Lipopolysaccharide binding protein (L.B.P.) – an inflammatory marker of prognosis in the acute appendicitis

LIPOPOLYSACCHARIDE BINDING PROTEIN (LBP) is an important mediator of the inflammatory reaction. A multitude of factors can determine the genic transcription activation and the increase of the LBP in the blood and the human body humours: Il1, Il 6, lipopolysaccharides, Gram-negative bacteria, as well as non-infectious agents. This paper is a prospective study performed on 147 patients admitted for acute appendicitis in 2010-2012 and evaluates the dynamics of LBP in acute appendicitis, by identifying the correlations between the pre- and post-operatory levels of LBP (up to 72 hours after surgery) and the anatomopathological type (i.e. catarrhal, phlegmonous and gangrenous). The mean pre-op LBP values are significantly different as to the histopathological result (p<0,005). Among the biological inflammatory markers measured in this present study, LBP has a dynamics of its own in the catarrhal and phlegmonous appendicitis. Thus, if after the surgical removal of the infectious source, the leukocites and neutrophiles decrease 72 hrs after surgery, LBP continues an ascending curve. The importance of this study consists in the introduction of last generation LBP-type inflammatory markers' dosage in the cecal appendix pathology. This implementation is brand new in the Romanian surgical practice. The good correlation between the LBP pre-op values and the histopathological diagnosis of the appendicits form that we discovered during the present study opens the way to large-scale use of the biochemical dosage of LBP in the management of acute appendicitis.