[Clinical study of serum lipopolysaccharide-binding protein and soluble CD14 in severe sepsis patients].
OBJECTIVE
To investigate the changes in serum lipopolysaccharide binding protein (LBP) and soluble CD14 (sCD14) levels in severe sepsis patients, and their relationship with severity and prognosis of patients.


METHODS
Serum concentration of LBP and sCD14 were measured by enzyme linked immuno adsorbent assay (ELISA) at different periods after the onset of severe sepsis in 41 patients. Serum concentrations of procalcitonin (PCT) and lipopolysaccharide (LPS) were determined within 24 hours of onset of severe sepsis. The relationship between all the determinations and the clinical picture and prognosis of the patients was analyzed.


RESULTS
Significantly higher than normal serum concentrations of LBP and sCD14 were found in severe sepsis patients (all P<0.01). There was no significant difference in LBP serum levels between non-survivors and survivors (all P>0.05). But sCD14 serum levels were significantly higher in non-survivors (all P<0.05). There was no correlation between serum LBP levels and PCT or acute physiology and chronic health evaluation II (APACHE II) at day 0. Serum LBP level was positively correlated with that of LPS significantly. There was significant positive correlation between serum sCD14 levels and PCT, APACHE II at day 0, but no correlation between sCD14 and LPS.


CONCLUSIONS
Significantly elevated serum concentrations of LBP and sCD14 are found in severe sepsis patients. LBP level reflects mainly systemic inflammatory response induced by LPS, and it cannot be used as an indicator of severity of sepsis and prognosis of the patient. In contrast, serum sCD14 level may be used as a prognostic marker in severe sepsis, as it can reflect the severity of sepsis in certain degree.
Zhang
Yun-tao
YT
Intensive Care Unit, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou 310003, Zhejiang, China. zhangyutao@zju.edu.cn
Ding
Guo-juan
GJ
Fang
Qiang
Q
D000209:Acute-Phase Proteins; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002352:Carrier Proteins / Q000097:blood*; D005260:Female; D006801:Humans; D018950:Lipopolysaccharide Receptors / Q000097:blood*; D008297:Male; D008562:Membrane Glycoproteins / Q000097:blood*; D008875:Middle Aged; D011379:Prognosis; D018805:Sepsis / Q000097:blood*; D000099231:Lipopolysaccharide-Binding Protein
D000209:Acute-Phase Proteins; D002352:Carrier Proteins; D018950:Lipopolysaccharide Receptors; D008562:Membrane Glycoproteins; D000099231:Lipopolysaccharide-Binding Protein