Mannan-binding lectin and healing of a radiation-induced chronic ulcer--a case report on mannan-binding lectin replacement therapy

TY - JOUR

T1 - Mannan-binding lectin and healing of a radiation-induced chronic ulcer--a case report on mannan-binding lectin replacement therapy

AU - Maaløe, Nanna

AU - Bonde, C

AU - Laursen, I

AU - Christiansen, M.

AU - Hölmich, L R

N1 - Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

PY - 2011/6

Y1 - 2011/6

N2 - Mannan-binding lectin is an important component of innate immunity, and insufficiency is associated with several clinical disorders. Recently, experimental replacement therapy with plasma-derived mannan-binding lectin has become an option. The current article presents the case of a patient with an insufficient level of mannan-binding lectin and a chronic radiation-induced ulcer following the treatment of breast cancer. After 15 months of initially conservative treatment and thereafter plastic surgery, the healing was still impaired with necrosis in the periphery of the ulcer. Immunological work-up of the patient revealed pronounced insufficiency of mannan-binding lectin. Following a 6-week experimental intravenous treatment with mannan-binding lectin purified from human plasma, that is, 0.2-0.3 mg mannan-binding lectin per kg body weight twice a week, the defect was completely healed. We suggest that deficiency of mannan-binding lectin can explain cases of otherwise unexplained impaired healing, and that replacement therapy is considered in such cases.

AB - Mannan-binding lectin is an important component of innate immunity, and insufficiency is associated with several clinical disorders. Recently, experimental replacement therapy with plasma-derived mannan-binding lectin has become an option. The current article presents the case of a patient with an insufficient level of mannan-binding lectin and a chronic radiation-induced ulcer following the treatment of breast cancer. After 15 months of initially conservative treatment and thereafter plastic surgery, the healing was still impaired with necrosis in the periphery of the ulcer. Immunological work-up of the patient revealed pronounced insufficiency of mannan-binding lectin. Following a 6-week experimental intravenous treatment with mannan-binding lectin purified from human plasma, that is, 0.2-0.3 mg mannan-binding lectin per kg body weight twice a week, the defect was completely healed. We suggest that deficiency of mannan-binding lectin can explain cases of otherwise unexplained impaired healing, and that replacement therapy is considered in such cases.

KW - Breast Neoplasms

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Injections, Intravenous

KW - Mannose-Binding Lectin

KW - Middle Aged

KW - Radiation Injuries

KW - Ulcer

KW - Wound Healing

U2 - 10.1016/j.bjps.2011.01.013

DO - 10.1016/j.bjps.2011.01.013

M3 - Journal article

C2 - 21353657

SN - 1878-0539

VL - 64

SP - e146-8

JO - Journal of plastic, reconstructive & aesthetic surgery : JPRAS

JF - Journal of plastic, reconstructive & aesthetic surgery : JPRAS

IS - 6

ER -