Pinciroli Riccardo, Checchi Simone, Bottiroli Maurizio, Monti Gianpaola, Casella Giampaolo, Fumagalli Roberto
Department of Anesthesia and Critical Care, Niguarda Hospital; University of Milan-Bicocca Medical School;
University of Milan-Bicocca Medical School.
J Vis Exp. 2019 Jun 24(148). doi: 10.3791/58507.
Lipopolysaccharide, also known as endotoxin, is a fundamental component of gram-negative bacteria and plays a crucial role in the development of sepsis and septic shock. The early identification of an infectious process that is rapidly evolving to a critical illness might prompt a quicker and more intensive treatment, thereby potentially leading to better patient outcomes. The Endotoxin Activity (EA) assay can be used at the bedside as a reliable biomarker of systemic endotoxemia. The detection of elevated endotoxin activity levels has been repeatedly shown to be associated with an increased disease severity in patients with sepsis and septic shock. The assay is quick and easy to perform. Briefly, after sampling, an aliquot of whole blood is mixed with an anti-endotoxin antibody and with added LPS. Endotoxin activity is measured as the relative oxidative burst of primed neutrophils as detected by chemioluminescence. The assay's output is expressed on a scale from 0 (absent) to 1 (maximal) and categorized as "low" (<0.4 units), "intermediate" (0.4-0.59 units), or "high" (≥0.6 units). The detailed methodology and rationale for the implementation of the EA assay are reported in this manuscript.
脂多糖，也称为内毒素，是革兰氏阴性菌的基本组成成分，在脓毒症和脓毒性休克的发展过程中起关键作用。早期识别迅速发展为危重病的感染过程可能促使更快、更强化的治疗，从而有可能带来更好的患者预后。内毒素活性（EA）检测可在床边用作全身性内毒素血症的可靠生物标志物。内毒素活性水平升高的检测已反复表明与脓毒症和脓毒性休克患者的疾病严重程度增加相关。该检测快速且易于操作。简要来说，采样后，将一份全血与抗内毒素抗体及添加的脂多糖混合。内毒素活性通过化学发光检测的经预处理中性粒细胞的相对氧化爆发来测量。该检测的结果以0（无）至1（最大）的范围表示，并分为“低”（<0.4单位）、“中”（0.4 - 0.59单位）或“高”（≥0.6单位）。本文报告了EA检测实施的详细方法和原理。
