Lipopolysaccharide Binding Protein Is Down-Regulated During Acute Liver Failure

Lipopolysaccharide binding protein (LBP) is involved in the modulation of acute liver injury and failure caused by acetaminophen (APAP). Although the biological activity of LBP is concentration dependent, little is known about its levels in acute liver failure. Serum and hepatic LBP were measured in acute APAP-induced liver injury in mice. Serum LBP was measured in patients with acute liver failure from APAP and non-APAP causes. Interestingly, contrary to other diseases, serum and hepatic LBP levels decreased significantly in mice within 24 h after being subjected to APAP-induced injury compared to the control (1.6 +/- A 0.1 vs. 3.5 +/- A 1.6 mu g/ml, respectively; P < 0.05). Similar decreases were noted in another mouse model of acute liver injury due to carbon tetrachloride. Among patients with acute liver failure due to APAP (n = 5) and non-APAP (n = 5) causes, admission LBP levels were decreased compared to those of healthy controls (5.4 +/- A 1.4 vs. 3.2 +/- A 0.2 mu g/ml, normal vs. acute liver failure; P = 0.07). However, the levels were not associated with the etiology of acute liver failure or 3-week outcome. Serum and hepatic LBP levels are significantly reduced early after the induction of severe acute liver injury/failure due to acetaminophen and other liver injuries. This reduction in LBP production is specific to acute liver failure and may be important in developing future diagnostic and therapeutic approaches for patients with acute liver failure.