Assay of pyrogenic contamination in pharmaceuticals by cytokine release from monocytes.

In 1984 it was reported that a batch of human recombinant growth hormone which had passed the rabbit pyrogen test and a Limulus amoebocyte lysate (LAL) test was pyrogenic in man (1). Further, it was shown that the growth hormone caused human monocytes to release leukocyte pyrogen which evoked fevers in rabbits (1). Leukocyte pyrogen is believed to comprise of a mixture of (at least) 2 lymphokines with potent pyrogenic and inflammatory activities, interleukin-1 (IL-1) and Tumour Necrosis Factor (TNF), which are synthesized and released by activated peripheral blood monocytes. The development at NIBSC of sensitive and specific bioassays and immunoassays of IL-1 (2) and TNF (3) have permitted a new type of pyrogen test based on the in vitro release by human monocytes of the lymphokines IL-1 and TNF. Studies are underway to evaluate the suitability of monocytic cell lines, rather than human monocytes, since these require a time-consuming and labour intensive preparation. Investigations are in progress to evaluate the suitability of the above "monocyte test" for pyrogen to replace or complement the rabbit pyrogen test which is routinely applied to biological medicines. The new method has already proved useful in detecting pyrogenic contamination of a large volume parenteral medicinal product which passed the rabbit pyrogen test but caused adverse reactions in patients.