Physiopathology of Hypophysial Disturbances and Diseases of Reproduction

The book reviewed here is dedicated to Dr. Bang and contains the proceedings of an "International conference on endotoxin standards and LAL use with parenteral drugs" that was held at Woods Hole in September 1981. Following the first two chapters, which include the keynote address by Dr. Bang and an excellent overview of the value and applications of the LAL test, most chapters are concerned with issues that will mainly interest the specialist and are written as scientific papers. In the first part of the book the LAL test is compared to other tests for endotoxin, such as the rabbit pyrogen test, in relation to the FDA standards for acceptable levels of contaminating endotoxin in drugs and fluids prepared for parenteral use in humans. Traditionally, endotoxin has been characterized biologically by its property of causing fever when injected into rabbits, so, when it is measured in a different way, problems arise over the definition of what is meant by "endotoxin." Since the LAL test for endotoxin is apparently more sensitive than other biological or physicochemical measurements, and the biological activity of endotoxin is tremendously influenced by its variable physical structure and chemical composition, the task of defining a "standard endotoxin" has been difficult. Later chapters describe modifications of the LAL assay, such as the use of a chromogenic substrate, which may make it possible to use the test in situations where gelation, the conventional end point, could be inhibited. With potential clinical applications for early detection of gram-negative infection and the current increasing awareness of the unwanted effects of contarmiinating endotoxin in cellular immunology and other fields, it is likely that interest in the LAL test will grow. This book, despite its 39 chapters, contains little that will appeal to the clinician or laboratory investigator, but it should be a valuable reference for those who prepare pharmaceuticals for parenteral administration or items of equipment that will come into contact with the human circulation. It is hoped that the unobtrusive horseshoe crab will survive any increased demand for its valuable blood!