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Effect of polymyxin B on experimental shock from meningococcal and Escherichia coli endotoxins

G Baldwin1, G Alpert, G L Caputo

  • 1Department of Medicine, Children's Hospital, Boston, MA 02115.

Insights

Polymyxin B (PMB) did not improve survival in rabbits with meningococcal shock. However, PMB showed protective effects against E. coli lipopolysaccharide (LPS) induced shock, suggesting differential activity against bacterial toxins.

Area of Science:

  • Microbiology
  • Immunology
  • Pharmacology

Background:

  • Meningococcemia is a leading cause of septic shock in children.
  • Lipooligosaccharide (LOS) from Neisseria meningitidis is a key virulence factor in meningococcal disease.
  • Polymyxin B (PMB) is an antibiotic with known endotoxin-neutralizing properties.

Purpose of the Study:

  • To evaluate the efficacy of Polymyxin B (PMB) in improving survival from meningococcal shock.
  • To compare PMB's protective activity against meningococcal lipooligosaccharide (LOS) with its activity against Escherichia coli lipopolysaccharide (LPS).

Main Methods:

  • Rabbits were challenged with lethal doses (LD90) of meningococcal LOS or (LD80) of E. coli LPS.
  • PMB was administered intravenously 30 minutes before challenge or premixed with the endotoxin in vitro.
  • Hemodynamic parameters, serum bicarbonate, tumor necrosis factor (TNF) levels, and 24-hour survival were monitored.

Main Results:

  • PMB administration before meningococcal LOS challenge did not significantly affect survival, heart rate, mean arterial pressure, serum bicarbonate, or TNF levels.
  • Premixing PMB with meningococcal LOS in vitro improved serum bicarbonate and 24-hour survival.
  • PMB administration before E. coli LPS challenge significantly increased serum bicarbonate, decreased TNF levels, and improved 24-hour survival.
  • In vitro studies confirmed PMB neutralized E. coli LPS but not meningococcal LOS.

Conclusions:

  • Polymyxin B pretreatment does not protect against shock induced by meningococcal LOS in rabbits.
  • PMB demonstrates protective effects against E. coli LPS-induced shock, indicating differential activity against bacterial endotoxins.
  • The findings suggest that PMB's efficacy in septic shock may depend on the specific bacterial pathogen and its endotoxin structure.

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