Kwakkel-van Erp JM, Paantjens AW, van Kessel DA, et al. Mannose-binding lectin deficiency linked to cytomegalovirus (CMV) reactivation and survival in lung transplantation. Clin Exp Immunol 2011; 165:410.
  35. Mullighan CG, Heatley S, Doherty K, et al. Mannose-binding lectin gene polymorphisms are associated with major infection following allogeneic hemopoietic stem cell transplantation. Blood 2002; 99:3524.
  36. Siassi M, Hohenberger W, Riese J. Mannan-binding lectin (MBL) serum levels and post-operative infections. Biochem Soc Trans 2003; 31:774.
  37. Garred P, Pressler T, Madsen HO, et al. Association of mannose-binding lectin gene heterogeneity with severity of lung disease and survival in cystic fibrosis. J Clin Invest 1999; 104:431.
  38. Mills TC, Chapman S, Hutton P, et al. Variants in the Mannose-binding Lectin Gene MBL2 do not Associate With Sepsis Susceptibility or Survival in a Large European Cohort. Clin Infect Dis 2015; 61:695.
  39. Peterslund NA, Koch C, Jensenius JC, Thiel S. Association between deficiency of mannose-binding lectin and severe infections after chemotherapy. Lancet 2001; 358:637.
  40. Neth O, Hann I, Turner MW, Klein NJ. Deficiency of mannose-binding lectin and burden of infection in children with malignancy: a prospective study. Lancet 2001; 358:614.
  41. Frakking FN, van de Wetering MD, Brouwer N, et al. The role of mannose-binding lectin (MBL) in paediatric oncology patients with febrile neutropenia. Eur J Cancer 2006; 42:909.
  42. Rubnitz JE, Howard SC, Willis J, et al. Baseline mannose binding lectin levels may not predict infection among children with leukemia. Pediatr Blood Cancer 2008; 50:866.
  43. Bultink IE, Hamann D, Seelen MA, et al. Deficiency of functional mannose-binding lectin is not associated with infections in patients with systemic lupus erythematosus. Arthritis Res Ther 2006; 8:R183.
  44. Bertoli AM, Fernández M, McGwin G Jr, et al. Systemic lupus erythematosus in a multiethnic US cohort: XXXVI. Influence of mannose-binding lectin exon 1 polymorphisms in disease manifestations, course, and outcome. Arthritis Rheum 2006; 54:1703.
  45. McBride MO, Fischer PB, Sumiya M, et al. Mannose-binding protein in HIV-seropositive patients does not contribute to disease progression or bacterial infections. Int J STD AIDS 1998; 9:683.
  46. Malik S, Arias M, Di Flumeri C, et al. Absence of association between mannose-binding lectin gene polymorphisms and HIV-1 infection in a Colombian population. Immunogenetics 2003; 55:49.
  47. Vallinoto AC, Freitas FB, Guirelli I, et al. Characterization of mannose-binding lectin plasma levels and genetic polymorphisms in HIV-1-infected individuals. Rev Soc Bras Med Trop 2011; 44:1.
  48. Hundt M, Heiken H, Schmidt RE. Low mannose-binding lectin serum concentrations in HIV long-term nonprogressors? AIDS Res Hum Retroviruses 2000; 16:1927.
  49. Maas J, de Roda Husman AM, Brouwer M, et al. Presence of the variant mannose-binding lectin alleles associated with slower progression to AIDS. Amsterdam Cohort Study. AIDS 1998; 12:2275.
  50. Singh KK, Lieser A, Ruan PK, et al. An age-dependent association of mannose-binding lectin-2 genetic variants on HIV-1-related disease in children. J Allergy Clin Immunol 2008; 122:173.
  51. Boniotto M, Crovella S, Pirulli D, et al. Polymorphisms in the MBL2 promoter correlated with risk of HIV-1 vertical transmission and AIDS progression. Genes Immun 2000; 1:346.
  52. Garred P, Madsen HO, Balslev U, et al. Susceptibility to HIV infection and progression of AIDS in relation to variant alleles of mannose-binding lectin. Lancet 1997; 349:236.
  53. Arraes LC, de Souza PR, Bruneska D, et al. A cost-effective melting temperature assay for the detection of single-nucleotide polymorphism in the MBL2 gene of HIV-1-infected children. Braz J Med Biol Res 2006; 39:719.
  54. Boniotto M, Braida L, Pirulli D, et al. MBL2 polymorphisms are involved in HIV-1 infection in Brazilian perinatally infected children. AIDS 2003; 17:779.
  55. Chatterjee A, Rathore A, Yamamoto N, Dhole TN. Mannose-binding lectin (+54) exon-1 gene polymorphism influence human immunodeficiency virus-1 susceptibility in North Indians. Tissue Antigens 2011; 77:18.
  56. Crovella S, Bernardon M, Braida L, et al. Italian multicentric pilot study on MBL2 genetic polymorphisms in HIV positive pregnant women and their children. J Matern Fetal Neonatal Med 2005; 17:253.
  57. da Silva GK, Guimarães R, Mattevi VS, et al. The role of mannose-binding lectin gene polymorphisms in susceptibility to HIV-1 infection in Southern Brazilian patients. AIDS 2011; 25:411.
  58. Mangano A, Rocco C, Marino SM, et al. Detrimental effects of mannose-binding lectin (MBL2) promoter genotype XA/XA on HIV-1 vertical transmission and AIDS progression. J Infect Dis 2008; 198:694.
  59. Pastinen T, Liitsola K, Niini P, et al. Contribution of the CCR5 and MBL genes to susceptibility to HIV type 1 infection in the Finnish population. AIDS Res Hum Retroviruses 1998; 14:695.
  60. Sheng A, Lan J, Wu H, et al. A clinical case-control study on the association between mannose-binding lectin and susceptibility to HIV-1 infection among northern Han Chinese population. Int J Immunogenet 2010; 37:445.
  61. Tan Y, Liu L, Luo P, et al. Association between mannose-binding lectin and HIV infection and progression in a Chinese population. Mol Immunol 2009; 47:632.
  62. Li H, Fu WP, Hong ZH. Replication study in Chinese Han population and meta-analysis supports association between the MBL2 gene polymorphism and HIV-1 infection. Infect Genet Evol 2013; 20:163.
  63. Israëls J, Scherpbier HJ, Frakking FN, et al. Mannose-binding lectin and the risk of HIV transmission and disease progression in children: a systematic review. Pediatr Infect Dis J 2012; 31:1272.
  64. Rantala A, Lajunen T, Juvonen R, et al. Mannose-binding lectin concentrations, MBL2 polymorphisms, and susceptibility to respiratory tract infections in young men. J Infect Dis 2008; 198:1247.
  65. Hoeflich C, Unterwalder N, Schuett S, et al. Clinical manifestation of mannose-binding lectin deficiency in adults independent of concomitant immunodeficiency. Hum Immunol 2009; 70:809.
  66. Buerke M, Murohara T, Lefer AM. Cardioprotective effects of a C1 esterase inhibitor in myocardial ischemia and reperfusion. Circulation 1995; 91:393.
  67. Collard CD, Montalto MC, Reenstra WR, et al. Endothelial oxidative stress activates the lectin complement pathway: role of cytokeratin 1. Am J Pathol 2001; 159:1045.
  68. Nauta AJ, Castellano G, Xu W, et al. Opsonization with C1q and mannose-binding lectin targets apoptotic cells to dendritic cells. J Immunol 2004; 173:3044.
  69. Roos A, Xu W, Castellano G, et al. Mini-review: A pivotal role for innate immunity in the clearance of apoptotic cells. Eur J Immunol 2004; 34:921.
  70. Russell L, Waring P, Beaver JP. Increased cell surface exposure of fucose residues is a late event in apoptosis. Biochem Biophys Res Commun 1998; 250:449.
  71. Duvall E, Wyllie AH, Morris RG. Macrophage recognition of cells undergoing programmed cell death (apoptosis). Immunology 1985; 56:351.
  72. Ogden CA, deCathelineau A, Hoffmann PR, et al. C1q and mannose binding lectin engagement of cell surface calreticulin and CD91 initiates macropinocytosis and uptake of apoptotic cells. J Exp Med 2001; 194:781.
  73. Nauta AJ, Raaschou-Jensen N, Roos A, et al. Mannose-binding lectin engagement with late apoptotic and necrotic cells. Eur J Immunol 2003; 33:2853.
  74. Saevarsdottir S, Vikingsdottir T, Vikingsson A, et al. Low mannose binding lectin predicts poor prognosis in patients with early rheumatoid arthritis. A prospective study. J Rheumatol 2001; 28:728.
  75. Ip WK, Lau YL, Chan SY, et al. Mannose-binding lectin and rheumatoid arthritis in southern Chinese. Arthritis Rheum 2000; 43:1679.
  76. Graudal NA, Homann C, Madsen HO, et al. Mannan binding lectin in rheumatoid arthritis. A longitudinal study. J Rheumatol 1998; 25:629.
  77. Garred P, Madsen HO, Marquart H, et al. Two edged role of mannose binding lectin in rheumatoid arthritis: a cross sectional study. J Rheumatol 2000; 27:26.
  78. Jacobsen S, Madsen HO, Klarlund M, et al. The influence of mannose binding lectin polymorphisms on disease outcome in early polyarthritis. TIRA Group. J Rheumatol 2001; 28:935.
  79. Maury CP, Aittoniemi J, Tiitinen S, et al. Variant mannose-binding lectin 2 genotype is a risk factor for reactive systemic amyloidosis in rheumatoid arthritis. J Intern Med 2007; 262:466.
  80. van de Geijn FE, Hazes JM, Geleijns K, et al. Mannose-binding lectin polymorphisms are not associated with rheumatoid arthritis--confirmation in two large cohorts. Rheumatology (Oxford) 2008; 47:1168.
  81. Jacobsen S, Garred P, Madsen HO, et al. Mannose-binding lectin gene polymorphisms are associated with disease activity and physical disability in untreated, anti-cyclic citrullinated peptide-positive patients with early rheumatoid arthritis. J Rheumatol 2009; 36:731.
  82. Saevarsdottir S, Steinsson K, Grondal G, Valdimarsson H. Patients with rheumatoid arthritis have higher levels of mannan-binding lectin than their first-degree relatives and unrelated controls. J Rheumatol 2007; 34:1692.
  83. Dolman KM, Brouwer N, Frakking FN, et al. Mannose-binding lectin deficiency is associated with early onset of polyarticular juvenile rheumatoid arthritis: a cohort study. Arthritis Res Ther 2008; 10:R32.
  84. Garred P, Voss A, Madsen HO, Junker P. Association of mannose-binding lectin gene variation with disease severity and infections in a population-based cohort of systemic lupus erythematosus patients. Genes Immun 2001; 2:442.
  85. Lee YH, Witte T, Momot T, et al. The mannose-binding lectin gene polymorphisms and systemic lupus erythematosus: two case-control studies and a meta-analysis. Arthritis Rheum 2005; 52:3966.
  86. Saevarsdottir S, Kristjansdottir H, Grondal G, et al. Mannan-binding lectin and complement C4A in Icelandic multicase families with systemic lupus erythematosus. Ann Rheum Dis 2006; 65:1462.
  87. Shoenfeld Y, Szyper-Kravitz M, Witte T, et al. Autoantibodies against protective molecules--C1q, C-reactive protein, serum amyloid P, mannose-binding lectin, and apolipoprotein A1: prevalence in systemic lupus erythematosus. Ann N Y Acad Sci 2007; 1108:227.
  88. Tsai YC, Yeh KW, Yao TC, et al. Mannose-binding lectin expression genotype in pediatric-onset systemic lupus erythematosus: associations with susceptibility to renal disease and protection against infections. J Rheumatol 2011; 38:1429.
  89. Pradhan V, Mahant G, Rajadhyaksha A, et al. A study on anti-mannose binding lectin (anti-MBL) antibodies and serum MBL levels in Indian systemic lupus erythematosus patients. Rheumatol Int 2013; 33:1533.
  90. Jakab L, Laki J, Sallai K, et al. Association between early onset and organ manifestations of systemic lupus erythematosus (SLE) and a down-regulating promoter polymorphism in the MBL2 gene. Clin Immunol 2007; 125:230.
  91. Mok MY, Ip WK, Lau CS, et al. Mannose-binding lectin and susceptibility to infection in Chinese patients with systemic lupus erythematosus. J Rheumatol 2007; 34:1270.
  92. Font J, Ramos-Casals M, Brito-Zerón P, et al. Association of mannose-binding lectin gene polymorphisms with antiphospholipid syndrome, cardiovascular disease and chronic damage in patients with systemic lupus erythematosus. Rheumatology (Oxford) 2007; 46:76.
  93. Troelsen LN, Garred P, Christiansen B, et al. Genetically determined serum levels of mannose-binding lectin correlate negatively with common carotid intima-media thickness in systemic lupus erythematosus. J Rheumatol 2010; 37:1815.
  94. Berger SP, Roos A, Mallat MJ, et al. Low pretransplantation mannose-binding lectin levels predict superior patient and graft survival after simultaneous pancreas-kidney transplantation. J Am Soc Nephrol 2007; 18:2416.
  95. Collard CD, Agah A, Reenstra W, et al. Endothelial nuclear factor-kappaB translocation and vascular cell adhesion molecule-1 induction by complement: inhibition with anti-human C5 therapy or cGMP analogues. Arterioscler Thromb Vasc Biol 1999; 19:2623.
  96. Collard CD, Väkevä A, Morrissey MA, et al. Complement activation after oxidative stress: role of the lectin complement pathway. Am J Pathol 2000; 156:1549.
  97. de Vries B, Walter SJ, Peutz-Kootstra CJ, et al. The mannose-binding lectin-pathway is involved in complement activation in the course of renal ischemia-reperfusion injury. Am J Pathol 2004; 165:1677.
  98. Berger SP, Roos A, Mallat MJ, et al. Association between mannose-binding lectin levels and graft survival in kidney transplantation. Am J Transplant 2005; 5:1361.
  99. Fildes JE, Shaw SM, Walker AH, et al. Mannose-binding lectin deficiency offers protection from acute graft rejection after heart transplantation. J Heart Lung Transplant 2008; 27:1353.
  100. Munster JM, van der Bij W, Breukink MB, et al. Association between donor MBL promoter haplotype and graft survival and the development of BOS after lung transplantation. Transplantation 2008; 86:1857.
  101. Rugonfalvi-Kiss S, Dósa E, Madsen HO, et al. High rate of early restenosis after carotid eversion endarterectomy in homozygous carriers of the normal mannose-binding lectin genotype. Stroke 2005; 36:944.
  102. Bilgin YM, Brand A, Berger SP, et al. Mannose-binding lectin is involved in multiple organ dysfunction syndrome after cardiac surgery: effects of blood transfusions. Transfusion 2008; 48:601.
  103. Collard CD, Shernan SK, Fox AA, et al. The MBL2 'LYQA secretor' haplotype is an independent predictor of postoperative myocardial infarction in whites undergoing coronary artery bypass graft surgery. Circulation 2007; 116:I106.
  104. Hovind P, Hansen TK, Tarnow L, et al. Mannose-binding lectin as a predictor of microalbuminuria in type 1 diabetes: an inception cohort study. Diabetes 2005; 54:1523.
  105. Saraheimo M, Forsblom C, Hansen TK, et al. Increased levels of mannan-binding lectin in type 1 diabetic patients with incipient and overt nephropathy. Diabetologia 2005; 48:198.
  106. Hansen TK, Tarnow L, Thiel S, et al. Association between mannose-binding lectin and vascular complications in type 1 diabetes. Diabetes 2004; 53:1570.
  107. Orsini F, Villa P, Parrella S, et al. Targeting mannose-binding lectin confers long-lasting protection with a surprisingly wide therapeutic window in cerebral ischemia. Circulation 2012; 126:1484.
  108. Wang ZY, Sun ZR, Zhang LM. The relationship between serum mannose-binding lectin levels and acute ischemic stroke risk. Neurochem Res 2014; 39:248.
  109. Ganter MT, Brohi K, Cohen MJ, et al. Role of the alternative pathway in the early complement activation following major trauma. Shock 2007; 28:29.
  110. Burk AM, Martin M, Flierl MA, et al. Early complementopathy after multiple injuries in humans. Shock 2012; 37:348.
  111. Bronkhorst MW, Lomax MA, Vossen RH, et al. Risk of infection and sepsis in severely injured patients related to single nucleotide polymorphisms in the lectin pathway. Br J Surg 2013; 100:1818.
  112. Sallenbach S, Thiel S, Aebi C, et al. Serum concentrations of lectin-pathway components in healthy neonates, children and adults: mannan-binding lectin (MBL), M-, L-, and H-ficolin, and MBL-associated serine protease-2 (MASP-2). Pediatr Allergy Immunol 2011; 22:424.
  113. Gadjeva M, Takahashi K, Thiel S. Mannan-binding lectin--a soluble pattern recognition molecule. Mol Immunol 2004; 41:113.
  114. Steffensen R, Thiel S, Varming K, et al. Detection of structural gene mutations and promoter polymorphisms in the mannan-binding lectin (MBL) gene by polymerase chain reaction with sequence-specific primers. J Immunol Methods 2000; 241:33.
  115. Mehr S. The immunological investigation of a child with chronic wet cough. Paediatr Respir Rev 2012; 13:144.
  116. Kjaer TR, Thiel S. Assay for estimation of the functional activity of the mannan-binding lectin pathway of the complement system. Methods Mol Biol 2014; 1100:131.
  117. Valdimarsson H, Vikingsdottir T, Bang P, et al. Human plasma-derived mannose-binding lectin: a phase I safety and pharmacokinetic study. Scand J Immunol 2004; 59:97.
  118. Bang P, Laursen I, Thornberg K, et al. The pharmacokinetic profile of plasma-derived mannan-binding lectin in healthy adult volunteers and patients with Staphylococcus aureus septicaemia. Scand J Infect Dis 2008; 40:44.
  119. Valdimarsson H. Infusion of plasma-derived mannan-binding lectin (MBL) into MBL-deficient humans. Biochem Soc Trans 2003; 31:768.
  120. Valdimarsson H, Stefansson M, Vikingsdottir T, et al. Reconstitution of opsonizing activity by infusion of mannan-binding lectin (MBL) to MBL-deficient humans. Scand J Immunol 1998; 48:116.
  121. Laursen I, Højrup P, Houen G, Christiansen M. Characterisation of the 1st SSI purified MBL standard. Clin Chim Acta 2008; 395:159.
  122. Ahn BC, Park JS, Kim D, et al. Overproduction of recombinant human mannose-binding lectin (MBL) in Chinese hamster ovary cells. Protein Expr Purif 2013; 88:1.