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Neutralization of Endotoxin by a Phospholipid Emulsion in Healthy Volunteers

2005; Oxford University Press; Volume: 191; Issue: 9 Linguagem: Inglês

10.1086/428908

1537-6613

Bruce R. Gordon, Thomas S. Parker, Daniel M. Levine, Fred Feuerbach, Stuart D. Saal, Betty‐Jane Sloan, Cindy S. Chu, Kurt H. Stenzel, Joseph E. Parrillo, Albert L. Rubin,

Neonatal Respiratory Health Research

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.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).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.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.