Diagnostic accuracy of lipopolysaccharide-binding protein for sepsis in patients with suspected infection in the emergency department

Abstract

Background Biomarkers can facilitate the diagnosis of sepsis, enabling early management and improving outcomes. Lipopolysaccharide-binding protein (LBP) has been reported as a biomarker for the detection of infection, but its diagnostic value is controversial. In this study, we assessed the diagnostic accuracy of LBP for sepsis in the emergency department (ED) patients, comparing it with more established biomarkers of sepsis, including procalcitonin (PCT) and C-reactive protein (CRP). Methods LBP and other sepsis biomarkers, including PCT and CRP, were measured on admission in 102 adult patients presenting with suspected infection . Classification of patients was performed using the recently updated definition for sepsis (Sepsis-3). The diagnostic accuracy of LBP, CRP and PCT for sepsis was evaluated by using receiver operating characteristic curve (ROC) analysis. Results A total of 49 patients were classified as having sepsis. In these patients, median (interquartile range) LBP (41.8 [41.1] µg/dL vs. 26.2 [25] µg/dL), CRP (240 [205] mg/L vs. 160 [148] mg/dL) and PCT (5.19 [13.68] µg/L vs. 0.39 [1.09] µg/L) were significantly higher than in patients classified as not having sepsis ( P < 0.001 for all three biomarkers). ROC curve analysis and area under curve (AUC) revealed a value of 0.701 for LBP, similar to CRP (0.707) and lower than that for PCT (0.844) ( P = 0.012). Conclusion In adult ED patients with suspected infection, the diagnostic accuracy for sepsis of LBP is similar to that of CRP but lower than that of PCT.

Proteomic Signature of Urosepsis: From Discovery in a Rabbit Model to Validation in Humans

“…LBP has an important role in the innate immune response, which binds to the lipid A moiety of LPS and promotes the release of cytokines. , In accordance with our result, García et al found that the diagnostic efficacy of LBP for sepsis was similar to that of CRP but lower than that of PCT in a study of 102 patients with suspected infections in the emergency department . Another study in rats revealed that blocking LBP by administration of a specific blockade peptide LBPK95A could significantly inhibit neutrophils infiltration .…”

Biomarkers of sepsis: time for a reappraisal

“…Although PCT is considered superior to CRP in many studies [139,140], it is not a definitive test for diagnosing sepsis because PCT levels can also be increased in other conditions [141]. PCT, similar to CRP, may be more useful to rule out sepsis than to diagnose it [142][143][144], and the combination of these two biomarkers may improve their Table 2 Sepsis biomarkers, except for C-reactive protein (CRP) and procalcitonin (PCT), that have been evaluated for their prognostic value in clinical studies with more than 300 subjects (Continued) Lipopolysaccharidebinding protein ED patients with sepsis ED patients with infection No better than PCT [40] Non-critically ill patients with sepsis Non-critically ill patients with infection…”

LBP rs2232618 polymorphism contributes to risk of sepsis after trauma

“…During sepsis, previous studies suggested that levels of serum LBP elevated almost seven times higher than normal levels [ 24 ]. Therefore, LBP might be a promising tool for the early clinical diagnosis of sepsis and appropriated in differentiating sepsis and systemic inflammatory response syndrome (SIRS) [ 25 ]. It was reasonable to suppose the SNP affecting the expression or activities of LBP might also have influence on individual susceptibility for sepsis.…”