Investigation of Mannose–Binding Lectin Level and Deficiency in Patients With Dermatophytosis

Background: Dermatophytosis is a cutaneous fungal infection with a worldwide occurrence. In dermatophyte infections, the release of keratinocyte cytokines, in the presence of dermatophyte antigens, causes an acute phase response; subsequently, the acute-phase proteins are produced by hepatocytes. Mannose–binding lectin (MBL), an acute-phase protein, also acts as a kind of pattern recognition receptor. MBL deficiency plays a role in susceptible viral, bacterial, fungal and parasitic infections.

Objectives: Some research has been conducted on the role of acute-phase proteins in dermatophyte infections. This study has been designed to determine the serum MBL levels in patients with dermatophytosis.

Materials and Methods: This cross-sectional study, included 96 healthy individuals and 105 patients with dermatophytosis, in access sampling procedure. Microscopic examinations were conducted and cultivated to detect dermatophytes, and in the cases that the identification of different dermatophyte species was necessary, complementary examinations were conducted. Additionally, the enzyme–linked immunosorbent assay (ELISA) was used to determine the serum MBL levels of healthy individuals and patients. Various tests (Chi-square, Fisher exact, Mann - Whitney, Kruskal Wallis, Kendal tau correlation coefficient and ROC curve analysis) were used to examine the relationships between variables, when the P < 0.05 were considered as significant level.

Results: The mean serum MBL level of healthy individuals and patients, was 1.53 ± 1.87 µg/mL and 1.97 ± 2.03 µg/mL (P = 0.039), respectively. Using ROC curve analysis, the MBL level was established as a significant predictor of dermatophytosis (P = 0.042). MBL deficiency (serum level < 1 µg/mL) was more common in healthy group (56.2%) than the patients with dermatophytosis (41.0%).

Conclusions: The findings showed that the increased concentrations of serum MBL in patients with dermatophytosis play a role in this fungal infection. The high frequency of MBL deficiency in healthy individuals was compared with patients indicated that MBL deficiency is not a predisposing factor of this type of infection.