Plasma endotoxin concentrations in experimental and clinical equine subjects.

J F Fessler, G D Bottoms, G L Coppoc, S Gimarc, H S Latshaw, J K Noble
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引用次数: 79

Abstract

Endotoxin (LPS) was quantitated in experimental subjects and in horses with naturally occurring gastrointestinal strangulation obstruction and/or septicaemic diseases to establish the fate of LPS and the clinical usefulness of the Limulus amoebocyte lysate (LAL) assay. The assay was validated for sensitivity (10 pg/ml), recovery (90 to 106 per cent), intra-assay precision (CV = 5.5 per cent) inter-assay precision (CV = 11 per cent), and stability of diluted, heat treated, frozen samples (at least 90 days). Plasma concentrations of LPS after sublethal (3 micrograms/kg) jugular or portal vein bolus injections of LPS rose to 4000 pg/ml and 1500 pg/ml respectively followed by a rapid phase of clearance. Peak plasma concentrations of LPS, associated with slow portal infusion, were lower than peak values associated with bolus injections, remained elevated during the infusion (2 h), but rapidly decreased after infusion was stopped. Thirty seven horses with 38 episodes of naturally occurring gastrointestinal or septicaemic disease were assayed for LPS. Eight episodes involving gastrointestinal disease and eight involving septicaemic disease were positive for LPS. It is concluded that the LAL assay is sensitive and reliable for detecting LPS in equine plasma and it may have clinical value for establishing the severity of endotoxaemia or for distinguishing between septic and non-septic conditions. Problems of rapid clearance of LPS from plasma, low concentrations, the possibility of sample contamination, and the time and method of sample procurement remain to be addressed.

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实验和临床马的血浆内毒素浓度。
在实验对象和患有自然发生的胃肠道绞窄性梗阻和/或败血症疾病的马中定量测定内毒素(LPS),以确定LPS的命运和鲎变形虫细胞裂解物(LAL)测定法的临床实用性。验证了该方法的灵敏度(10 pg/ml),回收率(90%至106%),测定内精度(CV = 5.5%),测定间精度(CV = 11%),以及稀释,热处理,冷冻样品的稳定性(至少90天)。亚致死(3微克/千克)颈静脉或门静脉注射LPS后,血浆LPS浓度分别上升至4000 pg/ml和1500 pg/ml,随后快速清除。与缓慢门脉输注相关的LPS血浆浓度峰值低于与快速注射相关的峰值,在输注期间(2小时)保持升高,但在输注停止后迅速下降。37匹马有38次自然发生的胃肠道或败血症疾病进行了脂多糖检测。8例涉及胃肠道疾病,8例涉及败血症,LPS呈阳性。结论:LAL法检测马血浆LPS敏感可靠,对确定内毒素血症严重程度或区分脓毒性和非脓毒性疾病具有临床价值。血浆中LPS的快速清除、低浓度、样品污染的可能性以及样品获取的时间和方法等问题仍有待解决。
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