Abstract
Currently, there is no way to predict with a high degree of sensitivity and specificity which patients are likely to develop systemic inflammatory response syndrome (SIRS) following systemic infection, trauma, organ rejection, or blood loss. The level of human lipopolysaccharide-binding protein (LBP) was determined in the plasma of 22 patients with a clinical diagnosis of early SIRS. Twenty-nine plasma samples from healthy volunteers were used as controls. The mean level of LBP in the plasma of healthy volunteers was 7.7 micrograms/ml (standard deviation, 6.2 micrograms/ml). Twenty-one of 22 patients (95%) with SIRS had an LBP level on admission at least 2 standard deviations above the mean LBP level for a healthy volunteer control group (range, 4.9 to 114.2 micrograms/ml; mean, 36.6 micrograms/ml; standard deviation, 22.2 micrograms/ml; P < 0.0001). The level of LBP in the plasma of the majority of patients with early SIRS is significantly increased compared to that in healthy controls. The sensitivity, specificity, and predictive value of elevated plasma LBP levels in patients with SIRS remain to be determined.
Full Text
The Full Text of this article is available as a PDF (151.3 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Abraham E., Wunderink R., Silverman H., Perl T. M., Nasraway S., Levy H., Bone R., Wenzel R. P., Balk R., Allred R. Efficacy and safety of monoclonal antibody to human tumor necrosis factor alpha in patients with sepsis syndrome. A randomized, controlled, double-blind, multicenter clinical trial. TNF-alpha MAb Sepsis Study Group. JAMA. 1995 Mar 22;273(12):934–941. [PubMed] [Google Scholar]
- Beal A. L., Cerra F. B. Multiple organ failure syndrome in the 1990s. Systemic inflammatory response and organ dysfunction. JAMA. 1994 Jan 19;271(3):226–233. [PubMed] [Google Scholar]
- Bone R. C., Balk R. A., Cerra F. B., Dellinger R. P., Fein A. M., Knaus W. A., Schein R. M., Sibbald W. J. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest. 1992 Jun;101(6):1644–1655. doi: 10.1378/chest.101.6.1644. [DOI] [PubMed] [Google Scholar]
- Bone R. C., Balk R. A., Fein A. M., Perl T. M., Wenzel R. P., Reines H. D., Quenzer R. W., Iberti T. J., Macintyre N., Schein R. M. A second large controlled clinical study of E5, a monoclonal antibody to endotoxin: results of a prospective, multicenter, randomized, controlled trial. The E5 Sepsis Study Group. Crit Care Med. 1995 Jun;23(6):994–1006. doi: 10.1097/00003246-199506000-00003. [DOI] [PubMed] [Google Scholar]
- Bone R. C. Sepsis, sepsis syndrome, and the systemic inflammatory response syndrome (SIRS). Gulliver in Laputa. JAMA. 1995 Jan 11;273(2):155–156. [PubMed] [Google Scholar]
- Calvano S. E., Thompson W. A., Marra M. N., Coyle S. M., de Riesthal H. F., Trousdale R. K., Barie P. S., Scott R. W., Moldawer L. L., Lowry S. F. Changes in polymorphonuclear leukocyte surface and plasma bactericidal/permeability-increasing protein and plasma lipopolysaccharide binding protein during endotoxemia or sepsis. Arch Surg. 1994 Feb;129(2):220–226. doi: 10.1001/archsurg.1994.01420260116016. [DOI] [PubMed] [Google Scholar]
- Cross A. S., Sidberry H., Sadoff J. C. The human antibody response during natural bacteremic infection with gram-negative bacilli against lipopolysaccharide core determinants. J Infect Dis. 1989 Aug;160(2):225–236. doi: 10.1093/infdis/160.2.225. [DOI] [PubMed] [Google Scholar]
- Fisher C. J., Jr, Dhainaut J. F., Opal S. M., Pribble J. P., Balk R. A., Slotman G. J., Iberti T. J., Rackow E. C., Shapiro M. J., Greenman R. L. Recombinant human interleukin 1 receptor antagonist in the treatment of patients with sepsis syndrome. Results from a randomized, double-blind, placebo-controlled trial. Phase III rhIL-1ra Sepsis Syndrome Study Group. JAMA. 1994 Jun 15;271(23):1836–1843. [PubMed] [Google Scholar]
- Gallay P., Barras C., Tobias P. S., Calandra T., Glauser M. P., Heumann D. Lipopolysaccharide (LPS)-binding protein in human serum determines the tumor necrosis factor response of monocytes to LPS. J Infect Dis. 1994 Nov;170(5):1319–1322. doi: 10.1093/infdis/170.5.1319. [DOI] [PubMed] [Google Scholar]
- Greenman R. L., Schein R. M., Martin M. A., Wenzel R. P., MacIntyre N. R., Emmanuel G., Chmel H., Kohler R. B., McCarthy M., Plouffe J. A controlled clinical trial of E5 murine monoclonal IgM antibody to endotoxin in the treatment of gram-negative sepsis. The XOMA Sepsis Study Group. JAMA. 1991 Aug 28;266(8):1097–1102. [PubMed] [Google Scholar]
- Grube B. J., Cochane C. G., Ye R. D., Green C. E., McPhail M. E., Ulevitch R. J., Tobias P. S. Lipopolysaccharide binding protein expression in primary human hepatocytes and HepG2 hepatoma cells. J Biol Chem. 1994 Mar 18;269(11):8477–8482. [PubMed] [Google Scholar]
- Heumann D., Gallay P., Le Roy D., Landmann R., Glauser M. P. Radioimmunoassay versus flow cytometric assay to quantify LPS-binding protein (LBP) concentrations in human plasma. J Immunol Methods. 1994 May 16;171(2):169–176. doi: 10.1016/0022-1759(94)90037-x. [DOI] [PubMed] [Google Scholar]
- Michie H. R., Manogue K. R., Spriggs D. R., Revhaug A., O'Dwyer S., Dinarello C. A., Cerami A., Wolff S. M., Wilmore D. W. Detection of circulating tumor necrosis factor after endotoxin administration. N Engl J Med. 1988 Jun 9;318(23):1481–1486. doi: 10.1056/NEJM198806093182301. [DOI] [PubMed] [Google Scholar]
- Opal S. M., Palardy J. E., Marra M. N., Fisher C. J., Jr, McKelligon B. M., Scott R. W. Relative concentrations of endotoxin-binding proteins in body fluids during infection. Lancet. 1994 Aug 13;344(8920):429–431. doi: 10.1016/s0140-6736(94)91767-1. [DOI] [PubMed] [Google Scholar]
- Parrillo J. E. Management of septic shock: present and future. Ann Intern Med. 1991 Sep 15;115(6):491–493. doi: 10.7326/0003-4819-115-6-491. [DOI] [PubMed] [Google Scholar]
- Parrillo J. E., Parker M. M., Natanson C., Suffredini A. F., Danner R. L., Cunnion R. E., Ognibene F. P. Septic shock in humans. Advances in the understanding of pathogenesis, cardiovascular dysfunction, and therapy. Ann Intern Med. 1990 Aug 1;113(3):227–242. doi: 10.7326/0003-4819-113-3-227. [DOI] [PubMed] [Google Scholar]
- Ramadori G., Meyer zum Buschenfelde K. H., Tobias P. S., Mathison J. C., Ulevitch R. J. Biosynthesis of lipopolysaccharide-binding protein in rabbit hepatocytes. Pathobiology. 1990;58(2):89–94. doi: 10.1159/000163569. [DOI] [PubMed] [Google Scholar]
- Rangel-Frausto M. S., Pittet D., Costigan M., Hwang T., Davis C. S., Wenzel R. P. The natural history of the systemic inflammatory response syndrome (SIRS). A prospective study. JAMA. 1995 Jan 11;273(2):117–123. [PubMed] [Google Scholar]
- Schumann R. R., Leong S. R., Flaggs G. W., Gray P. W., Wright S. D., Mathison J. C., Tobias P. S., Ulevitch R. J. Structure and function of lipopolysaccharide binding protein. Science. 1990 Sep 21;249(4975):1429–1431. doi: 10.1126/science.2402637. [DOI] [PubMed] [Google Scholar]
- Theofan G., Horwitz A. H., Williams R. E., Liu P. S., Chan I., Birr C., Carroll S. F., Mészáros K., Parent J. B., Kasler H. An amino-terminal fragment of human lipopolysaccharide-binding protein retains lipid A binding but not CD14-stimulatory activity. J Immunol. 1994 Apr 1;152(7):3623–3629. [PubMed] [Google Scholar]
- Tobias P. S., Soldau K., Ulevitch R. J. Identification of a lipid A binding site in the acute phase reactant lipopolysaccharide binding protein. J Biol Chem. 1989 Jun 25;264(18):10867–10871. [PubMed] [Google Scholar]
- Tobias P. S., Soldau K., Ulevitch R. J. Isolation of a lipopolysaccharide-binding acute phase reactant from rabbit serum. J Exp Med. 1986 Sep 1;164(3):777–793. doi: 10.1084/jem.164.3.777. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tobias P. S., Ulevitch R. J. Control of lipopolysaccharide-high density lipoprotein binding by acute phase protein(s). J Immunol. 1983 Oct;131(4):1913–1916. [PubMed] [Google Scholar]
- Wright S. D., Ramos R. A., Tobias P. S., Ulevitch R. J., Mathison J. C. CD14, a receptor for complexes of lipopolysaccharide (LPS) and LPS binding protein. Science. 1990 Sep 21;249(4975):1431–1433. doi: 10.1126/science.1698311. [DOI] [PubMed] [Google Scholar]
- Ziegler E. J., Fisher C. J., Jr, Sprung C. L., Straube R. C., Sadoff J. C., Foulke G. E., Wortel C. H., Fink M. P., Dellinger R. P., Teng N. N. Treatment of gram-negative bacteremia and septic shock with HA-1A human monoclonal antibody against endotoxin. A randomized, double-blind, placebo-controlled trial. The HA-1A Sepsis Study Group. N Engl J Med. 1991 Feb 14;324(7):429–436. doi: 10.1056/NEJM199102143240701. [DOI] [PubMed] [Google Scholar]