The recently chemically synthesized Escherichia coli lipid A and the natural free lipid A of E. coli were compared with respect to their endotoxic activities in the following test systems: lethal toxicity, pyrogenicity, local Shwartzman reactivity, Limulus amoebocyte lysate gelation capacity, tumour necrotizing activity, B cell mitogenicity, induction of prostaglandin synthesis in macrophages, and antigenic specificity. It was found that synthetic and natural free lipid A exhibit identical activities and are indistinguishable in all tests.

https://febs.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1432-1033.1985.tb08798.x

Synthetic and natural Escherichia coli free lipid A express identical endotoxic activities

The discovery of endotoxin dates from the late nineteenth century when Richard Pfeiffer, then working in Berlin, characterized endotoxins as heat-stable and cell-associated molecules (Westphal et al. 1977), thus distinguishing them from the heat-labile and proteinous exotoxins which are actively secreted by bacteria (Bhakdi et al. 1994). They were first found to be produced by Vibrio cholerae bacteria and later by Salmonella and Serratia. Endotoxins, due to their various potent biological activities soon attracted worldwide scientific interest. Initial chemical analyses of purified endotoxin indicated that it consists essentially of polysaccharide and lipid, and it was therefore termed lipopolysaccharide (LPS). Today the terms endotoxin (Wolff 1904) and lipopolysaccharide (Shear and Turner 1943) are used synonymously for the same molecule.

Bacterial endotoxin: Chemical constitution, biological recognition, host response, and immunological detoxification.

In mice treated with D-galactosamine, lipopolysaccharide (LPS) exhibits enhanced toxicity (C. Galanos, M. A. Freudenberg, and W. Reutter, Proc. Natl. Acad. Sci. USA 76:5939-5943, 1979). Pretreatment of mice with LPS before D-galactosamine rendered them tolerant to the enhanced lethal effect of LPS. Tolerance was established at 1 h after LPS injection and, depending on the dose of LPS used for pretreatment, lasted for up to 48 h. With C3H/HeJ mice with acquired sensitivity to LPS (M. A. Freudenberg, D. Keppler, and C. Galanos, Infect. Immun. 51:891-895, 1986), i.e., mice that had been administered C3H/HeN macrophages, pretreatment with LPS induced tolerance only if the C3H/HeN macrophages were already present at the time of pretreatment. This indicates that, like lethality, induction of tolerance by LPS is a macrophage-mediated phenomenon. Direct interaction of LPS with macrophages is the first step in the initiation of tolerance or toxicity. C3H/HeN macrophages (2 X 10(7], incubated with minute amounts of LPS (0.5 to 0.02 microgram) in vitro and transferred subsequently to C3H/HeJ mice, induced lethality when administered together with or after D-galactosamine and tolerance when injected before D-galactosamine. Macrophages activated in vitro lost their tolerance- and lethality-inducing properties upon further incubation in LPS-free culture medium for 18 h. Such macrophages could be successfully restimulated by a new addition of LPS.

Induction of tolerance to lipopolysaccharide (LPS)-D-galactosamine lethality by pretreatment with LPS is mediated by macrophages.

Gram-negative sepsis is an increasingly common problem, with up to 300,000 cases occurring each year in the United States alone. Despite the ongoing development of new antibiotics, mortality from gram-negative sepsis remains unacceptably high. To stimulate earlier therapeutic intervention by physicians, a new set of broad definitions has been proposed to define the systemic inflammatory response characteristic of sepsis. In this review, the signs and symptoms of this progressive, injurious process are reviewed and its management is discussed, as are the mechanisms by which bacterial endotoxin triggers the biochemical events that lead to such serious complications as shock, adult respiratory distress syndrome, and disseminated intravascular coagulation. These events often occur even when appropriate antimicrobial therapy has been instituted. An increased understanding of the structure of endotoxin and its role in the development of sepsis, together with advances in hybridoma technology, has led to the development of monoclonal antibodies that bind to endotoxin and significantly attenuate its adverse effects. These agents promise to substantially reduce the morbidity and mortality associated with gram-negative sepsis.

Gram-negative sepsis: a dilemma of modern medicine.

Molecular structure of lipid A, the endotoxic center of bacterial lipopolysaccharides.

Lipid A, the endotoxic principle of gram-negative bacterial lipopolysaccharides, when suitably exposed on the surface of bacterial cells, becomes immunogenic, eliciting the formation of antibodies specific to lipid A. Antibodies to lipid A occur naturally in the serum of normal humans and many animal species; the two exceptions found so far are mice (all strains tested) and guinea pigs. Antibodies to lipid A occur more frequently in patients with infections caused by gram-negative bacteria, such as urinary tract infections. Antibodies to lipid A interacted with free lipid A but not with lipid A as present in the intact lipopolysaccharide molecule. Antibodies to lipid A were induced in rabbits, but not in mice, following a single injection of immunogenic lipid A. Because of similarities between the lipid A of many gram-negative bacteria, antibodies to lipid A showed wide cross-reactions. With regard to biologic activity, antibodies to lipid A have been variously shown to be protective, damaging, or without effect.

Immunogenic Properties of Lipid A

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Immunogenic Properties of Lipid A