Bacterial endotoxins, found in the outer membrane of gram-negative bacteria, are members of a class of phospholipids called lipopolysaccharides (LPS) and they can be toxic for humans when in systemic circulation.

Endotoxin is present in plasma of all healthy humans at very variable levels between 1 and 50 pg/mL. When the concertation increases over ug/mL range it it can become a real danger. The presence of LPS in the blood or interstitial fluid can lead to septic shock under exaggerated immune response. Septic shock includes tachycardia, temperature modulations, and coagulation cascade activation, leading to arterial and venous dilation.

Several studies have demonstrated that oral administration of LPS is safe for animals. In fact, our gut is full of bacteria presenting LPS and does not suppose a hazard to us. There is an intestinal alkaline phosphatase produced by epithelial cells and antibacterial that detoxifies LPS preventing local inflammation as well as the translocation of active LPS into systemic circulation. However, there has also been proved that high-fat diet and weight gain have been associated with a higher gut permeability and subsequent systemic (mild) elevation in circulating plasma LPS.

Endotoxin is commonly found everywhere in our environment and it is the most significant pyrogen in parenteral drugs and medical devices. FDA has stablished regulations on the Endotoxin levels in all drugs for injection and medical devices that are in contact with blood and it varies product from product depending on the dose, where is administrated and body weight. On the contrary, food does not need to be proven Endotoxin free.

In my project, where I am trying to develop a new biosensor for LPS detection in complex matrices, I do daily work with LPS and some precautions need to be taken in order to minimize the risk of intoxication.

Special care needs to be taken when opening the containers with lyophilized LPS as the powder tends to jump out when opening the lid. A careful opening is required, as well as wear a face mask when dealing with it until it is completely solubilized.

Other major risk when working with LPS could be its direct penetration in our blood stream in case we have an open wound exposed to it. Thus, avoid working with it or assure that this direct entry into the bloodstream is well covered.

In short, LPS dealing might not be the most dangerous one but it is important to be conscious of its risk and take the appropriate risk mitigation measures.

In my project, I investigate the causative relationship between the solubility of proteins and their potential to act as an allergen. To address this question, I need to work with different conjugations of allergens and silica particles. There is always a certain risk that my co-workers or I are exposed to those allergens. The consequences are difficult to estimate, but one needs to keep in mind the possibility of allergic reactions. They are most likely mild and local; however, severe systemic reactions like anaphylaxis also need to be considered, seeing as the doses we are working with are much higher than one could expect from natural exposure. The best way of minimizing this risk is to properly train all the people working on this project, starting with proper handling of syringes to using correct personal protective equipment (PPE).

My research project has an aim to develop and refine the current methods to detect endotoxins also called lipopolysaccharides (LPS) using human cells. LPS originated from gram-negative bacteria is a toxic for human beings. Although human has a certain tolerant level for this toxin, an excess of LPS would be harmful for body which can lead to the death. Therefore, the first risk issue from my project is about handling LPS at the lab. Since LPS itself is a toxic, any uncareful or unprofessional manipulation can lead to the poison for the technician.

Another risk is the material used in the project. My project uses human blood got from donors to isolate the primary cells. Although blood donors must be healthy and not diagnosed to any infectious diseases, the blood still has a certain possibility carrying infectious diseases such as HBV, HIV, or some other viral or bacterial infections which are not screened before the blood donors. If the blood has any of those diseases, the technician has a risk to be transmitted. Therefore, they must get the well training to handle with blood as well as get the vaccines against such as HBV.

In any case, the most important thing is to prevent the risk exposing to the technician. Well trainings must be provided to the technician before carrying out any research activities.

Endotoxin is part of Gram-negative bacteria and activates the immune system if released in the human body and since Endotoxin is omnipresent in the environment – medication needs to be free of this molecule to not cause any negative reaction. Creating a novel Endotoxin-detection system that is approved and used in clinical applications is accompanied by the need to assess the product’s risk potential. Considering worst-case scenarios sharpens the eye for these risks. What would for instance happen if one of our developed detection kits malfunctions due to manufacturing defects? One outcome could be that the examined medication is falsely stated to be endotoxin-free. Administering this dose to a patient could lead to strong inflammatory reactions and suffering, potentially even death. Thinking about scenarios such as this raises our awareness for the responsibility of our work as researchers.

I am part of the Endonano consortium and one of the main goals of my part of the project is to develop beads that selectively target lipopolysaccharides (LPS) in complex solutions. The aim is to be able to decontaminate different injectable pharmaceuticals in order to achieve the conformity.

In the Risk Communication training we had a first contact on how to have a first approach with media specially in delicate situations.

As practical part we needed to think about possible risk situations that could happen with our project and how to proceed. Here, I thought that a possible risk situation would be if the beads for LPS removal are offered in the market and one of our customers, a big pharma company that produces insulin, used the LPS removal beads to remove LPS from a lot of insulin that was out of conformity (had more LPS than accepted by its pharmacopeia). After that, the drug passed in quality control evaluations and was commercialized. Some patients injected with that specific lot developed a severe immune response, not common to the application of insulin. All indicated that LPS remained in the solution, potentially conjugated to the beads. Some patients were hospitalized.

“It’s something that I as scientist have never thought about. We are never faced to talk to the public. It’s important to see this point of view.”

Meeting with experts during this workshop made the workshop very appealing and interesting for me and my colleagues.

It was very instructive to see how a journalist thinks. To see, how it is possible to direct the discussion and which words are catching attention.