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Updated: Aug 29, 2026

Intravenous Endotoxin Challenge in Healthy Humans: An Experimental Platform to Investigate and Modulate Systemic Inflammation
Published on: May 16, 2016
Regulation of interactions of endotoxin with host cells
Theresa L Gioannini1, Athmane Teghanemt, Kol A Zarember
1Department of Internal Medicine, Division of Infectious Diseases and The Inflammation Program, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA.
Abstract:
Potent Toll-like receptor 4 (TLR4)-dependent cell activation by endotoxin requires lipopolysaccharide-binding protein (LBP) and CD14-dependent delivery of endotoxin to cells containing MD-2 and TLR4. We have used metabolically labeled [(14)C] meningococcal lipooligosaccharide (LOS), purified recombinant endotoxin-binding proteins, and cultured endothelial cells to better define protein:endotoxin intermediates key in cell activation in the absence of functional membrane (m) CD14. Protein:endotoxin complexes or aggregates (agg) were purified by gel sieving and characterized by immunocapture and bio-assays. Cell activation closely correlated with LBP, albumin and soluble (s) CD14-dependent conversion of endotoxin agg (M(r) > or = 20 x 10(6)) to monomeric (M(r) approximately 55 x 10(3)) endotoxin:sCD14 complexes. Ordered interaction of LBP (+ albumin) and sCD14 with LOSagg was required for the efficient formation of a bioactive endotoxin:sCD14 complex and potent cell activation. Increasing the ratio of LBP/sCD14 or addition of bactericidal/permeability-increasing protein (BPI) reduced accumulation of endotoxin:sCD14 complexes and instead yielded aggregates of endotoxin (M(r) approximately 1-20 x 10(6)) containing LBP or BPI that were taken up by cells in a CD14- and TLR4-independent manner without inducing pro-inflammatory responses. These findings strongly suggest that host machinery linked to TLR4-dependent cellular activation or TLR4-independent cellular clearance of endotoxin selectively recognizes different protein:endotoxin complexes. At the outset of infection, the low concentrations of LBP present and absence of extracellular BPI favor formation of pro-inflammatory endotoxin:CD14 complexes. The mobilization of LBP and BPI that is triggered by inflammation directs endotoxin for clearance and hence resolution of endotoxin-triggered inflammation.
Insights
Lipopolysaccharide-binding protein (LBP) and soluble CD14 (sCD14) convert endotoxin aggregates into bioactive complexes that activate Toll-like receptor 4 (TLR4) cells. Other proteins like bactericidal/permeability-increasing protein (BPI) promote endotoxin clearance instead of activation.
Area of Science:
- Immunology
- Molecular Biology
- Biochemistry
Background:
- Toll-like receptor 4 (TLR4) activation by endotoxin is crucial for innate immune responses.
- Lipopolysaccharide-binding protein (LBP) and CD14 are key mediators in delivering endotoxin to TLR4-expressing cells.
Purpose of the Study:
- To elucidate the role of protein:endotoxin complexes in cell activation, particularly in the absence of membrane CD14.
- To define the specific protein interactions that lead to either pro-inflammatory cell activation or endotoxin clearance.
Main Methods:
- Utilized metabolically labeled meningococcal lipooligosaccharide (LOS) and purified endotoxin-binding proteins.
- Employed cultured endothelial cells and gel sieving to purify and characterize protein:endotoxin complexes.
- Assessed cell activation through bio-assays and immunocapture techniques.
Main Results:
- Cell activation correlated with the conversion of endotoxin aggregates to monomeric endotoxin:sCD14 complexes, dependent on LBP, albumin, and sCD14.
- An ordered interaction of LBP and sCD14 with LOS aggregates was essential for forming bioactive complexes and potent cell activation.
- Increased LBP/sCD14 ratios or BPI addition favored endotoxin aggregates, leading to CD14/TLR4-independent uptake without inflammation.
Conclusions:
- Host machinery distinguishes between protein:endotoxin complexes for TLR4-dependent activation versus TLR4-independent clearance.
- Low initial LBP and absent BPI favor pro-inflammatory endotoxin:CD14 complex formation during early infection.
- Mobilization of LBP and BPI during inflammation directs endotoxin clearance, resolving inflammation.
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