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Role of Bactericidal/Permeability-Increasing Protein (BPI) in Sepsis and Liver Cirrhosis, and Its Clinical Implications

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Background: Bactericidal/permeability-increasing protein (BPI) is a nat-ural cationic protein, which is stored in the polymorphonuclear leucocyte granules. It exerts anti-infective actions through damaging bacterial membranes, neutralizing microbial endotoxins, and promoting phagocytosis of gram-negative bacteria. Con-sequently, its role in sepsis initially raised much hope in infection control. On the other hand, patients with liver cirrhosis present an important risk of sepsis induced by gram-negative microorganism, especially in advanced stages.

Methods: MEDLINE was searched for terms including BPI, endotoxins, lipopoly-saccharides, lipopolysaccharide-binding protein, AND sepsis OR liver cirrhosis. Be-sides, trials addressing clinical BPI implication were retrieved and analyzed.

Results: Endotoxemia is frequently elevated in sepsis, in alcoholic liver disease, and in liver cirrhosis. BPI expression is higher in liver cirrhosis patients than in healthy individuals, with a significant increase in patients who present a more severe disease. Contrariwise, most clinical studies failed to show any substantial role of BPI in treating sepsis.

Conclusion: This review describes the role of BPI and some other proteins involved in sepsis, with a special focus on patients with alcoholic liver diseases. It outlines their mechanisms, indicates alterations associated with their deficiency, and explains obstacles that restrained their therapeutic use.
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Keywords: BPI; LPS-binding protein; cytokine; endotoxin; liver cirrhosis; sepsis

Document Type: Research Article

Publication date: August 1, 2016

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  • Anti-Infective Agents publishes original research, expert reviews, drug clinical trial studies and guest edited issues on all the latest and outstanding developments on the medicinal chemistry, biology, pharmacology and use of anti-infective and anti-parasitic agents. The scope of the journal covers all pre-clinical and clinical research on antimicrobials, antibacterials, antiviral, antifungal, and antiparasitic agents. Anti-Infective Agents is an essential journal for all infectious disease researchers in industry, academia and the health services.
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