title: Lipopolysaccharide toxicity-regulating proteins in bacteremia.
abstract: The toxicity of lipopolysaccharide (LPS) is modified by several proteins, such as bactericidal/permeability-increasing protein (BPI) and LPS-binding protein (LBP). BPI and LBP plasma levels were measured in patients with gram-negative (n = 36) or gram-positive (n = 28) bacteremia. Levels of BPI and LBP, which are proteins that neutralize and enhance LPS effects, respectively, were increased before bacteremia was first detected. The BPI/neutrophil ratio, reflecting neutrophil activation, was significantly associated with the presence of sepsis syndrome and death in bacteremic patients: 1.06 (0.11-6.49) versus 0.57 (0.06-3.82) in patients with and without sepsis syndrome (P < .01), respectively, and 0.64 (0.06-3.82) versus 1.02 (0.12-6.49) in survivors and nonsurvivors (P < .05), respectively (ratio in nanograms of BPI per 10(6) neutrophils). High LBP peak levels were significantly associated with the presence of sepsis syndrome (P < .01). No differences in BPI and LBP levels were observed in patients with gram-negative versus gram-positive bacteremia. BPI/neutrophil ratio, as a parameter of neutrophil activation, may be useful in monitoring infectious disease.
authors.affiliation: Department of Surgery, University Hospital Maastricht, University of Limburg, Netherlands.
authors.forename: A H
authors.initials: AH
authors.lastname: Froon
authors.forename: M A
authors.initials: MA
authors.lastname: Dentener
authors.forename: J W
authors.initials: JW
authors.lastname: Greve
authors.forename: G
authors.initials: G
authors.lastname: Ramsay
authors.forename: W A
authors.initials: WA
authors.lastname: Buurman
mesh_terms: D000209:Acute-Phase Proteins / Q000032:analysis*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000097:blood; D015214:Antigens, Differentiation, Myelomonocytic / Q000097:blood; D023181:Antimicrobial Cationic Peptides; D016470:Bacteremia / Q000097:blood* / Q000401:mortality; D001798:Blood Proteins / Q000032:analysis*; D002352:Carrier Proteins / Q000097:blood*; D002452:Cell Count; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000097:blood* / Q000401:mortality; D016908:Gram-Positive Bacterial Infections / Q000097:blood / Q000401:mortality; D006801:Humans; D018950:Lipopolysaccharide Receptors; D008297:Male; D008562:Membrane Glycoproteins; D008565:Membrane Proteins; D008875:Middle Aged; D018375:Neutrophil Activation; D009504:Neutrophils; D011446:Prospective Studies; D015996:Survival Rate; D000099231:Lipopolysaccharide-Binding Protein
chemical_list: D000209:Acute-Phase Proteins; D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D023181:Antimicrobial Cationic Peptides; D001798:Blood Proteins; D002352:Carrier Proteins; D018950:Lipopolysaccharide Receptors; D008562:Membrane Glycoproteins; D008565:Membrane Proteins; D000099231:Lipopolysaccharide-Binding Protein; C021623:bactericidal permeability increasing protein