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Endotoxemia: methods of detection and clinical correlates
Open accessAbstract
As an assay for endotoxin, the Limulus amebocyte lysate assay has several desirable properties: sensitivity, specificity, and potential for adaptation to a quantitative format. Several modifications have been developed to enhance its potential for clinical application. The modifications that allow quantitative measurement of endotoxin and also improve its application to blood samples are described in this review. In fluids other than blood, the detection of endotoxin with the Limulus amebocyte lysate assay can be used as an aid to identify the presence of gram-negative bacteria, and the assay has established utility. With blood, however, there are a range of factors that interfere with the detection of endotoxemia and there are disparate views with respect to the diagnostic and prognostic significance of the test results. In general, the clinical significance of the finding of endotoxemia broadly parallels the frequency and importance of gram-negative sepsis in the patient groups studied and a decline in endotoxin levels accompanies clinical improvement. However, with therapies designed to reduce levels of endotoxin, or to antagonize its effects, it is unclear whether clinical improvement occurs as a consequence of changes in the levels of endotoxemia.
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“Average resting endotoxin units in the current study remained within normal limits (<10 pg·mL−1), and were comparable to values observed (~11.0 ± 5.0 pg·mL−1) for healthy volunteers with similar fitness levels [14,39,40].”
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Metadata
- Authors
- Hurley, J. C.
- Affiliations
- Seattle Children's Hospital (US)
- Corresponding author
- Hurley, J C
- ORCID
- Hurley, J C
- Venue
- Clinical Microbiology Reviews
- Publisher
- American Society for Microbiology
- Published
- 1995-04
- Volume
- 8
- Issue
- 2
- Pages
- 268-292
- ISSN
- 0893-8512 (ISSN-L)
- 1098-6618
- PMC
- PMC172859
- OpenAlex
- W2134508859
- Cited by
- 318
- References
- 423
- Citations by year
- 2026: 12 · 2025: 5 · 2024: 7 · 2023: 12 · 2022: 10 · 2021: 10 · 2020: 14 · 2019: 8 · 2018: 11 · 2017: 20 · 2016: 25 · 2015: 6 · 2014: 18 · 2013: 9 · 2012: 20
- FWCI
- 6.55
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Microbiology Reviews (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Microbiology (medical) › Bacterial Identification and Susceptibility Testing
- Life Sciences › Immunology and Microbiology › Immunology › Inflammation biomarkers and pathways
- Keywords
- endotoxemia, Limulus amebocyte lysate assay, endotoxin detection, gram-negative sepsis, blood culture, assay interference, Gram-negative bacteria, endotoxin antagonists
- MeSH terms
- Endotoxins, Humans, Limulus Test, Risk Factors, Toxemia, Treatment Outcome, Sepsis
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