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What is Endotoxin shock?

  • When a large number of gram-negative pathogens in the lesion or bloodstream die, and a large amount of endotoxin released into the blood, endotoxemia can occur. A large amount of endotoxin acts on the body's macrophages, neutrophils, endothelial cells, platelets, as well as the complement system and coagulation system, etc., which will produce interleukin 1, 6, 8 and tumor necrosis factor alpha, histamine, 5 Bioactive substances such as serotonin, prostaglandin, kinin, etc. These substances act on small blood vessels to cause dysfunction and lead to microcirculation disorders. The clinical manifestations are microcirculation failure, hypotension, hypoxia, acidosis, etc., and then cause shock in the patient. This pathological reaction is called endotoxin shock.

    Regarding endotoxin shock, there have been painful lessons in the past. When penicillin first came out in the 1940s, doctors discovered that penicillin had a very significant effect on meningitis caused by Neisseria meningitidis. Therefore, when such patients are found, penicillin is always preferred for treatment; and according to the general rule, the dosage of the drug increases with the severity of the disease. As a result, an accident occurred. Many patients with severe meningitis suffered from endotoxin shock and died when high-dose penicillin was used to treat patients with severe meningitis. Later, after research and analysis, the whole story was discovered. In severely ill patients, there are many pathogenic bacteria in their bodies, and doctors use large doses to "bomb" in order to "kill the enemy in one fell swoop." This strategy of killing pathogens quickly and completely is unquestionable, but some doctors have overlooked another aspect. The pathogen of epidemic meningitis is Neisseria meningitidis, which is a gram-negative bacterium, and its causative substance is endotoxin. The endotoxin is released after the germs die. Nowadays, large doses of penicillin are used to kill all germs at once, which means that a large amount of endotoxin is released at one time, which promotes endotoxin shock and accelerates the death of patients. With the advancement of medicine, when doctors encounter such patients, on the one ****, they still have to use large doses of effective antibacterial drugs to deal with them, and at the same time add hormone drugs to protect cells sensitive to endotoxin from cells induced by endotoxin. The factor reacts to overcome the difficulty of "shock". It is like using anesthetics to make the patient lose the sense of pain during a surgical operation.

    Pathogenic microorganisms can also be called pathogenic bacteria, which refer to microorganisms that can invade the host and cause infection, including bacteria, fungi, and viruses.


    Why do pathogenic bacteria make people sick? It is because they can produce pathogenic substances and cause host infection. If no pathogenic substance is produced, it is a non-pathogenic bacteria. As for the normal flora, when it is in a state of ecological balance with the host, they do not cause infection of the body, so they belong to the category of non-pathogenic bacteria. However, under certain conditions, due to the imbalance of the flora, the low immune function of the host, or the change of the colony's colonization position, the normal flora can also cause infection, so they should be regarded as pathogenic bacteria. For this reason, these normal flora are called conditional pathogens or opportunistic pathogens, which means that under special conditions or when encountering suitable opportunities, they can also have the characteristics of pathogens and cause human infectious diseases.

    Vibrio cholerae, dysentery bacillus and E. coli can produce enterotoxins secreted outside of their cells to cause diarrhea in patients; the plague toxin secreted by Yersinia pestis acts on blood vessels and lymphatics throughout the body to cause bleeding and necrosis; some bacteria produce no secretion to the bacteria. Extracellular toxins, such as Salmonella. When we accidentally ruptured our hands and feet and the wound was deep, or rusted iron nailed into the flesh, we must go to the hospital to get a vaccination to prevent tetanus caused by Clostridium spp. Clostridium also comes from the soil and is an anaerobic bacteria that does not like oxygen. It reproduces in deep wounds with less oxygen and produces a toxin that can kill people. There is also a kind of Clostridium, which produces a toxin known to be the most powerful to humans (0.1 microgram is enough to kill people). It does not multiply in the host, but fish and meat marinated in cans. Reproduce in and produce toxins. However, modern advanced and effective food preservation methods have made botulism rare.

    The pathogenic substances of pathogenic bacteria can be divided into two categories: toxins and invasiveness. Toxins are toxic to the host and can directly destroy the structure and function of the body. Invasiveness itself is non-toxic, but it can break through the host body's physiological defense barrier, and can survive in the body (medically called colonization), multiply and spread. If the toxin is regarded as the "primal culprit", then the aggressiveness is the "accomplice".

    According to the nature, function and producing bacteria, the toxins of pathogenic bacteria are divided into two types: exotoxin and endotoxin. The following table lists the main differences between bacterial exotoxins and endotoxins.



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