Plasma bactericidal/permeability-increasing protein concentrations in critically ill children with the sepsis syndrome.
Bactericidal/permeability-increasing protein (BPI) is a neutrophil azurophilic granule component that is bactericidal towards Gram-negative bacteria and inhibits lipopolysaccharide-mediated inflammatory responses. We conducted a prospective study to measure plasma BPI concentrations in 36 critically ill children with and without the sepsis syndrome. Plasma BPI concentrations ranged from 0.5 to 452 ng/ml. Patients with the sepsis syndrome had higher median plasma BPI concentrations than critically ill controls (5.1 vs. 1.8 ng/ml, P = 0.006). Patients with organ system failure had higher median plasma BPI concentrations than those with no organ system failure (4.5 vs. 1.3 ng/ml, P = 0.001). Plasma BPI concentrations were positively associated with pediatric risk of mortality score (P = 0.03, rs = 0.4). These data provide the first clinical insights regarding the role of endogenous BPI production in critically ill children and suggest that BPI may play an important role in host defenses.
Wong
H R
HR
Department of Anesthesiology/Critical Care Medicine, University of Pittsburgh School of Medicine, PA, USA.
Doughty
L A
LA
Wedel
N
N
White
M
M
Nelson
B J
BJ
Havrilla
N
N
Carcillo
J A
JA
D000900:Anti-Bacterial Agents / Q000097:blood*; D023181:Antimicrobial Cationic Peptides; D001770:Blood Bactericidal Activity; D001798:Blood Proteins / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008565:Membrane Proteins; D011446:Prospective Studies; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood*
D000900:Anti-Bacterial Agents; D023181:Antimicrobial Cationic Peptides; D001798:Blood Proteins; D008565:Membrane Proteins; C021623:bactericidal permeability increasing protein