Lipopolysaccharide binding protein (LBP) as a marker of protein leakage in cerebrospinal fluid

Abstract
The presence of functional lipopolysaccharide binding protein (LBP) was investigated in cerebrospinal fluid (CSF) samples of patients with neurological disorders. LBP was detected in CSF by RIA and by a bioassay that measures the ability of LBP to present LPS to human monocytes. Mean concentration of LBP was 1.72 μg/ml in normal CSF, i.e. 1/10 of the concentration measured in normal plasma. LBP concentration was found to be increased in CSF of patients with neurological disorders associated with increased protein levels in CSF, in patients with meningitis/encephalitis and with compressing tumors. LBP levels correlated with protein levels, but not with the clinical presentation. Even in normal CSF, LBP was present in concentrations sufficient to trigger maximal activation of monocytes upon LPS challenge, as measured by tumor necrosis factor induction of mRNA and protein synthesis. The role played by LBP in CSF remains to be determined. However, because it is present and functionally fully active, LBP could play a detrimental role in CSF in the presence of low concentrations of LPS during episodes of Gram-negative infections.

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