Lipopolysaccharide-binding protein as a risk factor for development of infectious and inflammatory postsurgical complications in colorectal cancer paients

Yermek Turgunov, Alina Ogizbayeva, Lyudmila Akhmaltdinova, Kayrat Shakeyev, Yermek Turgunov, Alina Ogizbayeva, Lyudmila Akhmaltdinova, Kayrat Shakeyev

Abstract

Aim of the study: In this pilot study lipopolysaccharide-binding protein (LBP) levels were assessed as a possible risk factor for development of systemic inflammatory response syndrome (SIRS) and infectious and inflammatory complications in colorectal cancer (CRC) patients after surgery.

Material and methods: For LBP determination venous blood was taken 1 hour before the surgery and 72 hours after it. All patients were stratified by the presence or absence of acute bowel obstruction (ABO), SIRS and complications.

Results: 36 patients with CRC participated in the study. The LBP level before surgery was 879.8 ± 221.8 ng/ml (interquartile range (IQR) 749.3-1028.8); on the 3rd day it was 766.5 ± 159.4 ng/ml (IQR 669.5-847.6), which was a statistically significant decrease (p = 0.004). A decrease in LBP level by more than 280 ng/ml increases the probability of SIRS and complications in operated CRC patients (OR 6.6, 95% CI: 1.1-40.9 and OR 12.0, 95% CI: 1.8-80.4, respectively). In patients with ABO in the presence of SIRS, the LBP value decreased more than in those without SIRS (p = 0.046).

Conclusions: This study demonstrated that the LBP level in the operated CRC patients tends to decrease on the 3rd day after surgery. A bigger decrease in LBP level increases the probability of SIRS and postoperative infectious and inflammatory complications. Therefore, further studies with larger numbers of patients are required.

Keywords: SIRS; bacterial translocation; bowel obstruction; colorectal cancer; complications; lipopolysaccharide-binding protein.

Conflict of interest statement

The authors declare no conflict of interest.

Copyright © 2021 Termedia.

References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA: Cancer J Clin 2019; 69: 7-34.
    1. Kam MH, Tang CL, Chan E, et al. . Systematic review of intraoperative colonic irrigation vs manual decompression in obstructed left-sided colorectal emergencies. Int J Colorectal Dis 2009; 24: 1031-1037.
    1. Catena F, de Simone B, Coccolini F, et al. . Bowel obstruction: a narrative review for all physicians. World J Emerg Surg 2019; 14: 20.
    1. Webster PJ, Aldoori J, Burke DA. Optimal management of malignant left-sided large bowel obstruction: do international guidelines agree? World J Emerg Surg 2019; 14: 23.
    1. Sperry J, Cohen MJ. Acute obstruction. Surg Clin North Am 2014; 94: 77-96.
    1. Vaishnavi C. Translocation of gut flora and its role in sepsis. Indian J Med Microbiol 2013; 31: 334-342.
    1. Zweigner J, Schumann RR, Weber JR. The role of lipopolescchride-binding protein in modulating the innate immune response. Microb Infect 2006; 8: 946-952.
    1. Heumann D, Lauener R, Ryffel B. The dual role of LBP and CD14 in response to Gram-negative bacteria or Gram-negative compounds. J Endotoxin Res 2003; 9: 381-384.
    1. Ryu JK, Kim SJ, Rah SH, et al. . Reconstruction of LPS transfer cascade reveals structural determinants within LBP, CD14, and TLR4-MD2 for efficient LPS recognition and transfer. Immunity 2017; 46: 38-50.
    1. Leventhal JS, Schröppel B. Toll-like receptors in transplantation: sensing and reacting to injury. Kidney Int 2012; 81: 826-832.
    1. Chen R, Luo F-K, Wang Y-L, et al. . LBP and CD14 polymorphisms correlate with increased colorectal carcinoma risk in Han Chinese. World J Gastroenterol 2011; 17: 2326-2331.
    1. Citronberg JS, Wilkens LR, Marchand LL, et al. . Plasma lipopolysaccharide-binding protein and colorectal cancer risk: a nested case-control study in the multiethnic cohort. Cancer Causes Control 2018; 29: 115-123.
    1. Cybulska-Stopa B, Ługowska I, Wiśniowski R, et al. . Overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab plus FOLFOX chemotherapy. Contemp Oncol (Pozn) 2020; 24: 34-41.
    1. Akhmaltdinov L, Sirota V, Babenko D, et al. . Proinflammatory cytokines and colorectal cancer–the impact of the stage. Contemp Oncol (Pozn) 2020; 24: 207-210.
    1. Mu Q, Kirby J, Reilly CM, Luo XM. Leaky gut as a danger signal for autoimmune diseases. Front Immunol 2017; 8: 598.
    1. Cesaro C, Tiso A, Del Prete A, et al. . Gut microbiota and probiotics in chronic liver diseases. Dig Liver Dis 2011; 43: 431-438.
    1. Tuomi K, Logomarsino JV. Bacterial lipopolysaccharide, lipopolysaccharide-binding protein, and other inflammatory markers in obesity and after bariatric surgery. Metab Syndr Relat Disord 2016; 14: 279-288.
    1. Albillos A, de-la-Hera A, Alvarez-Mon M. Serum lipopolysaccharide-binding protein prediction of severe bacterial infection in cirrhotic patients with ascites. Lancet 2004; 363: 1608-1610.
    1. Gaini S, Koldkajer OG, Pedersen SS. Procalcitonin, lipopolysaccharide-binding protein, interleukin-6 and C-reactive protein in community-acquired infections and sepsis: a prospective study. Crit Care 2006; 10: R53.
    1. Kell DB, Pretorius E. On the translocation of bacteria and their lipopolysaccharides between blood and peripheral locations in chronic, inflammatory diseases: the central roles of LPS and LPS-induced cell death. Integr Biol 2015; 7: 1339-1377.
    1. Mierzchala M, Krzystek-Korpacka M, Gamian A, Durek G. Quantitative indices of dynamics in concentrations of lipopolysaccharide-binding protein (LBP) as prognostic factors in severe sepsis/septic shock patients–comparison with CRP and procalcitonin. Clin Biochem 2011; 44: 357-363.
    1. Whitehead AL, Julious SA, Cooper CL, Campbell MJ. Estimating the sample size for a pilot randomised trial to minimise the overall trial sample size for the external pilot and main trial for a continuous outcome variable. Stat Methods Med Res 2015; 25: 1057-1073.
    1. Deitch EA. Bacterial translocation or lymphatic drainage of toxic products from the gut: what is important in human beings? Surgery 2002; 131: 241-244.
    1. Komen N, Slieker J, Willemsen P, et al. . Acute phase proteins in drain fluid: a new screening tool for colorectal anastomotic leakage? The APPEAL study: analysis of parameters predictive for evident anastomotic leakage. Am J Surg 2014; 208: 317.
    1. Scheepers JG, Sietses C, Bos DG, et al. . Immunological consequences of laparoscopic versus open transhiatal resection for malignancies of the distal esophagus and gastroesophageal junction. Dig Surg 2008; 25: 140-147.
    1. Prucha M, Herold I, Zazula R, et al. . Significance of lipopolysaccharide-binding protein (an acute phase protein) in monitoring critically ill patients. Crit Care 2003; 7: 154-159.
    1. Villar J, Perez-Mendez L, Espinosa E, et al. . Serum lipopolysaccharide binding protein levels predict severity of lung injury and mortality in patients with severe sepsis. PLoS ONE 2009; 4: e6818.
    1. Opal SM, Scannon PJ, Vincent J-L, et al. . Relationship between plasma levels of lipopolysaccharide (LPS) and LPS-binding protein in patients with severe sepsis and septic shock. J Infect Dis 1999; 180: 1584-1589.
    1. Lamping N, Dettmer R, Schroder NWJ, et al. . LPS-binding protein protects mice from septic shock caused by LPS or gram-negative bacteria. J Clin Invest 1998; 101: 2065-2071.
    1. Zweigner J. High concentrations of lipopolysaccharide-binding protein in serum of patients with severe sepsis or septic shock inhibit the lipopolysaccharide response in human monocytes. Blood 2001; 98: 3800-3808.
    1. Morris MC, Gilliam EA, Li L. Innate immune programing by endotoxin and its pathological consequences. Front Immunol 2015; 5: 680.

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