Advances in endotoxin analysis

The outer membrane of gram-negative bacteria is primarily composed of lipopolysaccharide (LPS). In addition to protection, LPS defines the distinct serogroups used to identify bacteria specifically. Furthermore, LPS also act as highly potent stimulators of innate immune cells, a phenomenon essential to understanding pathogen invasion in the body. The complex multi-step process of LPS binding to cells involves several binding partners, including LPS binding protein (LBP), CD14 in both membrane-bound and soluble forms, membrane protein MD-2, and toll-like receptor 4 (TLR4). Once these pathways are activated, pro-inflammatory cytokines are eventually expressed. These binding events are also affected by the presence of monomeric or aggregated LPS. Traditional techniques to detect LPS include the rabbit pyrogen test, the monocyte activation test and Limulus-based tests. Modern approaches are based on protein, antibodies or aptamer binding. Recently, novel techniques including electrochemical methods, HPLC, quartz crystal microbalance (QCM), and molecular imprinting have been developed. These approaches often use nanomaterials such as gold nanoparticles, quantum dots, nanotubes, and magnetic nanoparticles. This chapter reviews current developments in endotoxin detection with a focus on modern novel techniques that use various sensing components, ranging from natural biomolecules to synthetic materials. Highly integrated and miniaturized commercial endotoxin detection devices offer a variety of options as the scientific and technologic revolution proceeds.

Applicability of modified carbon sorbent for removing potentially toxic biologically active molecules of aromatic structure from blood plasma

The modification of the mesoporous carbon sorbent with 3-phenylpropanoic acid was carried out in order to create preparations of complex, prolonged action, exhibiting detoxifying, antibacterial, and antifungal properties due to the applied modifier, which is capable of migrating into the solution and exhibiting its own biospecific properties. A technique was developed for fixing 3-phenylpropionic acid (PhPA) on a carbon support by its adsorption from solution. Three types of sorbents with various content of the modifier (PhPA) and the sorbent without modifier were studied. The sorption activity of new sorbents was studied using liquid-liquid extraction and gas chromatography-mass spectrometry methods on model experiments with plasma and aqueous additives of hydroxylated phenyl-containing acids (PhCAs) in various concentrations. The specific surface area was significantly changed for sorbent, modified with 1 × 10^-3 mol/L of PhPA solution, and was 25% less than the area of unmodified sorbent. Potentially toxic biologically active hydroxylated PhCAs were used to create model solutions. The degrees of sorption of these compounds were close to 100%, except phenyllactic acid (over 80%). The sorbent without modifier and two sorbents with the lowest content of the modifier are considered to be more effective for the purification of the plasma from the hydroxylated PhCAs than the sorbent with the highest concentration of the modifier. Simultaneous adsorption of toxic metabolites from the bloodstream and desorption of beneficial ones can be used for a more subtle correction of the patient's condition.

Pathogen enrichment from human whole blood for the diagnosis of bloodstream infection: Prospects and limitations

Blood culture represents the current reference method for the detection of bacteria or fungi in the circulation. To accelerate pathogen identification, molecular diagnostic methods, mainly based on polymerase chain reaction (PCR), have been introduced to ensure early and targeted antibiotic treatment of patients suffering from bloodstream infection. Still, these approaches suffer from a lack of sensitivity and from inhibition of PCR in a number of clinical samples, leading to false negative results. To overcome these limitations, various approaches aiming at the enrichment of pathogens from larger blood volumes prior to the extraction of pathogen DNA, thereby also depleting factors interfering with PCR, have been developed. Here, we provide an overview of current systems for diagnosing bloodstream infection, with a focus on approaches for pre-analytical pathogen enrichment, and highlight emerging applications of pathogen depletion for therapeutic purposes as a potential adjunctive treatment of sepsis patients.