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Immune Response in the Critically Ill pp 335–357Cite as

Endotoxemia in Healthy Subjects as a Human Model of Inflammation

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Part of the book series: Update in Intensive Care Medicine ((UICMSOFT,volume 31))

Abstract

Endotoxin is a lipopolysaccharide (LPS) that is a major component of the outer membrane of Gram-negative bacteria. Endotoxin has strong pro-inflammatory properties and can activate multiple inflammatory cascades. It is therefore considered to play a key role in the toxic sequelae of Gram-negative sepsis [1, 2]. LPS is composed of a lipid moiety, designated lipid A, and a hydrophilic polysaccharide chain. The polysaccharide portion of LPS consists of the O-chain, that protrudes from the bacterial membrane, and a ‘core part’, connecting the O-chain with lipid A. While the O-chain consists of a series of structurally and antigenically diverse oligosaccharides that determine the many different O-specific serotypes, the core part is identical for many different bacteria. Lipid A is the highly conserved biologically active part of LPS which is completely embedded in the bacterial membrane, shielded by the O-chain. Pro-inflammatory effects of Gramnegative bacteria can, therefore, not be readily explained by the effects of cellbound LPS. However, LPS can be shed by Gram-negative bacteria via several mechanisms, including destruction of the bacterial cell wall by complement factors.

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Authors and Affiliations

  1. Department of Experimental Internal Medicine Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    T. van der Poll & S. J. H. van Deventer

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  1. T. van der Poll
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Editors and Affiliations

  1. Department of Surgery Interdepartmental Division of Critical Care Medicine, Toronto General Hospital University of Toronto, Toronto, Ontario, Canada

    John C. Marshall MD (Professor of Surgery) (Professor of Surgery)

  2. Department of Infectious Diseases & Microbiology Division of Investigative Science, Imperial College School of Medicine Hammersmith Hospital, London, UK

    Jonathan Cohen FRCP, FRCPath, FRCPE, FMedSci (Chairman) (Chairman)

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van der Poll, T., van Deventer, S.J.H. (2002). Endotoxemia in Healthy Subjects as a Human Model of Inflammation. In: Marshall, J.C., Cohen, J. (eds) Immune Response in the Critically Ill. Update in Intensive Care Medicine, vol 31. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-57210-4_22

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