Journal ArticleDOI
Studies on the pathogenesis of the Jarisch-Herxheimer reaction: development of an animal model and evidence against a role for classical endotoxin.
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Data suggest that classical endotoxin is not the cause of the Jarisch-Herxheimer reaction, and rabbits were not refractory to the pyrogenic effects of endotoxin, and syphilitic rabbits rendered tolerant to endotoxin still developed fever when treated with penicillin.Abstract:
The etiology of the Jarisch-Herxheimer reaction is unknown, but the reaction may result from toxic products of dead or dying treponemes reacting with sensitized syphilitic tissues. Because of similarities of spirochetes with gram-negative bacteria, endotoxin has been proposed as the responsible toxin. In 19 patients with syphilis, a reaction occurred in 15 (79%) during treatment with penicillin. Endotoxemia was not found by the limulus amoebocyte lysate test. All animal model of the Jarisch-Herxheimer reaction was developed in rabbits infected with Treponema pallidum. When treated with penicillin, 18 (78%) of 23 rabbits infected 18-29 days previously developed a reaction that resembled that in humans. Endotoxemia was not detected by the lysate test. After the reaction, rabbits were not refractory to the pyrogenic effects of endotoxin, and syphilitic rabbits rendered tolerant to endotoxin still developed fever when treated with penicillin. These data suggest that classical endotoxin is not the cause of the Jarisch-Herxheimer reaction.read more
Citations
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Toll-like receptor 2 functions as a pattern recognition receptor for diverse bacterial products
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Biology of Borrelia species.
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Endotoxemia: methods of detection and clinical correlates.
TL;DR: The Limulus amebocyte lysate (LAL) as mentioned in this paper has been used for the detection of endotoxin in other fluids other than blood, such as gram-negative sepsis.
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Kinetics of Endotoxin Release During Antibiotic Therapy For Experimental Gram-Negative Bacterial Sepsis
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Modulation of Release of Proinflammatory Bacterial Compounds by Antibacterials: Potential Impact on Course of Inflammation and Outcome in Sepsis and Meningitis
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TL;DR: Substantial evidence for the validity of the concept of modulating the release of proinflammatory bacterial compounds by antibacterials has been accumulated in vitro and in animal experiments to justify clinical trials in sepsis and meningitis.
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