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. 2004 Nov;89(6):F551–F554. doi: 10.1136/adc.2003.030049

Lipopolysaccharide binding protein in preterm infants

D Behrendt, J Dembinski, A Heep, P Bartmann
PMCID: PMC1721788  PMID: 15499153

Abstract

Objective: To assess serum concentrations of lipopolysaccharide binding protein (LBP) in preterm infants with neonatal bacterial infection (NBI).

Methods: Blood samples were analysed of 57 preterm (28+1 to 36+6, median 33+2 weeks gestation) and 17 term infants admitted to the neonatal intensive care unit within the first 72 hours of life with suspicion of NBI. Samples were obtained at first suspicion of sepsis and after 12 and 24 hours. Diagnosis of NBI was confirmed by raised concentrations of C reactive protein and/or interleukin 6. The influence of gestational age and labour was analysed.

Results: Maximum LBP concentrations in infants with NBI were greatly increased compared with infants without NBI (13.0–46.0 µg/ml (median 20.0 µg/ml) v 0.6–17.4 µg/ml (median 4.2 µg/ml)). LBP concentrations in infected infants were not yet significantly raised when NBI was first suspected. The LBP concentrations of preterm infants were comparable to those of term infants. Regression analysis revealed no significant effect of labour or gestational age on LBP.

Conclusions: Raised LBP concentrations indicate NBI in preterm and term infants. Preterm infants of > 28 weeks gestation seem to be capable of producing LBP as efficiently as term infants. Neonatal LBP concentrations are not influenced by labour. LBP may be a useful diagnostic marker of NBI in preterm infants.

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Figure 1.

Figure 1

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 Maximum lipopolysaccharide binding protein (LBP) in infants who were positive or negative for neonatal bacterial infection (NBI). *Significantly different from NBI positive (p < 0.0001).

Figure 2.

Figure 2

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 Maximum lipopolysaccharide binding protein (LBP) concentration by gestational age group.

Figure 3.

Figure 3

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 Maximum lipopolysaccharide binding protein (LBP) concentration in infants with neonatal bacterial infection born before or after the onset of labour.

Figure 4.

Figure 4

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 Maximum lipopolysaccharide binding protein (LBP) concentration in infants without neonatal bacterial infection born before or after the onset of labour.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alt R., Erny P., Messer J., Willard D. Infections bactériennes néo-natales. Etude cinétique de la C réactive protéine et de l'orosomucoïde. Presse Med. 1984 May 26;13(22):1373–1376. [PubMed] [Google Scholar]
  2. Berner Reinhard, Fürll Birgitt, Stelter Felix, Dröse Jana, Müller Hans-Peter, Schütt Christine. Elevated levels of lipopolysaccharide-binding protein and soluble CD14 in plasma in neonatal early-onset sepsis. Clin Diagn Lab Immunol. 2002 Mar;9(2):440–445. doi: 10.1128/CDLI.9.2.440-445.2002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bessler H., Kuperman A., Beilin B., Klinger G., Gurary N., Mozes C., Sirota L. Labor affects cytokine production in newborns. Am J Reprod Immunol. 1998 Jan;39(1):27–32. doi: 10.1111/j.1600-0897.1998.tb00330.x. [DOI] [PubMed] [Google Scholar]
  4. Boujoukos A. J., Martich G. D., Supinski E., Suffredini A. F. Compartmentalization of the acute cytokine response in humans after intravenous endotoxin administration. J Appl Physiol (1985) 1993 Jun;74(6):3027–3033. doi: 10.1152/jappl.1993.74.6.3027. [DOI] [PubMed] [Google Scholar]
  5. Buonocore G., De Filippo M., Gioia D., Picciolini E., Luzzi E., Bocci V., Bracci R. Maternal and neonatal plasma cytokine levels in relation to mode of delivery. Biol Neonate. 1995;68(2):104–110. doi: 10.1159/000244225. [DOI] [PubMed] [Google Scholar]
  6. Dembinski J., Behrendt D., Heep A., Dorn C., Reinsberg J., Bartmann P. Cell-associated interleukin-8 in cord blood of term and preterm infants. Clin Diagn Lab Immunol. 2002 Mar;9(2):320–323. doi: 10.1128/CDLI.9.2.320-323.2002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Dembinski J., Behrendt D., Reinsberg J., Bartmann P. Endotoxin-stimulated production of IL-6 and IL-8 is increased in short-term cultures of whole blood from healthy term neonates. Cytokine. 2002 Apr 21;18(2):116–119. doi: 10.1006/cyto.2002.0880. [DOI] [PubMed] [Google Scholar]
  8. Doellner H., Arntzen K. J., Haereid P. E., Aag S., Austgulen R. Interleukin-6 concentrations in neonates evaluated for sepsis. J Pediatr. 1998 Feb;132(2):295–299. doi: 10.1016/s0022-3476(98)70448-2. [DOI] [PubMed] [Google Scholar]
  9. Ehl S., Gehring B., Pohlandt F. A detailed analysis of changes in serum C-reactive protein levels in neonates treated for bacterial infection. Eur J Pediatr. 1999 Mar;158(3):238–242. doi: 10.1007/s004310051058. [DOI] [PubMed] [Google Scholar]
  10. Franz A. R., Kron M., Pohlandt F., Steinbach G. Comparison of procalcitonin with interleukin 8, C-reactive protein and differential white blood cell count for the early diagnosis of bacterial infections in newborn infants. Pediatr Infect Dis J. 1999 Aug;18(8):666–671. doi: 10.1097/00006454-199908000-00003. [DOI] [PubMed] [Google Scholar]
  11. Froon A. H., Dentener M. A., Greve J. W., Ramsay G., Buurman W. A. Lipopolysaccharide toxicity-regulating proteins in bacteremia. J Infect Dis. 1995 May;171(5):1250–1257. doi: 10.1093/infdis/171.5.1250. [DOI] [PubMed] [Google Scholar]
  12. Liechty K. W., Koenig J. M., Mitchell M. D., Romero R., Christensen R. D. Production of interleukin-6 by fetal and maternal cells in vivo during intraamniotic infection and in vitro after stimulation with interleukin-1. Pediatr Res. 1991 Jan;29(1):1–4. doi: 10.1203/00006450-199101000-00001. [DOI] [PubMed] [Google Scholar]
  13. Martich G. D., Danner R. L., Ceska M., Suffredini A. F. Detection of interleukin 8 and tumor necrosis factor in normal humans after intravenous endotoxin: the effect of antiinflammatory agents. J Exp Med. 1991 Apr 1;173(4):1021–1024. doi: 10.1084/jem.173.4.1021. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Mathers N. J., Pohlandt F. Diagnostic audit of C-reactive protein in neonatal infection. Eur J Pediatr. 1987 Mar;146(2):147–151. doi: 10.1007/BF02343221. [DOI] [PubMed] [Google Scholar]
  15. Messer J., Eyer D., Donato L., Gallati H., Matis J., Simeoni U. Evaluation of interleukin-6 and soluble receptors of tumor necrosis factor for early diagnosis of neonatal infection. J Pediatr. 1996 Oct;129(4):574–580. doi: 10.1016/s0022-3476(96)70123-3. [DOI] [PubMed] [Google Scholar]
  16. Myc A., Buck J., Gonin J., Reynolds B., Hammerling U., Emanuel D. The level of lipopolysaccharide-binding protein is significantly increased in plasma in patients with the systemic inflammatory response syndrome. Clin Diagn Lab Immunol. 1997 Mar;4(2):113–116. doi: 10.1128/cdli.4.2.113-116.1997. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Opal S. M., Scannon P. J., Vincent J. L., White M., Carroll S. F., Palardy J. E., Parejo N. A., Pribble J. P., Lemke J. H. Relationship between plasma levels of lipopolysaccharide (LPS) and LPS-binding protein in patients with severe sepsis and septic shock. J Infect Dis. 1999 Nov;180(5):1584–1589. doi: 10.1086/315093. [DOI] [PubMed] [Google Scholar]
  18. Schibler K. R., Trautman M. S., Liechty K. W., White W. L., Rothstein G., Christensen R. D. Diminished transcription of interleukin-8 by monocytes from preterm neonates. J Leukoc Biol. 1993 Apr;53(4):399–403. doi: 10.1002/jlb.53.4.399. [DOI] [PubMed] [Google Scholar]
  19. 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]
  20. Wagle S., Grauaug A., Kohan R., Evans S. F. C-reactive protein as a diagnostic tool of sepsis in very immature babies. J Paediatr Child Health. 1994 Feb;30(1):40–44. doi: 10.1111/j.1440-1754.1994.tb00564.x. [DOI] [PubMed] [Google Scholar]
  21. Wasunna A., Whitelaw A., Gallimore R., Hawkins P. N., Pepys M. B. C-reactive protein and bacterial infection in preterm infants. Eur J Pediatr. 1990 Mar;149(6):424–427. doi: 10.1007/BF02009664. [DOI] [PubMed] [Google Scholar]
  22. Yachie A., Takano N., Yokoi T., Kato K., Kasahara Y., Miyawaki T., Taniguchi N. The capability of neonatal leukocytes to produce IL-6 on stimulation assessed by whole blood culture. Pediatr Res. 1990 Mar;27(3):227–233. doi: 10.1203/00006450-199003000-00005. [DOI] [PubMed] [Google Scholar]

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