2.3. Experimental human endotoxemia
Subjects were admitted twice to the intensive care research unit of the Radboud university medical center in Nijmegen, The Netherlands, to receive both LPS challenges. All subjects underwent the same procedures on both hospitalization days which were 7 days apart. One day prior to both admissions, subjects needed to refrain from alcohol and caffeine, and no food or drinks were allowed from 10 hours before start of the challenge days. After admission, an intravenous cannula was inserted in the antebrachial vein to administrate fluids and LPS. A radial artery catheter was placed to withdraw blood and monitor blood pressure continuously. One hour before the challenge, 1.5 L prehydration fluid (2.5% Glucose/0.45% NaCl) was administered. Subsequently, a bolus of 2 ng/kg LPS (E. coli type O113, Lot no. 94332B1; List Biological Laboratories, Campbell, USA) was administered intravenously and similar hydration fluid was continued at an infusion rate of 150 mL/h for 8 hours. Heart rate was monitored using a 4-lead electrocardiogram (M50 Monitor, Philips, Eindhoven, The Netherlands) and intra-arterial blood pressure was measured with a pressure transducer (Edward Lifesciences, Irvine, USA). Every 30 minutes, we measured core temperature with a tympanic thermometer (FirstTemp Genius 2, Covidien, Dublin, Ireland) and LPS-induced symptoms (headache, nausea, cold shivers, muscle- and back pain) were scored using a numeric six-point scale (0 = no symptoms, 5 = worst symptoms experienced ever). The sum of these scores in addition of 3 points in case of vomiting, resulted in a total symptom score ranging from 0 to 28. Blood was withdrawn before prehydration (T = -60 minutes), just before LPS administration (T = 0 minutes), and respectively 60, 90, 120, 180, 240, 360 and 480 minutes after the LPS bolus. Plasma cytokine concentrations (tumour necrosis factor-alpha (TNF-α), interleukin (IL)-6, IL-8, IL-10, macrophage inflammatory protein (MIP)-1α, MIP-1β, monocyte chemoattractant protein (MCP)-1 and IL-1RA (receptor antagonist)) were determined batchwise using a simultaneous luminex assay (Milliplex, Millipore, Billerica, USA).
• Product #9433 – GMP LPS Lipopolysaccharide List™ Hpt™ From Escherichia Coli Type O113