Beta-glucans and endotoxins in end-stage kidney disease

  • Research type

    Research Study

  • Full title

    Beta-glucans and endotoxins in end-stage kidney disease

  • IRAS ID

    168251

  • Contact name

    Jonathan P Wong

  • Contact email

    jonathan.wong@nhs.net

  • Sponsor organisation

    East and North Hertfordshire NHS Trust

  • Duration of Study in the UK

    0 years, 5 months, 1 days

  • Research summary

    Endotoxins are fragments of bacterial cell wall which are associated with inflammation. Endotoxins are conventionally detected using the Limulus amoeboycte lysate (LAL). The LAL is sensitive to endotoxin, but it may also be activated by beta-glucan, a component of fungal cell walls. Beta-glucan contamination may result in artificial elevation in 'endotoxin' levels. Beta-glucan interference with the LAL can be blocked with glucan buffers.

    Endotoxins are reportedly high in patients on dialysis. However, the published literature are conflicting and some studies report very low levels only. Most studies do not use buffers or other alternative means to block the effect of beta-glucan on the LAL assay. It is possible that beta-glucan may lead to falsely elevated endotoxin levels in dialysis patients.

    The primary purpose of this study is to determine whether beta-glucan interference contributes to raised endotoxin levels in patients on dialysis.

    We intend to measure endotoxin levels in 20 patients on haemodialysis with and without the use of glucan buffers to determine whether endotoxin levels are higher when blood is measured using LAL without a buffer. A sample of the blood will be sent to an external organisation (Associates of Cape Cod) for measurement of beta-glucan levels.

  • REC name

    East Midlands - Leicester South Research Ethics Committee

  • REC reference

    14/EM/1266

  • Date of REC Opinion

    2 Dec 2014

  • REC opinion

    Further Information Favourable Opinion