Lipopolysaccharide Toxicity-Regulating Proteins in Bacteremia

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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 106 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 beuseful in monitoring infectious disease,

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