Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Endotoxin initiates the systemic inflammatory response, haemodynamic changes, and multi-organ failure that may occur as a consequence of systemic gram-negative bacterial infection. The serum protein lipopolysaccharide-binding protein (LBP) binds to the lipid A component of bacterial endotoxin and facilitates its delivery to the CD14 antigen on the macrophage, where inflammatory cytokines are released and a cascade of host mediators is initiated. The neutrophil granular protein bactericidal/permeability-increasing protein (BPI) competes with LBP for endotoxin binding and functions as a molecular antagonist of LBP-endotoxin interactions. We have measured concentrations of both proteins in body fluids from 49 consecutive patients. In 16 of 17 samples of fluid from closed-space infections, BPI was present in greater concentration than LBP (median BPI/LBP ratio 7.6 [95% CI 2.32-22.1]). The ratio of BPI and LBP was not significantly different from 1.0 in abdominal fluid from 10 patients with peritonitis (ratio 0.235 [0.18-0.47]), whereas the BPI/LBP ratio was low in 22 non-infected body fluids (0.01 [0.001-0.04]) and concentrations of both proteins approached those in normal human plasma. BPI concentrations were directly correlated with the quantity of neutrophils within clinical samples (rs = 0.81, p < 0.0001). Thus, within abscess cavities BPI is available in sufficient quantities for effective competition with LBP for endotoxin. BPI may attenuate the local inflammatory response and the systemic toxicity of endotoxin release during gram-negative infections.
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PMID:Relative concentrations of endotoxin-binding proteins in body fluids during infection. 752 Jan 6

During systemic infection, the serum lipopolysaccharide binding protein (LBP) binds to the lipid A component of bacterial endotoxins and facilitates its delivery to the CD 14 receptor on the cell surface of macrophages, where proinflammatory cytokines are released. There is no knowledge to date whether LBP is also present in the effluent of patients with continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis. We investigated the dialysis effluent of 37 patients with CAPD peritonitis for immunoreactive LBP, tumor necrosis factor (TNF)-alpha, and interleukin (IL)-1 beta and compared the findings with the cytokine levels in 20 noninfected CAPD patients. The mean +/- SEM concentrations of LBP, TNF-alpha, and IL-1 beta were significantly higher in the effluent of patients with peritonitis than in noninfected CAPD effluent. In comparison to controls (0.23 +/- 0.05 microgram/mL), LBP was 0.68 +/- 0.13 microgram/mL in the effluent of patients with CAPD-associated infectious peritonitis. For TNF-alpha, levels were 0.50 +/- 0.25 pg/mL in the control effluent versus 124.7 +/- 46.6 pg/mL in the effluent of peritonitis patients. For IL-1 beta the levels were 0.24 +/- 0.14 pg/mL in the control effluent and 71.23 +/- 17.53 pg/mL in the peritonitis patients. Our findings demonstrate that LBP is significantly elevated in the effluent of CAPD patients during an episode of CAPD-associated peritonitis and might be used as a marker of intraperitoneal bacterial infection.
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PMID:Lipopolysaccharide binding protein: a marker for intraperitoneal bacterial infection in patients with CAPD peritonitis. 936 Jun 83