Abstract
Healthy human volunteers carry a large amount of endotoxin in their intestines (a mean of 109 pg per gram of faeces) [1]. The controlling mechanisms preventing the occurrence of systemic endotoxaemia must be extremely effective, as even such small concentrations as 2–5 ng/kg of endotoxin in blood can cause fever, thrombocytopenia etc. The first barrier constituting this important control mechanism is an intact mucosal lining, through which leakage is minimal [2]. The second barrier is the liver; intestinal endotoxin which passes the intestinal mucosa (portal endotoxaemia) is effectively cleared by Kupffer cells in the liver [3]. Finally, the third line of defence against endotoxin is the endotoxin-binding properties of the blood which neutralize endotoxin following spillover of the liver [4].
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References
van Saene JJM, Stoutenbeek CP, van Saene HKF (1989) Reduction of intestinal endotoxin pool by oral polymyxin E in human volunteers. Microb Ecol Health Dis 1 (in press)
Wardle EN (1978) A review of endotoxin and its absorption from the gut. In: Hemmings WA (ed) Antigen absorption by the gut. MTP Press, Lancaster, p 183
Jacob AI, Goldberg PK, Bloom N, Degenschein GA, Kozinn PJ (1977) Endotoxin and bacteria in portal blood. Gastroenterol 72: 1268–1270
Springer GF, Adye JC (1975) Endotoxin-binding substances from human leukocytes and platelets. Infect Immun 12: 978–986
Walker RI, Porvaznik M (1983) Association of bacteria and endotoxin with posttrauma events. In: Ninneman JL (ed) Traumatic injury. University Press, Baltimore, pp 1–16
Bradfield JW (1974) Control of spillover: the importance of Kupffer cell function in clinical medicine. Lancet 11: 883–885
McCartney AC, Banks JG, Clements GB, Sleigh JD, Tehrani M, McLedingham I (1983) Endotoxaemia in septic shock: clinical and post mortem correlation. Int Care Med 9: 117–122
Wilkinson SP, Arroyo V, Gazzard BG, Moodie H, Williams R (1974) Relation of renal impairment and haemorrhagic diathesis to endotoxaemia in fulminant hepatic failure. Lancet 1: 521–524
Schweinburg FB, Shapiro PB, Frank ED, Fine J (1957) Host resistance in hemorrhagic shock IX. Demonstration of circulating lethal toxin in hemorrhagic shock. Proc Soc Exp Biol Med 95: 646–650
Fine J, Frank ED, Ravin HA, Rutenberg SH, Schweinburg FB (1959) The bacterial factor in traumatic shock. N Engl J Med 260: 214–220
Koike M, Iida K, Matsuo T (1969) Electron microscopic studies on mode of action of polymyxin. J Bacteriol 97: 448–452
Bannatyne RM, Harnett NM, Lee K, Biggar WD (1977) Inhibition of the biological effects of endotoxin on neutrophils by polymyxin B sulphate. J Infect Dis 136: 469–474
Corrigan JJ, Bell BM (1971) Endotoxin-induced intravascular coagulation: prevention with polymyxin B sulphate. J Lab Clin Med 77: 802–810
Liehr H, Grün M, Brunswig D, Sautter Th (1975) Endotoxaemia in liver cirrhosis: treatment with polymyxin B. Lancet 1: 810–811
Gardi A, Arpagous GR (1980) Improved microtechnique for endotoxin assay by the limulus amebocyte lysate test. Anal Biochem 109: 382–385
Goris H, de Boer F, van der Waaig D (1986) Oral administration of antibiotics and intestinal flora associated endotoxin in mice. Scand J Infect Dis 18: 55–63
van Saene HKF, Stoutenbeek CP, Miranda DR, Zandstra DF (1983) A novel approach to infection control in the intensive care unit. Acta Anaesth Belg 34: 193–208
Best WR (1970) On the logarithmic transformation of intestinal bacterial counts. J Clin Nutr 23: 1608–1609
van Saene HKF, Stoutenbeek CP, Faber-Nijholt R, van Saene JJM (1989) Selective flora elimination contributes to control of disseminated intravascular coagulation in severe liver impairment. Am J Clin Path (in press)
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van Saene, J.J.M., Stoutenbeek, C.P., van Saene, H.K.F. (1989). Significant Reduction of Faecal Endotoxin Pool by Oral Polymyxin E and Tobramycin in Human Volunteers. In: van Saene, H.K.F., Stoutenbeek, C.P., Lawin, P., Ledingham, I.M. (eds) Infection Control in Intensive Care Units by Selective Decontamination. Update in Intensive Care and Emergency Medicine, vol 7. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-83752-4_35
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DOI: https://doi.org/10.1007/978-3-642-83752-4_35
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