Anti-endotoxin therapeutic options for the treatment of sepsis

J Antimicrob Chemother. 1998 Jan;41 Suppl A:71-80. doi: 10.1093/jac/41.suppl_1.71.


The identification of lipopolysaccharide binding protein (LBP) and CD14 as key molecules in the cellular response to endotoxin has been a major advance in unravelling the pathophysiological basis of Gram-negative sepsis. Much interest has focused on developing effective anti-endotoxin treatments to abrogate the inflammatory consequences of Gram-negative infection. The therapeutic options can be divided into those aimed at neutralizing or clearing circulating endotoxin, including anti-endotoxin antibodies and endotoxin neutralizing proteins, and those that antagonize the effects of endotoxin on human cells--for example, lipid A analogues. Initial experiences with anti-lipopolysaccharide antibodies have been disappointing but a new generation of anti-endotoxin agents is about to enter clinical trials. Whether these will prove sufficiently effective to reduce the morbidity and mortality of Gram-negative sepsis remains to be seen.

Publication types

  • Review

MeSH terms

  • Endothelium / immunology
  • Endotoxins / chemistry
  • Endotoxins / immunology*
  • Humans
  • Immunity, Cellular
  • Immunization, Passive*
  • Immunoglobulins
  • Immunotherapy
  • Lipid A / analogs & derivatives
  • Lipopolysaccharide Receptors / immunology
  • Macrophages / immunology
  • Neutrophils / immunology
  • Sepsis / immunology
  • Sepsis / therapy*
  • Signal Transduction


  • Endotoxins
  • Immunoglobulins
  • Lipid A
  • Lipopolysaccharide Receptors
  • antilipopolysaccharide antibodies