title: Endotoxin contamination causes neutrophilia following pulmonary allergen challenge.
abstract: Segmental bronchoprovocation (SBP) with allergen was used in an attempt to study eosinophils recruited to the airway 24 h after challenge. Unexpectedly, in the first four patients, neutrophils (rather than eosinophils) were recruited in the bronchoalveolar lavage (BAL) fluids, and we hypothesized that the allergen extracts were contaminated with endotoxin. The extracts used for challenge in the first four patients tested positive for bacterial endotoxin in a limulus amebocyte lysate assay. Rechallenge of one patient from the first group with a comparable dose of an endotoxin-free extract and SBP with endotoxin-free extract in five additional patients resulted in preferential recruitment of eosinophils rather than neutrophils. The number of neutrophils recovered from the challenged segments in the patients challenged with endotoxin-free extract was significantly less than that observed in the first four patients. Taken together, these observations suggest that neutrophil recruitment in the 24-h BAL fluids from the first four patients was probably due to endotoxin contamination of the allergen extract. We caution investigators that endotoxin contamination of allergen extract may alter the cellular inflammation during the late airway response following allergen challenge.
authors.affiliation: Division of Allergic Diseases and Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: L W
authors.initials: LW
authors.lastname: Hunt
authors.forename: G J
authors.initials: GJ
authors.lastname: Gleich
authors.forename: T
authors.initials: T
authors.lastname: Ohnishi
authors.forename: D A
authors.initials: DA
authors.lastname: Weiler
authors.forename: E S
authors.initials: ES
authors.lastname: Mansfield
authors.forename: H
authors.initials: H
authors.lastname: Kita
authors.forename: S
authors.initials: S
authors.lastname: Sur
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens; D001249:Asthma / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology*; D001985:Bronchial Provocation Tests / Q000009:adverse effects*; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry / Q000166:cytology*; D004340:Drug Contamination; D004731:Endotoxins / Q000009:adverse effects*; D004804:Eosinophils; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications* / Q000175:diagnosis; D015592:Immunoradiometric Assay; D007249:Inflammation; D007958:Leukocyte Count; D019272:Leukocyte Elastase; D008033:Limulus Test; D008297:Male; D009504:Neutrophils; D010196:Pancreatic Elastase / Q000032:analysis; D012882:Skin Tests; D013997:Time Factors
chemical_list: D000485:Allergens; D004731:Endotoxins; D010196:Pancreatic Elastase; D019272:Leukocyte Elastase