• Yun-tao Zhang, Guo-juan Ding, and Qiang Fang.
• Intensive Care Unit, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou 310003, Zhejiang, China. zhangyutao@zju.edu.cn
• Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2006 Feb 1;18(2):78-81.

ObjectiveTo investigate the changes in serum lipopolysaccharide binding protein (LBP) and soluble CD14 (sCD14) levels in severe sepsis patients, and their relationship with severity and prognosis of patients.MethodsSerum concentration of LBP and sCD14 were measured by enzyme linked immuno adsorbent assay (ELISA) at different periods after the onset of severe sepsis in 41 patients. Serum concentrations of procalcitonin (PCT) and lipopolysaccharide (LPS) were determined within 24 hours of onset of severe sepsis. The relationship between all the determinations and the clinical picture and prognosis of the patients was analyzed.ResultsSignificantly higher than normal serum concentrations of LBP and sCD14 were found in severe sepsis patients (all P<0.01). There was no significant difference in LBP serum levels between non-survivors and survivors (all P>0.05). But sCD14 serum levels were significantly higher in non-survivors (all P<0.05). There was no correlation between serum LBP levels and PCT or acute physiology and chronic health evaluation II (APACHE II) at day 0. Serum LBP level was positively correlated with that of LPS significantly. There was significant positive correlation between serum sCD14 levels and PCT, APACHE II at day 0, but no correlation between sCD14 and LPS.ConclusionSignificantly elevated serum concentrations of LBP and sCD14 are found in severe sepsis patients. LBP level reflects mainly systemic inflammatory response induced by LPS, and it cannot be used as an indicator of severity of sepsis and prognosis of the patient. In contrast, serum sCD14 level may be used as a prognostic marker in severe sepsis, as it can reflect the severity of sepsis in certain degree.

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