title: Treatment of toxic shock syndrome with endotoxin-neutralizing antibody.
abstract: The enhancement of host susceptibility to endotoxin (lipopolysaccharide, LPS) by toxic shock syndrome toxin-1 (TSST-1) is an important mechanism in the pathogenesis of toxic shock syndrome. In these studies, we sought to determine whether an endotoxin-neutralizing monoclonal antibody could be useful in the treatment of toxic shock syndrome. We isolated a murine monoclonal hybridoma (3-H3) which secreted monoclonal antibody (mAb) specific for Escherichia coli 0111:B4 LPS. Spleen cells cocultured with E. coli 0111:B4 LPS demonstrated up to a 60% decrease in mitogenic activity in the presence of 3-H3 mAb, but not control mAb, demonstrating that this antibody neutralized endotoxin in vitro. Rabbits pretreated with 3-H3 mAb or control mAb were injected intradermally with E. coli 0111:B4 LPS. One day later rabbits received E. coli 0111:B4 LPS intravenously to elicit the dermal Shwartzman reaction. Rabbits pretreated with 3-H3 mAb did not develop this reaction (0/6) compared to animals pretreated with control mAb (5/6), demonstrating that this antibody neutralized endotoxin in vivo (P less than 0.05). When this antibody was evaluated in a rabbit model of lethal toxic shock syndrome, rabbits pretreated with antibody demonstrated greater survival (8/14) than saline control animals (1/10) after challenge with TSST-1 and E. coli 0111:B4 LPS (P less than 0.05). Since the suspicion exists that low levels of endogenous LPS may potentiate TSST-1 activity during clinical toxic shock syndrome, we hypothesized that endotoxin-neutralizing antibodies could be useful in the treatment of this lethal disease process.
authors.affiliation: Department of Surgery, University of Minnesota, Minneapolis 55455.
authors.forename: B P
authors.initials: BP
authors.lastname: Priest
authors.forename: P M
authors.initials: PM
authors.lastname: Schlievert
authors.forename: D L
authors.initials: DL
authors.lastname: Dunn
mesh_terms: D000818:Animals; D000911:Antibodies, Monoclonal / Q000276:immunology / Q000627:therapeutic use; D002455:Cell Division / Q000187:drug effects; D004797:Enzyme-Linked Immunosorbent Assay; D007116:Immunization, Passive; D007136:Immunoglobulins; D008070:Lipopolysaccharides / Q000037:antagonists & inhibitors / Q000276:immunology* / Q000494:pharmacology / Q000627:therapeutic use; D051379:Mice; D011817:Rabbits; D012772:Shock, Septic / Q000401:mortality / Q000628:therapy*; D013154:Spleen / Q000166:cytology
chemical_list: D000911:Antibodies, Monoclonal; D007136:Immunoglobulins; D008070:Lipopolysaccharides; C042866:antilipopolysaccharide antibodies