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

Author(s): Al Ghossaini Najib, Ghoussaini Maya

Journal Name: Anti-Infective Agents
(Formerly Anti-Infective Agents in Medicinal Chemistry)

Volume 14 , Issue 2 , 2016

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Graphical Abstract:


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.

Keywords: BPI, sepsis, endotoxin, LPS-binding protein, liver cirrhosis, cytokine.

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Article Details

Year: 2016
Published on: 22 September, 2016
Page: [76 - 83]
Pages: 8
DOI: 10.2174/2211352514666160819161520
Price: $25

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