Elevated levels of lipopolysaccharide-binding protein and soluble CD14 in plasma in neonatal early-onset sepsis.
No data on lipopolysaccharide-binding protein (LBP) in newborns with sepsis have been available up to now. We therefore determined levels of LBP and soluble CD14 (sCD14) in plasma of healthy and septic neonates in order to evaluate their potential diagnostic role. The study included prospectively collected patient samples of two recently published studies on cytokine expression in neonatal sepsis. Twenty-nine septic patients were enrolled in the present analysis. Samples--either cord blood or peripheral blood--from patients admitted within the first 24 h of life for suspicion of sepsis and cord blood samples of a control group of 40 healthy mature infants delivered spontaneously were analyzed. For seven patients of the septic group, a second sample collected between 24 and 48 h of life was available. Levels of sCD14 and LBP in plasma were determined by an enzyme immunoassay using recombinant CD14 and LBP as standards. LBP and sCD14 were correlated to cytokine plasma levels. In septic neonates, LBP (median, 36.6 versus 7.8 microg/ml; P < 0.001) and sCD14 (median, 0.42 versus 0.28 microg/ml; P < 0.001) levels were highly elevated when compared to those of healthy neonates and strongly correlated to granulocyte colony-stimulating factor (G-CSF), interleukin-1beta (IL-1beta), IL-6, and IL-8 levels. LBP levels in septic neonates analyzed between 24 and 48 h of life even increased when compared to samples obtained at or shortly after delivery (median, 36.6 versus 60 microg/ml; P = 0.038). In summary, levels of LBP in plasma of neonates with early-onset sepsis are significantly elevated; the elevated plasma levels seem to persist for more than 24 h, which could provide the clinician with a prolonged time period to identify the newborn with bacterial sepsis.
Berner
Reinhard
R
University Children's Hospital, D-79106 Freiburg, Germany. berner@kikli.ukl.uni-freiburg.de
Fürll
Birgitt
B
Stelter
Felix
F
Dröse
Jana
J
Müller
Hans-Peter
HP
Schütt
Christine
C
D000209:Acute-Phase Proteins; D000210:Acute-Phase Reaction / Q000097:blood; D015415:Biomarkers; D002352:Carrier Proteins / Q000097:blood*; D016207:Cytokines / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D018950:Lipopolysaccharide Receptors / Q000097:blood*; D008562:Membrane Glycoproteins; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis* / Q000276:immunology; D012995:Solubility; D000099231:Lipopolysaccharide-Binding Protein
D000209:Acute-Phase Proteins; D015415:Biomarkers; D002352:Carrier Proteins; D016207:Cytokines; D018950:Lipopolysaccharide Receptors; D008562:Membrane Glycoproteins; D000099231:Lipopolysaccharide-Binding Protein