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Review

Outstanding Contributions of LAL Technology to Pharmaceutical and Medical Science: Review of Methods, Progress, Challenges, and Future Perspectives in Early Detection and Management of Bacterial Infections and Invasive Fungal Diseases

1
LPS Consulting Office, Tokyo 160-0023, Japan
2
Department of Host Defense and Biochemical Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
3
Microcoat Biotechnologie GmbH, 82347 Bernried, Germany
*
Author to whom correspondence should be addressed.
Academic Editor: Amedeo Amedei
Biomedicines 2021, 9(5), 536; https://doi.org/10.3390/biomedicines9050536
Received: 12 April 2021 / Revised: 3 May 2021 / Accepted: 4 May 2021 / Published: 11 May 2021
(This article belongs to the Section Molecular and Translational Medicine)
The blue blood of the horseshoe crab is a natural, irreplaceable, and precious resource that is highly valued by the biomedical industry. The Limulus amebocyte lysate (LAL) obtained from horseshoe crab blood cells functions as a surprisingly sophisticated sensing system that allows for the extremely sensitive detection of bacterial and fungal cell-wall components. Notably, LAL tests have markedly contributed to the quality control of pharmaceutical drugs and medical devices as successful alternatives to the rabbit pyrogen test. Furthermore, LAL-based endotoxin and (1→3)-β-D-glucan (β-glucan) assay techniques are expected to have optimal use as effective biomarkers, serving as adjuncts in the diagnosis of bacterial sepsis and fungal infections. The innovative β-glucan assay has substantially contributed to the early diagnosis and management of invasive fungal diseases; however, the clinical significance of the endotoxin assay remains unclear and is challenging to elucidate. Many obstacles need to be overcome to enhance the analytical sensitivity and clinical performance of the LAL assay in detecting circulating levels of endotoxin in human blood. Additionally, there are complex interactions between endotoxin molecules and blood components that are attributable to the unique physicochemical properties of lipopolysaccharide (LPS). In this regard, while exploring the potential of new LPS-sensing technologies, a novel platform for the ultrasensitive detection of blood endotoxin will enable a reappraisal of the LAL assay for the highly sensitive and reliable detection of endotoxemia. View Full-Text
Keywords: endotoxin; LPS; LAL test; sepsis; (1→3)-β-D-glucan; fungal infections endotoxin; LPS; LAL test; sepsis; (1→3)-β-D-glucan; fungal infections
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MDPI and ACS Style

Tamura, H.; Reich, J.; Nagaoka, I. Outstanding Contributions of LAL Technology to Pharmaceutical and Medical Science: Review of Methods, Progress, Challenges, and Future Perspectives in Early Detection and Management of Bacterial Infections and Invasive Fungal Diseases. Biomedicines 2021, 9, 536. https://doi.org/10.3390/biomedicines9050536

AMA Style

Tamura H, Reich J, Nagaoka I. Outstanding Contributions of LAL Technology to Pharmaceutical and Medical Science: Review of Methods, Progress, Challenges, and Future Perspectives in Early Detection and Management of Bacterial Infections and Invasive Fungal Diseases. Biomedicines. 2021; 9(5):536. https://doi.org/10.3390/biomedicines9050536

Chicago/Turabian Style

Tamura, Hiroshi, Johannes Reich, and Isao Nagaoka. 2021. "Outstanding Contributions of LAL Technology to Pharmaceutical and Medical Science: Review of Methods, Progress, Challenges, and Future Perspectives in Early Detection and Management of Bacterial Infections and Invasive Fungal Diseases" Biomedicines 9, no. 5: 536. https://doi.org/10.3390/biomedicines9050536

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