Gel clot LAL assay in the initial management of peritoneal dialysis patients with peritonitis: a retrospective study

Highly Sensitive Electrochemical Endotoxin Sensor Based on Redox Cycling Using an Interdigitated Array Electrode Device

The Limulus amebocyte lysate (LAL) reaction-based assay, the most commonly used endotoxin detection method, requires a skilled technician. In this study, to develop an easy-to-use and highly sensitive endotoxin sensor, we created an electrochemical endotoxin sensor by using an interdigitated array electrode (IDAE) device with advantages of amplifiable signals via redox cycling and portability. We added Boc-Leu-Gly-Arg-p-aminophenol (LGR-pAP) as an electrochemical substrate for an LAL reaction and detected p-aminophenol (pAP) released from LGR-pAP as a product of an endotoxin-induced LAL reaction via an IDAE device. The IDAE device showed a great redox cycling efficiency of 79.8%, and a 4.79-fold signal amplification rate. Then, we confirmed that pAP was detectable in the presence of LGR-pAP through chronoamperometry with the potential of the anode stepped from -0.3 to 0.5 V vs. Ag/AgCl while the cathode was biased at -0.3 V vs. Ag/AgCl. Then, we performed an endotoxin assay by using the IDAE device. Our endotoxin sensor detected as low as 0.7 and 1.0 endotoxin unit/L after the LAL reaction for 1 h and 45 min, respectively, and these data were within the cut-off value for ultrapure dialysis fluid. Therefore, our highly sensitive endotoxin sensor is useful for ensuring medical safety.

Effluent lipopolysaccharide is a prompt marker of peritoneal dialysis-related gram-negative peritonitis

BACKGROUND

To investigate the value of effluent lipopolysaccharide (LPS) for early detection of gram-negative peritonitis (GNP) in peritoneal dialysis (PD) patients.

METHODS

PD-related peritonitis episodes occurring between January 2016 and December 2018 were included in the study. Effluent LPS and the other infectious parameters were measured at peritonitis presentation, and peritonitis was categorized as GNP, non-GNP, and culture-negative peritonitis. Receiver operating characteristic (ROC) analysis was employed to evaluate the efficacy of effluent LPS to distinguish GNP.

RESULTS

A total of 161 peritonitis episodes were analyzed, including 49 GNP episodes and 82 non-GNP episodes. In contrast with non-GNP, GNP presented with higher effluent leukocyte count (3236 (1497-6144) vs. 1904 (679-4071) cell mm^-3, p = 0.008), increased effluent LPS (1.552 (0.502-2.500) vs. 0.016 (0.010-0.030) EU mL^-1, p < 0.001), lower blood leukocyte count (9.95 ± 3.18 vs. 11.56 ± 4.37 × 10⁹ L^-1, p = 0.017), greater neutrophil predominance (87.1 ± 4.6% vs. 83.4 ± 7.7%, p = 0.001), and greater "procalcitonin" (PCT, 4.90 (2.20-12.60) vs. 1.00 (0.51-4.07) µg L^-1, p < 0.001). It took 5.2 ± 3.1 h to report the results of effluent LPS. Effluent LPS cutoff value of >0.035 EU mL^-1 showed an area under the ROC curve of 0.972 (95% CI 0.951-0.994, p < 0.001) in differentiating GNP from non-GNP with a sensitivity of 100% and a specificity of 80.5%, and its joint utilization with PCT further increased the specificity (91.4%) to discriminate GNP.

CONCLUSIONS

PD effluent LPS could be an applicable early marker of gram-negative organism-related peritonitis in PD patients.

A polymyxin B-silver nanoparticle colloidal system and the application of lipopolysaccharide analysis

Polymyxin B (PMB) is a small cyclic polycationic lipopeptide, which can be used as an antibiotic drug against Gram-negative bacteria. In this work, the interaction between citrate capped silver nanoparticles (AgNPs) and PMB is studied. Experimental results show that the association constant is extremely high and the binding event leads to a significant variation in the localized surface plasmon resonance (LSPR) of AgNPs. Moreover, the PMB-AgNP colloidal system can be further exploited as a sensitive analytical platform. Taking lipopolysaccharide (LPS) as an example, we demonstrate a facile colorimetric LPS detection method. LPS is a major constituent of the Gram-negative bacterial cell wall which is used as an optimal biomarker for some diseases like urinary tract infections and sepsis. In this study, target LPS is able to tightly bind to PMB, which effectively inhibits the PMB induced aggregation of AgNPs. By monitoring the UV-vis absorption spectra, the LPS concentration can be quantitatively determined with high sensitivity. The sensing strategy is quite simple, which allows effortless diagnosis of many diseases at different stages.

Preparation of a Peptide-Modified Electrode for Capture and Voltammetric Determination of Endotoxin

Endotoxin is the major structural constituent of the outer membrane of Gram-negative bacteria, which is a great threat to human health. Herein, a sensitive electrochemical biosensor for the detection of endotoxin is established by recording the voltammetric responses of the peptide-modified electrode. The utilized peptide has a high affinity for the target endotoxin, which ensures the high selectivity of this method. After the capture of endotoxin on the electrode surface, a negatively charged layer is formed, and the electron-transfer process is significantly hindered because of the increased steric hindrance and the electrostatic repulsion. The declined electrochemical signal could be used to indicate the concentration of endotoxin. This method is simple but effective, which requires limited reagents. Another highlight of this method is its user-friendly operation. Moreover, its applicability in human blood plasma promises its great potential utility in the near future.

A quartz crystal microbalance sensor for endotoxin assay by monitoring limulus amebocyte lysate protease reaction

Endotoxin is able to trigger strong innate immune responses by interacting with specific receptors on immune cells. Therefore, accurate and rapid detection of endotoxin is of primary importance. In this study, endotoxin induced viscosity variation of limulus amebocyte lysate (LAL) reagent is monitored by a quartz crystal microbalance (QCM) sensor with enhanced signal. Based on the analysis of the relationship between endotoxin concentration and QCM frequency shift with time, an effective sensing strategy is developed for endotoxin assay, which shows excellent sensitivity and specificity in the linear detection range from 0.005 to 10 EU mL^-1. Moreover, this QCM sensor could be reused after a simple regeneration procedure. Therefore, it has potential practical utility for endotoxin determination in various applications.

In vitro human fecal microbial metabolism of Forsythoside A and biological activities of its metabolites

The present study aimed to investigate the metabolism of Forsythoside A (FTA) by human fecal bacteria to clarify the relationship between its intestinal metabolism and its pharmacological activities. FTA was incubated with human fecal microflora in vitro to investigate its metabolic process, and highly sensitive and specific ultra-performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS) was performed using MetaboLynx software for metabolite analysis. Caffeic acid (CA) and hydroxytyrosol (HT) were obtained by hydrolysis of FTA, and CA was further hydrogenated to form 3,4-dihydroxybenzenepropionic acid (DCA). The anticomplementary, antimicrobial and antiendotoxin activities of FTA and its metabolites by human fecal microflora were evaluated in vitro with a hemolysis assay, the agar disc-diffusion method, the MIC value and the gel clot LAL assay, respectively. The metabolites showed higher biological activity than FTA, especially HT and DCA. Orally administered FTA may be metabolized to HT and DCA, and the pharmacological effects of FTA may be dependent on intestinal bacterial metabolism.

TLR4 and NLRP3 inflammasome activation in monocytes by N-propionyl cysteaminylphenol-maleimide-dextran (NPCMD)

BACKGROUND

N-propionyl cysteaminylphenol-maleimide-dextran (NPCMD) is a toxic tyrosinase substrate developed to treat melanoma.

OBJECTIVE

We investigated the effect of NPCMD on innate immune responses in monocytes.

METHODS

CD14⁺ monocytes and a monocytic cell line, THP-1, were stimulated with NPCMD in vitro. Cytokines in the culture supernatants were determined by ELISA and flow cytometry.

RESULTS

NPCMD stimulated CD14⁺ monocytes and THP-1 cells to secrete TNFα, IL-6 and IL-8, but not IL-10 or IL-12. TNFα secretion from THP-1 cells stimulated with NPCMD was inhibited by addition of an anti-TLR4 mAb in culture. Moreover, NPCMD stimulated production of pro-IL-1β in CD14⁺ monocytes and monocytic cell line THP-1 cells and activated the NLRP3-inflammasome, resulting in production of mature IL-1β. Use of ASC and NLRP3-deficient THP-1 cell lines established involvement of the NLRP3 inflammasome in an IL-1β secretion in treatment with NPCMD. Inhibition of IL-1β secretion by an endocytosis inhibitor, cytochalasin B, and a lysosomal enzyme cathepsin B inhibitor, CA-074 Me, suggested the involvement of lysosomal rupture and leakage of cathepsin B into the cytosol in NLRP3 activation by NPCMD.

CONCLUSION

The immunopotentiating effect of NPCMD mediated by TLR4 and NLRP3 inflammasome activation could be useful for eliciting effective adaptive immune responses against melanoma and other tumors.

Relationship between the treatment and the evolution of the clinical course in scouring Merino lambs from "La Serena" (Southwest Spain)

This work investigated the link between the type of treatment and the clinical evolution of lambs suffering from diarrhoea attributed to non-enterotoxigenic Escherichia coli. Two hundred and forty scouring lambs, and 25 healthy lambs selected as control, were used in this trial. The faecal samples from the scouring lambs were positive to non-enterotoxigenic E. coli. All the scouring lambs received supportive care and they were randomly allotted to two groups of 120 animals (treated group and untreated group). The lambs in the treated group were given two daily doses of 20 mg/kg live weight spectinomycin for 3 days, while the other group of lambs (untreated group) did not receive any antibiotic. Serum endotoxin was higher in the treated lambs. The combined infection of E. coli + Proteus mirabilis was the most frequent microbiological result in the deceased treated lambs, while the only enteric pathogen isolated in the untreated lambs submitted to necroscopy was E. coli. The pathological findings most commonly recorded in the untreated lambs were suggestive of a generalized inflammatory process attributed to colibacilosis, while the lesions in the treated lambs might correspond to an enterotoxoemic process. The overproduction of P. mirabilis might be consequence of the antibiotic treatment and it would be the most probable cause of the endotoxemia, the high mortality rate and the pathological findings in the treated lambs. Therefore, a supportive care without antibiotics does not lead to a poorer chance of survival in lambs with diarrhoea attributed to non-enterotoxigenic E. coli.

Evaluation of endotoxaemia in the prognosis and treatment of scouring merino lambs

This study looked at measurement of endotoxaemia as a tool in determining prognosis and probable response to treatment in scouring lambs. One hundred eighty-three lambs in the first 15-20 days of life, from eight Merino sheep farms located in the region of La Serena, south-west Spain, were used in this experiment. Scouring and normal/control lambs were selected following a clinical examination, the scouring group was further divided into subgroups, specifically those that did or did not survive 72 h following treatment. At the time of the clinical examination, faecal and blood samples were taken. Faecal culture and commercial faecal antigen tests for detection of enteropathogens in faeces and serum endotoxin measurement using chromogenic lymulus amoebocyte lysate (LAL) were carried out. Scouring lambs received 0.07 mg/kg liveweight halofuginone once a day for 3 days, a single oral dose of 0.20 mg/kg liveweight of spectinomycin and oral rehydration fluid. The pathogens isolated were Cryptosporidium spp. and Escherichia coli. The case fatality rate was 51% in the scouring lambs. Postmortem findings were consistent with enterotoxigenic E. coli infection. The concentration of endotoxin was 0.18 +/- 0.12 ng/ml in the control group, 0.35 +/- 0.17 ng/ml in the surviving lambs and 0.46 +/- 0.14 ng/ml in the non-surviving lambs. Significant differences between groups were found. Case fatality rate of the scouring lambs with endotoxaemia below 0.30 ng/ml was 0%, while it was 100% above 0.50 ng/ml. These results may be utilized as a prognostic indicator in lambs affected by E. coli and Cryptosporidium that will help aid in decision-making as to whether to treat a lamb or not based on its chances of survival.

Endotoxin and Mammalian Host Responses During Experimental Disease

Endotoxin is an integral component of the outer membrane of Gram-negative bacteria and a prime example of unique and highly conserved bacterial surface molecules that engage with the innate immune system of the mammalian host via pattern recognition receptors on a range of host cells. The results of this interaction, which may be beneficial or detrimental to the development and welfare of the host, are reviewed, focusing on the different sensitivities and consequences in a range of hosts of experimental exposure to endotoxin, the disease outcomes and recent developments in our understanding of the mechanisms involved.