Endotoxin as a therapeutic target in septic shock.

Endotoxin initiates a broad inflammatory response in mammals that has many similarities to de novo septic shock in patients. The presumed role of endotoxin in septic shock has led to the investigation of antiendotoxin therapies for the treatment of this syndrome. However, a causative role for endotoxin in human septic shock has not been established. Recent information about the biochemistry of endotoxin, mechanisms of endotoxin-induced cell activation, and the pathogenesis of septic shock has provided insights useful to the development of new antiendotoxin agents, but also has raised concerns about the suitability of endotoxin as a therapeutic target. Definitive proof of the pathogenic importance of endotoxin in human septic shock will depend upon demonstrating that a putative antiendotoxin therapy has clinical efficacy.