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Changes of blood lipopoly saccharide activity modulating proteins and its clinical significance in patients with chronic severe viral hepatitis B
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摘要: 探讨内毒素结合蛋白 （lipopolysaccharidebindingprotein、LBP）、杀菌性 /通透性增加蛋白 （bactericidal/permeability -increasingprotein、BPI）及可溶性sCD14 （solubleCD14、sCD14 ）水平在慢重肝患者伴肠源性内毒素血症中的临床意义。应用基质显色法和ELISA双抗体夹心法 ,检测 2 4例慢重肝患者血中内毒素脂多糖（Lipopolysaccharide ,LPS）、LBP、BPI和sCD14的水平 ,并以 10例献血员和 16例慢性乙型肝炎患者作为对照。结果 :慢重肝患者在早期、中期、晚期 ,其血中LPS、LBP、BPI和sCD14的水平均明显高于慢乙肝患者及献血员 ;慢重肝死亡者其LPS、LBP、BPI和sCD14的水平也显著高于存活者 ;慢重肝患者随着病情的加重 ,LBP/BPI比值增大。慢重肝患者伴肠源性内毒素血症时 ,高水平的LBP和sCD14及相对不足的BPI ,可显著提高机体对LPS的敏感性
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关键词:
- 慢性重型肝炎 /
- 内毒素 /
- 内毒素结合蛋白 /
- 杀菌性/通透性增加蛋白 /
- 可溶性CD14
Abstract: To explore the changes of blood levels of Lipopolysaccharide (LPS) ?Lipopolysaccharide-binding protein (LBP) ?bactericidal / permeability-increasing protein? (BPI) ?soluble CD14 (sCD14) and their clinical significance in patients with chronic severe viral hepatitis B. The blood levels of LPS were detected with chromogenic limulus amebocyte lysate assay and LBP?BPI and sCD14 were detected with ELISA in 24 patients of chronic severe viral hepatitis B while 10 normal subjects and 16 patients with chronic hepatitis B were used as controls. The blood levels of LPS?LBP?BPI and sCD14 were significantly higher than in patients with the early stage?midterm?later period of chronic severe viral hepatitis B than in normal subjects. and those with chronic hepatitis B. The blood levels of LPS?LBP?BPI and sCD14 were also significantly higher in patients who died of chronic severe viral hepatitis B than in chronic severe viral hepatitis B survivors. So higher LBP?LPS and relative deficiency of BPI levels in patients with chronic severe viral hepatitis B accompanied by Intestinal endotoxemia (IETM) may significantly increase the sensitivity of body to endotoxin. administration of monoclonal anti-LBP antibody?monoclonal anti-CD14 antibody and the recombinant BPI is effective in attenuating LPS to hepatocyte injury. -
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