Predictive value of studying lipopolysaccharide -binding protein in liver cirrhosis


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Abstract

The aim of the study was to establish the prognostic and diagnostic value of the study of the concentration of lipopolysaccharide - binding protein (LBP) in the blood of patients with liver cirrhosis (LC). Material and methods. The study involved 120 patients with LC of viral, alcoholic and mixed etiology and 30 apparently healthy donors (control group). The studies were carried out during the hospitalization of the patient in the gastroenterological department in the phase of exacerbation of the disease. LBP concentration in blood plasma was determined by enzyme-linked immunosorbent assay. Results. The median values of LBP concentration in LC with a high degree of reliability (p <0.001) was higher than in the control group. The variability of LBP indices in LC ranged from 10,4 ng/ml to 58,3 ng/ ml. The level of protein in the blood plasma was increased compared with the normal ranges in 88% of patients. The increase in LBP concentration did not have significant differences depending on the etiology of LC. An increase in LBP values was significantly associated with disease activity, severity of portal hypertension (PH) and associated syndromes: ascites, chronic hepatic encephalopathy, degree of esophageal varicose veins, increased Child-Pugh gradation, and LC decompensation. A comparative study of the clinical and laboratory characteristics of the disease was carried out in two subgroups of LC patients with the lowest (LBP <30 ng/ml; n=20) and highest (LBP> 45 ng/ml; n=38) protein concentrations. Differences in the compared subgroups had a high degree of statistical significance (p <0,01). It has been shown that in patients with LC, a significant (threefold and higher, compared with the normal ranges) increase in the blood LBP level is associated with a more severe course of the disease, the appearance of endotoxemia and systemic inflammation syndromes, a high risk of developing decompensation of LC, compared with patients with no more than a twofold increase in LBP concentration. Conclusion. The study of LBP concentration in blood in patients with LC can be used to diagnose syndromes of bacterial overgrowth in the intestine, endotoxemia. The detection of a threefold or more increase in the LBP concentration in the blood characterizes the severity of the pathological process in the liver, the severity of PH and associated syndromes, and allows predicting the development of decompensated LC.

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About the authors

Boleslav N. Levitan

Astrakhan State Medical University of the Ministry of Healthcare of Russia

Email: bolev@mail.ru
MD, professor, head of the Department of faculty therapy and occupational diseases with a postgraduate course

Tatiana R. Kasyanova

Astrakhan State Medical University of the Ministry of Healthcare of Russia

Email: kasyanova.tatjana@yandex.ru
MD, associate professor of the Department of faculty therapy and occupational diseases with a postgraduate course

Olga A. Voloshina

Alexandro-Mariinsky Regional Clinical Hospital

Email: vololga@yandex.ru
PhD, gastroenterologist

Anastasia D. Martynova

Astrakhan State Medical University of the Ministry of Healthcare of Russia

postgraduate student of the Department of faculty therapy and occupational diseases with a postgraduate course

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