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Intravenous Endotoxin Challenge in Healthy Humans: An Experimental Platform to Investigate and Modulate Systemic Inflammation
07:48

Intravenous Endotoxin Challenge in Healthy Humans: An Experimental Platform to Investigate and Modulate Systemic Inflammation

Published on: May 16, 2016

Endotoxin immunity and the development of the systemic inflammatory response syndrome in critically ill children

R C M Stephens1, K Fidler2, P Wilson3

  • 1Critical Care Group, Portex Unit, Institute of Child Health, 30 Guilford Street, WC1N 1EH, London, UK. r.stephens@ich.ucl.ac.uk.

Intensive Care Medicine
|February 2, 2006
PubMed

Insights

Children with lower endotoxin core antibodies (EndoCAb) are more likely to develop systemic inflammatory response syndrome (SIRS) after non-infectious ICU admissions. This suggests EndoCAb may protect against SIRS in post-operative and head-injured pediatric patients.

Area of Science:

  • Pediatric Intensive Care
  • Immunology
  • Critical Care Medicine

Background:

  • Systemic inflammatory response syndrome (SIRS) can be triggered by endotoxin.
  • Endotoxin core antibodies (EndoCAb) are protective in sepsis and post-surgery.
  • Previous research suggests a link between EndoCAb and patient outcomes.

Purpose of the Study:

  • To investigate the relationship between endotoxin core antibodies (EndoCAb) and the development of SIRS in pediatric intensive care unit (PICU) patients.
  • To determine if EndoCAb levels differ in patients who develop SIRS versus those who do not, stratified by infection status.

Main Methods:

  • 139 pediatric patients with multiple organ failure were recruited.
  • Patients were categorized by infectious or non-infectious diagnosis upon PICU admission.
  • Serum IgG EndoCAb levels were measured and correlated with SIRS development within 48 hours, alongside C-reactive protein and mannose-binding lectin.

Main Results:

  • In non-infectious cases (post-operative, head injury), significantly lower IgG EndoCAb levels were observed in patients who developed SIRS (72 MU/ml) compared to those who did not (131 MU/ml).
  • In infectious cases, no significant difference in IgG EndoCAb levels was found between patients who developed SIRS and those who did not.
  • These findings were independent of confounding variables like C-reactive protein and mannose-binding lectin.

Conclusions:

  • Pediatric patients with head injuries or post-operative conditions admitted to the PICU who develop early SIRS have significantly lower serum IgG EndoCAb levels.
  • EndoCAb may play a protective role against SIRS in specific pediatric patient populations, particularly those without infection.
Abstract

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