Endotoxemia is masked in fungal infection due to enhanced endotoxin clearance by beta-glucan.
Employing a novel turbidimetric assay, the amount of endotoxin and beta-glucan in plasma was monitored in postoperative patients suffering from both bacterial and fungal infections. The patients, whose beta-glucan level was markedly elevated, were always negative for endotoxin, suggesting a possible role of beta-glucan in the clearance of circulating endotoxin. In order to test the above hypothesis, effects of beta-glucan (carboxy methylated curdlan or lentinan) on endotoxin clearance were studied in rabbits. beta-glucan (4 micrograms/kg or 40 micrograms/kg) was intravenously administered to rabbits which received 4 micrograms/kg endotoxin injection, simultaneously or 120 min before the injection. Either of the beta-glucans increased the endotoxin clearance in a dose-dependent manner, and the preinjection of beta-glucan was more effective than the coinjection. The increased amount of plasma beta-glucan results in the unexpectedly low level of plasma endotoxin, which may be removed by the reticuloendothelial system activated by beta-glucan, in cases with both bacterial and fungal infections. Thus, it is important to recognize that endotoxemia may be masked by the coexisting fungal infection.
Yokota
M
M
Second Department of Surgery, Osaka University Medical School, Japan.
Tsujinaka
T
T
Kambayashi
J
J
Watase
M
M
Sakon
M
M
Mori
T
T
D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000818:Animals; D001424:Bacterial Infections / Q000378:metabolism*; D004731:Endotoxins / Q000097:blood*; D005260:Female; D005936:Glucans / Q000097:blood* / Q000627:therapeutic use; D006801:Humans; D007668:Kidney / Q000378:metabolism; D007912:Lentinan / Q000627:therapeutic use; D008099:Liver / Q000378:metabolism; D008168:Lung / Q000378:metabolism; D008297:Male; D009181:Mycoses / Q000378:metabolism*; D010538:Peritonitis / Q000378:metabolism / Q000382:microbiology*; D011183:Postoperative Complications / Q000378:metabolism / Q000382:microbiology*; D011817:Rabbits; D047071:beta-Glucans
D000276:Adjuvants, Immunologic; D004731:Endotoxins; D005936:Glucans; D047071:beta-Glucans; C063424:carboxymethylcurdlan; D007912:Lentinan