Antiendotoxic

Antiendotoxic denotes substances or strategies that counteract endotoxins, mainly lipopolysaccharide (LPS) from Gram-negative bacteria. Endotoxins can provoke systemic inflammation and septic shock through Toll-like receptor 4 (TLR4) signaling, among other pathways; antiendotoxic interventions seek to prevent or mitigate these responses and are studied in sepsis and other inflammatory conditions.

Mechanisms include direct binding and neutralization of LPS, sequestration from plasma, and modulation of immune signaling to dampen cytokine production. Some approaches use extracorporeal removal of endotoxin with adsorptive cartridges; others rely on agents that bind lipid A portion of LPS, thereby preventing TLR4 activation.

Clinical examples include polymyxin antibiotics (polymyxin B and colistin), which have endotoxin-binding properties in addition to antimicrobial effects, and endotoxin-adsorber devices such as polymyxin B-immobilized columns used in certain settings. These strategies have shown mixed results in clinical trials, with limited or inconsistent improvements in mortality; they can also cause nephrotoxicity and neurotoxicity, or be limited by logistical considerations.

In research, antiendotoxic therapy remains an area of ongoing investigation, with focus on better understanding endotoxin biology, identifying safe and effective agents, and designing trials with appropriate endpoints. The term is used in pharmacology, critical care, and veterinary contexts to describe efforts to reduce endotoxemia and its systemic effects.