Relationship between plasma levels of lipopolysaccharide (LPS) and LPS-binding protein in patients with severe sepsis and septic shock.
Plasma endotoxin and lipopolysaccharide-binding protein (LBP) levels were measured in a group of 253 patients at the onset of severe sepsis and/or septic shock. Endotoxin levels were significantly greater than control levels (n=33; mean +/- SD, 5.1+/-7.3 pg/mL) in 78.3% of patients. Median endotoxin levels in patients with sepsis were 300 pg/mL (25%-75% interquartile range, 110-726 pg/mL). LBP levels were elevated in 97% of patients compared with normal control values of 4.1+/-1.65 microgram/mL. Median LBP levels in patients with sepsis were 31.2 microgram/mL (interquartile range, 22.5-47.7 microgram/mL). Median endotoxin levels at study entry were more highly elevated (515 vs. 230 pg/mL; P<.01), and LBP levels were less highly elevated (28.0 vs. 33.2 microgram/mL; P<.05) in nonsurvivors than survivors over the 28-day study period. No correlation was found between endotoxin and LBP levels. The quantitative level of both endotoxin and LBP may have prognostic significance in patients with severe sepsis.
Opal
S M
SM
Infectious Disease Division, Brown University School of Medicine and Memorial Hospital of Rhode Island, Providence, Rhode Island 02860, USA. Steven_Opal@brown.edu
Scannon
P J
PJ
Vincent
J L
JL
White
M
M
Carroll
S F
SF
Palardy
J E
JE
Parejo
N A
NA
Pribble
J P
JP
Lemke
J H
JH
D000209:Acute-Phase Proteins; D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000097:blood*; D002352:Carrier Proteins / Q000097:blood*; D004731:Endotoxins / Q000097:blood*; D005260:Female; D016469:Fungemia / Q000097:blood*; D006801:Humans; D008070:Lipopolysaccharides / Q000097:blood*; D008297:Male; D008562:Membrane Glycoproteins; D008875:Middle Aged; D011379:Prognosis; D012772:Shock, Septic / Q000097:blood*; D000099231:Lipopolysaccharide-Binding Protein
D000209:Acute-Phase Proteins; D002352:Carrier Proteins; D004731:Endotoxins; D008070:Lipopolysaccharides; D008562:Membrane Glycoproteins; D000099231:Lipopolysaccharide-Binding Protein