Neutralization of endotoxin by a phospholipid emulsion in healthy volunteers.
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.
Gordon
Bruce R
BR
The Rogosin Institute, New York, New York 10021, USA. gordobr@mail.rockefeller.edu
Parker
Thomas S
TS
Levine
Daniel M
DM
Feuerbach
Fred
F
Saal
Stuart D
SD
Sloan
Betty-Jane
BJ
Chu
Cindy
C
Stenzel
Kurt H
KH
Parrillo
Joseph E
JE
Rubin
Albert L
AL
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
D004655:Emulsions; D004731:Endotoxins; D010743:Phospholipids