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Clinical Chemistry 40: 1575-1579, 1994;
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Clinical Chemistry, Vol 40, 1575-1579, Copyright © 1994 by American Association for Clinical Chemistry

Endotoxin binding to platelets in blood from patients with a sepsis syndrome

HJ Salden and BM Bas
Stichting Deventer Ziekenhuis, Department of Clinical Chemistry, The Netherlands.

Endotoxin, the lipopolysaccharide cell wall constituent of Gram- negative bacteria, produces symptoms of the Gram-negative sepsis syndrome. By measuring endotoxin in blood from septic patients it may be possible to select a subpopulation of patients in which mortality can be prevented by treatment with anti-endotoxin antibodies. We evaluated the performance of an endotoxin-free blood-collection tube. Within-run and between-run CVs of our endotoxin assay were 4-18% and 8- 20%, respectively. In endotoxin-positive samples (LPS > or = 6 ng/L), the concentration of endotoxin in platelet-rich plasma was significantly higher (P < 0.001) than in platelet-poor plasma. Apparent binding of endotoxin to platelets ranged from 0% to 92%. The correlation between the apparent percentage binding of LPS to platelets and the platelet count in platelet-rich plasma is linear and positive, but LPS is not bound solely to platelets. We conclude that endotoxin must be measured in platelet-rich plasma.


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