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In vivo biological activities of endotoxin.

The basic mechanisms by which bacterial lipopolysaccharides (LPS) interact with cells and tissues of the endotoxin sensitive host have been examined within the context of defining critical targets for the manifestation of the multiple pathophysiologic effects of this potent bacterial toxin. Evidence has been presented to suggest that metabolic processing of bacteria by phagocytic cells can result in the release of biologically active endotoxin. The available experimental data would indicate that, in the mouse, a bone marrow derived radiosensitive cell is responsible for the toxic effects of endotoxin. The precise mechanism by which lipopolysaccharides interact with these cells remains to be elucidated. Although interaction with critical targets on the membrane of LPS responsive cells is established, the evidence for specific endotoxin receptor molecules is weak and still controversial. Recent data suggest that, if such endotoxin receptors do, in fact exist, they are at best only weakly immunogenic. The use of the C3H/HeJ "endotoxin unresponsive" mouse strain, however, remains as an extremely useful experimental model to define the mode of action of endotoxin at the molecular level.

Animals↗

Endotoxin suppresses the generation of O2- and H2O2 by "resting" and lymphokine-activated human blood-derived macrophages.

In evaluation of macrophage-activating principles other than lymphokines, we systematically investigated the effects of endotoxin on the formation of reactive oxygen intermediates measured by chemiluminescence. Surprisingly, endotoxin exposure of human blood monocytes cultured in vitro for 36 h lessened in a dose-dependent manner the amount of O2- and H2O2 secreted in response to phagocytosis of opsonized particles or to PMA, a soluble stimulant. Blunting of the respiratory burst by endotoxin was independent from the state of macrophage activation. Endotoxin thus impaired formation of reactive oxygen metabolites before, during, or after activation of macrophages by IFN-gamma. The median effective concentration (EC50) was 1.95 ng/ml LPS in resting macrophages and 7.22 ng/ml in IFN-gamma-activated macrophages with as little as 0.1 ng/ml reproducibly giving detectable inhibition. Lipid A, but not "detoxified" monophosphoryl lipid A gave an inhibition comparable to that of complete LPS. The inhibitory effect of endotoxin was attenuated by dexamethasone, but not by inhibitors of arachidonic acid metabolism. Because endotoxin induces and dexamethasone inhibits production of some monokines, it is tempting to speculate that endotoxin is part of an autoregulatory system of mononuclear phagocytes for the control of excessive production of potentially harmful oxidants. The two monokines identified to be secreted in response to LPS and to be inhibited by dexamethasone, IL-1 and TNF, had, however, no comparable effect on chemiluminescence.

Animals↗

Preparation and use of endotoxin indicators for depyrogenation process studies. LAL Users Group.

Biological Indicators (B.I.'s) have traditionally been employed in the validation and routine monitoring of sterilization processes used for the manufacture and control of pharmaceuticals and medical devices. In this paper, the phrase "Endotoxin Indicator" has been coined to describe a tool analogous to the BI which can be used in the validation and routine control of endotoxin reduction processes. Like the BI, the Endotoxin Indicator provides the user with an in vitro biological test to complement physical measurement used to control the manufacturing process. It must be remembered that the total pyroburden in an aseptically processed drug is the sum of the pyroburden of each factor contributing to the manufacture of that product. This includes raw materials, packaging components, the environment and the manufacturing process itself. Therefore, all aspects of the process must be considered for a complete validation. This pyroburden may also change during processing of a drug. Fluctuations in pH, solvent content, and temperature may decrease pyroburden while introduction of some raw materials, especially water, may increase endotoxin content. Regularly scheduled monitoring of all aseptic processes should identify and address each step of the process considered to have potential for the possible introduction or removal of endotoxin in the final product. Most of these situations can be thoroughly studied using Endotoxin Indicators to challenge routine production conditions, thereby providing insight to the assurance of endotoxin-free final products.

Endotoxins↗

Effect of hemorrhagic hypotension on endotoxin-induced lung injury in awake sheep.

Pulmonary insufficiency is a major cause for mortality and morbidity following shock and sepsis. We studied the effect of hemorrhagic shock and retransfusion on endotoxin-induced lung dysfunction. Eighteen unanesthetized sheep with chronic lung lymph fistulae were divided into 3 groups. In Group I (n = 5) hemorrhagic shock of 50 torr was induced by arterial bleeding. Shed blood was retransfused after 4 h, and the animals were observed for 5 h. In Group II (n = 7) 1 microgramg/kg E. coli endotoxin was injected intravenously, and the animals were observed for 5 h. In Group III (n = 6) hemorrhagic shock was induced similarly to Group I. After 2 h of hypotension, E. coli endotoxin was injected similarly to Group II. Blood was retransfused after 4 h. During hemorrhagic shock arterial oxygen tension (PaO2) increased from 78.0 to 94.0 torr (P less than 0.005), lymph flow (QL) decreased from 7.2 to 5.2 ml/h (P less than 0.05) and lymph protein clearance (L/P.QL) from 4.6 to 3.3 ml/h (P less than 0.05). Calculated pulmonary microvascular pressure (Pmv) decreased from 11.1 to 7.0 torr (P less than 0.05). Plasma TXB2 increased from 197 to 967 pg/ml (P less than 0.05) and lymph TXB2 from 272 to 833 pg/ml (P less than 0.05). Endotoxin infusion was followed by a fall in WBC to 2,900/microliters (P less than 0.001), rise in pulmonary artery pressure (Ppl) from 17.5 to 49.7 torr (P less than 0.005), and Pmv from 12.1 to 23.7 torr (P less than 0.01). PaO2 decreased from 78.0 to 61.0 torr (P less than 0.01), QL increased to 36.9 ml/h (P less than 0.001), and L/P.QL to 24.3 ml/h (P less than 0.001). Plasma TXB2 increased to 7,600 pg/ml (P less than 0.005) and 6-Keto PGF1 alpha to 1,519 pg/ml (P less than 0.01). Infusion of endotoxin during hemorrhagic shock was followed by a comparable fall in WBC, pulmonary hypertensive response and hypoxemia, while Pmv increased only to 19.2 torr which was significantly lower than Group II (P less than 0.05). The rise in QL to 17.4 and L/P.QL to 10.6 ml/h in response to endotoxin was also significantly lower than Group II (P less than 0.05 and P less than 0.05, respectively). Plasma and lymph TXB2 and 6-Keto PGF1 alpha were unchanged. It is concluded that hemorrhagic shock reduced endotoxin-induced pulmonary microvascular pressure, pulmonary lymph production and protein flux, while the fall in WBC, early pulmonary hypertensive phase, hypoxemia, and prostanoid production were not altered by the hypotensive insult.

Animals↗

In vitro studies of intestinal endotoxin absorption. I. Kinetics of absorption in the isolated everted gut sac.

Previous studies have shown in a qualitative manner that endotoxin can cross gut epithelium, but precise quantitation has not been possible. The present studies were undertaken to measure quantitatively the mucosal to serosal unidirectional flux of endotoxin with the use of an in vitro rat gut sac preparation. 51Cr-Labeled endotoxin was placed in the mucosal bath in concentrations ranging from 0.05 to 2.0 mg per ml. Over a 2-hr period of time, a small amount of endotoxin was transported transmurally, which was shown chromatographically to be similar to the starting material and which retained its toxic and immunogenic properties. It was first shown that the presence of 2.0 mg per ml of endotoxin in the mucosal bath did not significantly alter the tissue's histology or permeability to 3-O-methyl-D-glucose. When unidirectional fluxes were measured, it was found that the flux was not proportional to the endotoxin concentration as would be expected with a passively permeable solute, but rather its transport system became "saturated," displaying a maximum transport rate of 4.72 (mug per cm) per 2 hr and a Km of 0.425 mg per ml. The isolated gut sac provides an excellent model for the precise study of factors involved in endotoxin absorption.

Animals↗

The organ distribution of [3H]endotoxin following partial hepatectomy.

3H-labeled endotoxin was intravenously injected into Wistar rats 24 hours following 70% hepatectomy and also into the normal rats. They were sacrificed 12 hours, 24 hours or 5 days after the injection. Microscopical autoradiography was performed on the rats' organs. The distribution of endotoxin in the organs was investigated by quantitatively measuring their radioactivity. Endotoxin was taken up mainly by Kupffer cells of the liver in all the groups. Endotoxin was observed also in macrophages of the spleen and the lung in all the groups. The amount of endotoxin per 1 g organ weight of the hepatectomized rat was significantly smaller in the liver, and significantly larger in the spleen, lung and blood (per 1 ml) than that of the control groups early after hepatectomy. These differences of the organ accumulation of endotoxin between groups diminished 5 days later. Deficient tolerance of the liver to endotoxin at the peak phase of regeneration following partial hepatectomy was suggested.

Animals↗

Endotoxin protects against hyperoxic decrease in membrane fluidity in endothelial cells but not in fibroblasts.

We evaluated the ability of endotoxin to protect against hyperoxic depression of plasma membrane fluidity in endothelial cells and fibroblasts in culture. Second- to-fifth passage porcine aortic endothelial cells and human newborn foreskin fibroblasts with 20 ng/ml of endotoxin or diluent in the culture medium were exposed to 20% O2 (control) or 95% O2 (hyperoxic) in 5% CO2 for 4 hours. After exposure, cells were labeled with 1,6-diphenyl-1,3,5-hexatriene (DPH), an aromatic hydrocarbon that partitions into the hydrophobic core of lipid bilayer membranes, or transparinaric acid (TPA), a natural, conjugated fatty acid that orients parallel to fatty acyl chains of membrane phospholipids. Membrane fluidity was monitored by measuring changes in the steady state fluorescence anisotropies (rs) for DPH and for TPA by using fluorescence spectroscopy. Reductions in membrane fluidity increase the value of rs. Addition of endotoxin to the culture medium of control endothelial cells and fibroblasts had no effect on rs for DPH or TPA. In hyperoxic endothelial cells, rs for DPH and rs for TPA were increased (p less than 0.001). Addition of endotoxin to the medium of hyperoxic endothelial cells prevented the increases in rs for DPH and TPA. Hyperoxia increased rs for DPH (p less than 0.003) but not rs to TPA in fibroblasts, and endotoxin failed to prevent this increase. These results indicate that hyperoxia decreases plasma membrane fluidity in endothelial cells and fibroblasts and demonstrate that endotoxin prevents the decrease in plasma membrane fluidity in endothelial cells, but not in fibroblasts. These membrane-protective effects may represent an alternative mechanism by which endotoxin protects against hyperoxic cellular injury, and this mechanism may be specific for hyperoxic injury to endothelial cells.

Animals↗

Repeated Escherichia coli endotoxin-induced pulmonary inflammation causes chronic pulmonary hypertension in sheep. Structural and functional changes.

Chronic pulmonary hypertension occurs in several human diseases in which there is evidence of chronic or repeated bouts of pulmonary inflammation. To determine whether prolonged lung inflammation causes persistent pulmonary hypertension Escherichia coli endotoxin was given to seven chronically instrumented awake sheep three times a week for 10 to 14 weeks. Pulmonary artery, left atrial and systemic arterial pressures, cardiac output, arterial blood gases and pH were monitored before starting endotoxin treatment and twice weekly, immediately before endotoxin infusion. Three sheep receiving saline over a similar time period served as controls. Pulmonary vasoreactivity to breathing 12% oxygen and a bolus infusion of an analog of prostaglandin H2 was also assessed. Peripheral lung biopsy tissue was taken at baseline and at periods throughout the experiment to assess pulmonary inflammation. Repeated endotoxin infusions resulted in a significant increase in mean pulmonary artery pressure from the 8th week of treatment and more than a 50% increase from week 10 (baseline = 18.4 cm H2O +/- 1.0 (mean +/- SE); 10 weeks endotoxin = 27.8 +/- 4.3; p less than 0.05). Pulmonary vasoreactivity to both an analog of prostaglandin H2 and 12% oxygen decreased in the period from 4 to 8 weeks of endotoxin treatment. Light microscopic assessment of lung biopsy tissue showed a persistent four-fold increase above baseline in number of peripheral lung granulocytes. Electron microscopy revealed that granulocytes, lymphocytes, and monocytes sequestered in the lungs of these animals, and that structural damage to the endothelium was minimal. Morphometry of lungs obtained at autopsy in which the pulmonary arteries had been distended with barium-gelatin showed extension of muscle into the walls of smaller intra-acinar arteries (than normal) and a reduction in number of filled peripheral arteries. We conclude that repeated infusions of endotoxin into sheep cause persistent lung inflammation, altered pulmonary vasoreactivity, sustained pulmonary hypertension, and some of the structural changes characteristic of this disease. Chronic inflammation may play a role in the pathogenesis of chronic pulmonary hypertension.

Animals↗

Endotoxin detection and elimination in biotechnology.

Endotoxins liberated by gram-negative bacteria are frequent contaminants of aqueous and physiological solutions. Because of their potent biological effects in vivo and in vitro, their detection and removal are essential for the safe parenteral administration of products produced from natural sources, as well as those produced by recombinant DNA technology. Traditional methods of endotoxin detection include the U.S. Pharmacopeia rabbit test and the Limulus amebocyte lysate test. Elimination of endotoxins, however, continues to be a problem. Standard methods of sterilization, such as autoclaving or sterile filtration, have little effect on endotoxin levels. Various techniques for the prevention of endotoxin contamination and endotoxin removal have been discussed. The overall role of endotoxin prevention, detection, and elimination in biotechnology is emphasized.

Endotoxins↗

Quantitation of endotoxin in products using the LAL kinetic turbidimetric assay.

The data presented here show the kinetic turbidimetric LAL assay to be a highly quantitative and effective method for determining endotoxin concentrations in products. The assay allows for the accurate assessment of inhibiting or enhancing effects in products when related to a LRW standard curve. However, designating some products as inhibitors or enhancers can be both misleading and erroneous unless qualified as to the dilution and/or endotoxin concentration. Our results demonstrate that some products can yield both inhibiting and enhancing results when related to water. Due to the enhanced resolution of the kinetic turbidimetric assay, these complicating inhibition/enhancing effects can usually be avoided by diluting to the WED. Alternatively, products could be related to a PSC in which the endotoxin response is defined and quantified within the product itself. The practicality of a PSC, however, depends upon the pass/fail limit established, the "cleanliness" of the product used as a standard and the degree of product "lot to lot" variability. Current FDA Guidelines consider a PSC valid providing the value of the "unspiked" product extrapolated from the regression line of the PSC is less than 10% of lambda, the lowest endotoxin concentration used to construct the standard. All products in which LAL kinetics have not been previously analyzed will require a characterization similar to that used with the four products described. From these data, the optimal methodology for kinetically testing the product (dilution to a WED or generation of a PSC) can be determined. Although analysis of endotoxin in a product will always require a characterization of the kinetics of the LAL-endotoxin-product reaction, subsequent testing should be rapid and straightforward. More importantly, the kinetic turbidimetric assay allows the user to quantitatively assess product endotoxin levels with a degree of precision greater than that of any other methodology currently in use.

Endotoxins↗

In vivo and in vitro effect of toxic and radio-detoxified endotoxin preparations on chemiluminescence of peritoneal cells of mice.

Chemiluminescence (CL) of peritoneal cells was investigated one and five days after injection of toxic and radio-detoxified endotoxin. The CL was triggered by toxic and radio-detoxified endotoxin. The radio-detoxified endotoxin has less pronounced in vivo activating effect than the toxic endotoxin. As triggering agent the toxic endotoxin was more effective than the radio-detoxified endotoxin. However, the radio-detoxified endotoxin has preserved some in vivo activating and in vitro triggering effect.

Adjuvants, Immunologic↗

Immunoradiometric assay of endotoxin in serum.

We describe an immunoradiometric assay for the specific detection and quantitation of endotoxin from Escherichia coli 026, with use of 125I-labeled antibody. The sensitivty of this assay is 1 microgram/L.E. coli 026 endotoxin was detected in serum of rats for as long as 24 h after intraperitoneal injection of 0.1 mg of endotoxin per 100 g body weight. The assay is specific for the O-polysaccharide portion of this endotoxin, as confirmed by results after protein digestion and oxidation of the endotoxin, as well as by failure to detect endotoxin in serum after similar injections of E. coli 0127 and Salmonella typhosa 0901 endotoxins.

Animals↗

Effects of endotoxin on the splenic microcirculation and its cellularity.

This report describes the effects of endotoxin treatment on the intrasplenic microcirculation and cellularity in rats. Four and 16 h after a single intravenous injection of endotoxin (2 mg/100g body weight), altered intrasplenic microcirculation was observed. The open circulation was reduced from 97% in the control rats to 79% in the endotoxin treated rats, while the closed circulation increased from 3% in the controls to 21% in the endotoxin treated rats. Such changes in the splenic microcirculation may be partly due to the presence of fibrin and the pooling of polymorphonuclear leukocytes and red blood cells in the red pulp. The most apparent cellular changes seen in the white pulp of endotoxin treated rats 16 h after endotoxin injection are the disappearance of lymphocytes from the periarterial lymphatic sheath and the appearance of many giant macrophages within the white pulp. The giant macrophages contain lymphocytes undergoing various stages of degradation. This suggests that the lymphocytes may be injured by endotoxin treatment and are subsequently phagocytosed by macrophages.

Animals↗

The inflammatory response to endotoxins.

1. Endotoxins are very potent and widely spread inflammation-inducing substances. 2. In the course of local infections endotoxins represent one of the main principles of the pathogenicity of gram-negative bacteria by inducing acute nonspecific inflammation. 3. The pharmacological activities of endotoxins consist primarily in generating and liberating the classic mediators of acute nonspecific inflammation. 4. Endotoxins are able to enter into the circulation through their capicity to activate pharmacological mediators. 5. The endotoxic mediators which increase the permeability of the microcirculation of the intestinum enable endotoxins as components of the physiological intestinal flora to enter into the circulation; these induce systemic disease or shock depending on their concentration in the circulation. 6. In the course of chronic inflammation recidivism or recrudescence as trasient acute inflammatory outburst can be caused by local effects of endotoxins. 7. According to some recent observations the inflammation inducing capacity of endotoxins may promote the entry of aerobic bacteria into the blood stream which can result in mixed septicemia.

Animals↗

The removal of 14C labeled endotoxin by activated charcoal.

Endotoxin shock due to Gram-negative enteric bacteria is of major medical concern with an estimated 100,000 fatalities in the United States per year. An effective therapy for endotoxin shock, particularly in combination with significant liver damage, has not been available to date. Since activated charcoal is known as a universal sorbent, the use of activated charcoal in a hemoperfusion apparatus to remove endotoxin has interesting possibilities. Current assays for endotoxin are inadequate. The Limulus Amoebocyte Lysate (LAL) assay was found to give nonreproducible results within our range of requirements for accuracy. We, therefore, grew Salmonella typhimurium in 14C-labeled glucose to obtain 14C labeled endotoxin. Radiolabeled endotoxin was used to measure the rate of adsorption on activated charcoal. The rates of removal of endotoxin from normal saline, plasma, and whole blood will be presented in graphical form for use in design calculations. This work provides a foundation for encouraging in vivo hemoperfusion experimentation now underway at the University of Oklahoma and the Veteran's Administration Hospital in Oklahoma City.

Adsorption↗

Endotoxin absorption in hay-fed and lactic acidotic sheep.

Absorption of endotoxin from the gastrointestinal tract was evaluated in hay-fed and lactic acidotic sheep duodenally infused with 10 mg of Escherichia coli endotoxin, and in lactic acidotic sheep not infused. The effect of abomasal fluid on biological activity of endotoxin was also evaluated. Leukopenia was the criterion used for detecting endotoxemia. Absorption of endotoxin from the gastrointestinal tract was not detected in either hay-fed or lactic acidotic sheep. Endotoxin appeared to maintain its activity after incubation with abomasal fluid, and the presence of endogenous endotoxin in abomasal contents was indicated. The results indicate that endotoxin of alimentary origin may not be involved in the lactic acidosis syndrome in ruminants.

Abomasum↗

Endotoxin-induced hematologic and blood chemical changes in ponies: effects of flunixin meglumine, dexamethasone, and prednisolone.

To evaluate the effect of certain drugs on hematologic changes, blood chemical values, and survival in endotoxin shock, anesthetized ponies were given (IV) endotoxin (Escherichia coli O55:B5) and then treated as follows: Group A ponies--given a saline infusion at 5 minutes and at 3 hours after they were given endotoxin; group B ponies--given flunixin meglumine at 5 minutes and at 3, 6, 9, and 24 hours after they were given endotoxin; group C ponies--treated with dexamethasone; and group D ponies--treated with prednisolone at 5 minutes and at 3, 9, and 24 hours after they were given endotoxin. Anesthesia was maintained for 4 hours, after which time the ponies were allowed to recover. Throughout the experiment, samples of blood were collected for blood gas, hematologic, and blood chemical values. The endotoxin effects were seen in the 4 groups: lactic acidosis, prolonged coagulation times, leukopenia, hemoconcentration, and elevated blood chemical values. Although none of the treatments prevented the effects of endotoxin, changes were less severe and survival times were longer in ponies treated with flunixin meglumine.

Animals↗

Endotoxin-induced prostanoid production by the burn wound can cause distant lung dysfunction.

We injected Escherichia coli endotoxin, 2 micrograms/kg, beneath the eschar of sheep with 25% total body surface full-thickness burns to determine whether burn tissue in the presence of endotoxin releases prostanoids, particularly thromboxane A2, (TxA2), and if increased local TxA2 production can lead to distant lung dysfunction. We compared this response to the lung injury produced by the same dose given intravenously. We noted a marked increase in burn tissue TxA2 production after subeschar endotoxin as reflected in significant increases in burn lymph and pulmonary artery TxB2 levels. Pulmonary artery pressure increased from 22 to 38 mm Hg and PaO2 decreased from 89 to 71 torr while lung lymph flow (QL) increased only modestly with no evidence of increased lung permeability. The TxA2 production and the lung response were prevented by the subeschar injection of ibuprofen, 12.5 mg/kg. Circulating endotoxin was noted in only one of five sheep. After intravenous (endotoxin), a significant increase in lung TxA2 production was noted and a characteristic two-phase lung injury was seen with an initial phase basically identical to that seen with the subeschar injection followed by an increase in lung protein permeability. Burn tissue endotoxin can stimulate local TxA2 production leading to distant lung dysfunction without the need for circulating endotoxin. The source of the TxA2 is the burn, while with endotoxemia the source is the lung.

Animals↗