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Langenbeck's Archives of Surgery

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01-08-2010 | Overview

Endotoxin elimination in sepsis: physiology and therapeutic application

Authors: Klaus Buttenschoen, Peter Radermacher, Hendrik Bracht

Published in: Langenbeck's Archives of Surgery | Issue 6/2010

Abstract

Purpose

The present review summarizes key papers on the elimination of endotoxin in human.

Results

Lipopolysaccharides (LPS) are extremely strong stimulators of inflammatory reactions, act at very low concentrations, and are involved in the pathogenesis of sepsis and septic shock. Elimination of LPS is vital; therefore, therapeutic detoxification of LPS may offer new perspectives. Multiple mechanisms eliminate LPS in human comprising molecules that bind LPS and prevent it from signaling, enzymes that degrade and detoxify LPS, processes that inactivate LPS following uptake into the reticulo-endothelial system, and mechanisms of adaptation that modify target cells responding to LPS. These mechanisms are powerful and detoxification capacity adapts as required. Results of therapeutic interventions aiming at the removal of LPS by medication (immunoglobulins) or extracorporeal means are controversial. At least in part, animal experiments revealed increased survival. Human trials confirmed the positive effects on parameters of secondary importance, but not on morbidity or survival which was attributed to the heterogeneity of patients suffering from consequences of severe infectious diseases and sepsis.

Conclusion

The hypothesis of LPS-driven inflammatory processes remains very attractive. However, few therapeutic yet immature options have been developed to date.

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Title: Endotoxin elimination in sepsis: physiology and therapeutic application
Authors: Klaus Buttenschoen
Peter Radermacher
Hendrik Bracht
Publication date: 01-08-2010
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 6/2010
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-010-0658-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Endotoxin elimination in sepsis: physiology and therapeutic application

Abstract

Purpose

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Results

Conclusion

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