Mannose Binding Lectin in Nephrology

The complement system is a mediator and marker of renal damage. There are three pathways of complement activation: classical, alternative and lectin pathway. Lectin pathway is initiated by binding of mannose-binding lectin (MBL) which recognize patterns of carbohydrate ligands that are found on the surface of a wide variety of microorganisms. The variation in MBL levels is important in the development of renal diseases. Lower MBL levels are associated with increased risk of infection. Dialysis patients who have lower MBL levels are associated with higher incidence of spontaneous bacterial peritonitis. Furthermore, MBL levels influence the outcome in kidney transplantation, higher pre-transplant MBL levels are associated with poorer greft survival. Inflammation and complement activation by MBL pathway have been suggested to play a role in pathogenesis of diabetic microvascular complications. The complement and MBL deposition is detected in kidney biopsies of patients with IgA nephropathy and Henoch-Schönlein vasculitis, systemic lupus erythematosus. The MBL pathway of complement system contributes to renal damage in many diseases. Understanding MBL will aid us to understand the pathophysiology of renal diseases and provide support for making the correct diagnosis and treatment.