Lipopolysaccharide binding protein in cirrhotic patients with severe sepsis

Jau Min Lien, Yun Shing Peng, Yung Chang Chen, Ya Chung Tian, Ji Tseng Fang, Pang Chi Chen, Chih Wei Yang, Cheng Shyong Wu, Ming Hung Tsai

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Background: Lipopolysaccharide binding protein (LBP) is an acute-phase protein produced by the liver. It has been shown that LBP plays an important role in the inflammatory response to sepsis. LBP has also been shown to protect animals from endotoxin challenge by facilitating the removal of endotoxin from the blood circulation. Cirrhotic patients are susceptible to bacterial infection. It is unknown whether pre-existing liver dysfunction impacts the LBP levels and thus the prognosis in severe sepsis. Methods: We evaluated the serum LBP, inflammatory cytokines, and the relationship between LBP concentrations, functional liver reserve and outcomes in 58 critically ill cirrhotic patients with severe sepsis. Results: The serum LBP levels were significantly higher in 28-day survivors, while the interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were significantly higher in non-survivors. We analyzed the receiver operating characteristic (ROC) curve to determine the cut-off point for LBP to predict 28-day mortality. The cumulative rates at 28 days were 58.3% versus 16.7% for the high LBP group (>46 ng/mL) and low LBP group (<46 ng/mL) (p < 0.001). The high-LBP group had significantly lower INR, Child-Pugh, Model for End-stage Liver Disease (MELD) scores and TNF-α level. Meanwhile, the LBP levels were inversely correlated with INR, and Child-Pugh, MELD and sequential organ failure assessment (SOFA) scores. Conclusion: The concentration of LBP is associated inversely with disease severity scores and outcomes in critically ill cirrhotic patients with severe sepsis.

Original languageEnglish
Pages (from-to)68-74
Number of pages7
JournalJournal of the Chinese Medical Association
Volume77
Issue number2
DOIs
Publication statusPublished - Feb 2014

Keywords

  • Lipopolysaccharide binding protein
  • Liver cirrhosis
  • Severe sepsis

ASJC Scopus subject areas

  • Medicine(all)

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