LIPOPOLYSACCHARIDE TOXICITY-REGULATING PROTEINS IN BACTEREMIA

The toxicity of lipopolysaccharide (LPS) is modified by several protei ns, such as bactericidal/permeability-increasing protein (BPI) and LPS -binding protein (LBP). BPI and LBP plasma levels were measured in pat ients with gram-negative (n = 36) or gram-positive (n = 28) bacteremia . Levels of BPI and LBP, which are proteins that neutralize and enhanc e LPS effects, respectively, were increased before bacteremia was firs t detected. The BPI/neutrophil ratio, reflecting neutrophil activation , was significantly associated with the presence of sepsis syndrome an d death in bacteremic patients: 1.06 (0.11-6.49) versus 0.57 (0.06-3.8 2) in patients with and without sepsis syndrome (P < .01), respectivel y, and 0.64 (0.06-3.82) versus 1.02 (0.12-6.49) in survivors and nonsu rvivors (P < .05), respectively (ratio in nanograms of BPI per 10(6) n eutrophils). High LBP peak levels were significantly associated with t he presence of sepsis syndrome (P < .01). No differences in BPI and LB P levels were observed in patients with gram-negative versus gram-posi tive bacteremia. BPI/neutrophil ratio, as a parameter of neutrophil ac tivation, may be useful in monitoring infectious disease.