title: Neutralization of endotoxin by a phospholipid emulsion in healthy volunteers.
abstract: BACKGROUND
  An approach to endotoxin (lipopolysaccharide [LPS]) blockade makes use of the ability of lipoproteins, via surface phospholipids, to bind and neutralize LPS. The aim of the present study was to determine whether the intravenous administration of a protein-free, phospholipid-rich emulsion is an effective method for neutralizing the effects of LPS in healthy persons.
  
  
  METHODS
  This was a double-blind, placebo-controlled study in 20 volunteers. Volunteers received Escherichia coli endotoxin (2 ng/kg) intravenously 2 h into a 6-h infusion of either emulsion (210 mg/kg) or placebo (Intralipid diluted 1 : 64).
  
  
  RESULTS
  The volunteers who received emulsion had a lower mean clinical score (P<.01), temperature (P<.05), pulse rate (P<.05), neutrophil count (P<.05), tumor necrosis factor- alpha level (P<.05), and interleukin-6 level (P<.05) than did the volunteers who received placebo. Response was related to serum phospholipid level. The greatest effects were observed in the volunteers achieving phospholipid levels of approximately 500 mg/dL or higher.
  
  
  CONCLUSIONS
  Phospholipid emulsion attenuates the clinical and laboratory effects associated with the administration of LPS in humans, suggesting a novel approach to the treatment of endotoxemia.
authors.affiliation: The Rogosin Institute, New York, New York 10021, USA. gordobr@mail.rockefeller.edu
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Gordon
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Parker
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Levine
authors.forename: Fred
authors.initials: F
authors.lastname: Feuerbach
authors.forename: Stuart D
authors.initials: SD
authors.lastname: Saal
authors.forename: Betty-Jane
authors.initials: BJ
authors.lastname: Sloan
authors.forename: Cindy
authors.initials: C
authors.lastname: Chu
authors.forename: Kurt H
authors.initials: KH
authors.lastname: Stenzel
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Parrillo
authors.forename: Albert L
authors.initials: AL
authors.lastname: Rubin
mesh_terms: D000328:Adult; D004655:Emulsions; D004731:Endotoxins / Q000009:adverse effects / Q000037:antagonists & inhibitors* / Q000097:blood; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D010743:Phospholipids / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D012016:Reference Values
chemical_list: D004655:Emulsions; D004731:Endotoxins; D010743:Phospholipids