Lipopolysaccharide-binding protein to soluble cluster of differentiation 14 ratio (LBP/sCD14 ratio)

The Lipopolysaccharide-binding protein to soluble cluster of differentiation 14 ratio (LBP/sCD14 ratio) is a clinical biomarker used to evaluate systemic endotoxemia and the intensity of the host innate immune response to Gram-negative bacterial products [2, 7]. LBP is an acute-phase protein synthesized by the liver that facilitates the transfer of lipopolysaccharide (LPS) to CD14, which subsequently presents the LPS to the Toll-like receptor 4 (TLR4) complex to trigger pro-inflammatory signaling [1, 5, 6]. Soluble CD14 (sCD14) is a circulating form of the receptor that can promote LPS signaling in CD14-negative cells or assist in the neutralization and clearance of LPS from the blood [1, 8]. The ratio between these two proteins serves as a sensitive indicator for microbial translocation and chronic inflammation in various conditions, including sepsis, metabolic syndrome, and chronic infections like HIV [7, 11, 13]. While the ratio is not a direct drug target, its individual components are of high therapeutic interest; for example, the anti-CD14 monoclonal antibody IC14 has been investigated for its ability to reduce LPS-mediated systemic inflammation [9, 15].

Other names

LBP/sCD14 ratiosCD14/LBP ratioLipopolysaccharide-binding protein/CD14 ratioEndotoxemia biomarker ratio

The ratio itself is used as a biomarker for clinical assessment; however, therapeutic strategies targeting its components typically involve monoclonal antibodies (e.g., IC14) or peptides that block the interaction between lipopolysaccharide (LPS), LBP, and CD14 to prevent the activation of the Toll-like receptor 4 (TLR4) pro-inflammatory signaling cascade [1, 9, 15].