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Plasma bactericidal/permeability-increasing protein concentrations in critically ill children with the sepsis
H R Wong1, L A Doughty, N Wedel
1Department of Anesthesiology/Critical Care Medicine, University of Pittsburgh School of Medicine, PA, USA.
Insights
Critically ill children with sepsis syndrome show higher levels of bactericidal/permeability-increasing protein (BPI). Elevated BPI concentrations correlate with organ system failure and mortality risk in pediatric sepsis.
Area of Science:
- Immunology
- Pediatric Critical Care
- Biochemistry
Background:
- Bactericidal/permeability-increasing protein (BPI) is a key component of neutrophil azurophilic granules.
- BPI exhibits bactericidal activity against Gram-negative bacteria and modulates lipopolysaccharide-induced inflammation.
Purpose of the Study:
- To investigate plasma BPI concentrations in critically ill children.
- To assess the relationship between BPI levels and sepsis syndrome, organ system failure, and mortality risk in pediatric patients.
Main Methods:
- A prospective study was conducted with 36 critically ill children.
- Plasma BPI concentrations were measured using quantitative assays.
- Statistical analyses were performed to compare BPI levels between groups and assess correlations.
Main Results:
- Patients with sepsis syndrome had significantly higher median plasma BPI concentrations compared to critically ill controls (5.1 vs. 1.8 ng/ml, P = 0.006).
- Higher BPI levels were observed in children with organ system failure (4.5 vs. 1.3 ng/ml, P = 0.001).
- Plasma BPI concentrations showed a positive association with the pediatric risk of mortality score (P = 0.03, rs = 0.4).
Conclusions:
- This study provides initial clinical evidence on endogenous BPI production in critically ill children.
- BPI may play a significant role in the host defense mechanisms against Gram-negative bacterial infections and sepsis in pediatric populations.
Abstract:
Bactericidal/permeability-increasing protein (BPI) is a neutrophil azurophilic granule component that is bactericidal towards Gram-negative bacteria and inhibits lipopolysaccharide-mediated inflammatory responses. We conducted a prospective study to measure plasma BPI concentrations in 36 critically ill children with and without the sepsis syndrome. Plasma BPI concentrations ranged from 0.5 to 452 ng/ml. Patients with the sepsis syndrome had higher median plasma BPI concentrations than critically ill controls (5.1 vs. 1.8 ng/ml, P = 0.006). Patients with organ system failure had higher median plasma BPI concentrations than those with no organ system failure (4.5 vs. 1.3 ng/ml, P = 0.001). Plasma BPI concentrations were positively associated with pediatric risk of mortality score (P = 0.03, rs = 0.4). These data provide the first clinical insights regarding the role of endogenous BPI production in critically ill children and suggest that BPI may play an important role in host defenses.