[Detection of endotoxins in the blood serum and ascitic fluid in liver cirrhosis].
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Lactulose (beta-galactosido-fructose) was found to have anti-endotoxin properties: 670 mg lactulose abolished the gelating activity of mg E. coli endotoxin on Limulus lysate in vitro. When lactulose was fed to rats (6.3 +/- 1.1 g/kg/day) over a period of 4 or 8 days before i.v. administration of 0.5 g/kg galactosamine, the liver damage that normally develops was prevented. Since galactosamine-induced necrosis of hepatocytes and inflammatory reaction of the liver are mediated by systemic endotoxemia of intestinal origin, an anti-endotoxin effect of lactulose was demonstrated in vivo. We suggest that lactulose might offer a therapeutic basis in clinical situations in which endotoxemia is of pathogenetic significance, such as certain gastrointestinal and liver diseases, shock states and gram-negative sepsis.
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In liver disease low prekallikrein levels may be found which has been suggested to be due to diminished synthesis. However, it may also be due to endotoxemia accompanying liver disease. To study the last possiblity prekallikrein, endotoxins and Normotest were determined in 18 cirrhosis patients. The relation between the prekallikrein concentration (after 15 min activation) and the Normotest was significant (r = + 0.72, P less than 0.001). Endotoxemia was only found in the more severe forms of liver disease (Normotest below 60%). During endotoxemia the prekallikrein levels were significantly lower than when no endotoxins were present in the blood of the same patients. The Normotest did not differ significantly in these patients in relation to the presence or absence of endotoxins. The activation of prekallikrein was slower in the more severe forms of liver disease. This might be due to reduced levels of factor XII and high molecular weight kininogen. In conclusion the reduced prekallikrein level in liver cirrhosis may be due to both diminished synthesis and endotoxemia. In the more severe forms of liver disease the time necessary to activate prekallikrein is increased.
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A sequential extraction procedure was used to provide 3 endotoxin fractions from Pasteurella haemolytica with distinct biological and solubility properties. After acetone dessication, extraction with phenol, chloroform, and petroleum ether (2:5:8) provided a fraction designated rough lipopolysaccharide (LPS). Subsequent extraction of the cells with 45% phenol at 68 C yielded a fraction designated smooth LPS, which was further divided into smooth precipitate and smooth supernatant, based on sedimentation at 105,000 x g for 4 hours. Yields of the 3 fractions were 1.5%, 3%, and 5.5% of the dry weight of the cells. The polysaccharide moieties of the rough LPS amd smooth precipitate fractions were obtained by partial acid hydrolysis followed by chloroform extraction. Biological activities of all 5 fractions were compared with activities of standard LPS fractions from Serratia marcescens and Salmonella typhimurium. Results of chicken embryo lethality, the local Shwartzman's phenomenon, nonspecific resistance enhancement ot challenge exposure by S typhimurium pyrogenicity, and the Limulus amebocyte lysate assay were reported.
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Strain Y3343 isolated from a goat with septicemia and polyarthritis was studied. The strain was virulent and induced septicemia, polyarthritis and coagulopathy in two goats. Limulus amebocyte lysate active material was present in plasma, but not in higher titre in inoculated goats. Sonicated mycoplasma material induced a dramatic somatic cell response in the mammary gland of cows and goats and marked clotting of the cows' milk, but it did not clot limulus amebocyte lysate or kill chick embryos. Phenol-water extract clotted limulus amebocyte lysate and induced somatic cell response in cows but not in goats. The phenol-water extract did not kill chick embryos, was not pyrogenic in rabbits or goats, and did not induce generalized Shwartzman reaction or change the leukocyte kinetics in rabbits. It therfore appears that the virulence mechanisms of strain Y3343 can not be explained on the basis of factors with strong endotoxin activity.
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