EC Clinical and Medical Case Reports

Endotoxin (lipopolysaccharide) is the component of the outer membrane of gram-negative bacteria and is released into the circulation upon disruption of the intact bacteria. Endotoxin stimulates the release of inflammatory mediators (cytokines, nitric oxide etc.) giving rise to smooth muscle relaxation, vasodilation, and increased vascular permeability.

Endotoxic shock is a consequence of severe, generalized inflammatory response induced by bloodstream infection when humans are infected with gram-negative bacteria.

Treatment methods for endotoxic shock would be more effective if treatment is started before or at the onset of endotoxemia, as many of the required mediators are released within minutes of the onset. Such treatment methods may include supportive care of the endotoxemic patient, blood purification techniques, use of endotoxin synthesis inhibitors, anti endotoxin vaccines or anti endotoxin antibodies, blocking the interaction of endotoxin with target cells, and blocking endogenous mediators generated following endotoxin interaction with target cells using variety of potential therapeutic agents.

Amongst the potential therapeutic agents, norepinephrine is the first-line therapeutic agent for initial blood pressure management in endotoxic shock.

In the present article, attempt was made to provide an insight on endotoxin and endotoxic shock, non-therapeutic ways to manage the endotoxic shock as well as a number of chemical substances investigated as potential therapeutic agents.

Keywords: Endotoxin; Endotoxic Shock; Potential Therapeutic Agents

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