<p>Pyrogens are substances that may induce fever in the human body. They can be parts of bacteria, virus or fungi and due to the reaction they may cause in the body, they are routinely looked for in the medical technology industries. A method called <em>in vitro</em> pyrogen test (IPT) has been developed to detect these pyrogens. It is based on the fever reaction in the human body and only requires blood in combination with a solution believed to contain pyrogens. If the result is positive, the production of cytokines is started. The cytokines of interest in the IPT method are those involved in the fever process and two of them are IL-1<em>β</em> and TNF-<em>α</em>, which are the cytokines used as markers of infection in this study. Since the production of cytokines is in proportion to the amount of pyrogens, the inflammation-inducing potential of the sample can be decided. Due to problems in standardizing the method, mainly because it handles with living blood cells, focus is still pointed at improving it. The aim of this study was to optimize parameters within the IPT method by analysing air samples taken in indoor surroundings believed to contain pyrogens. The different parameters included extraction of the filter from the air sampling, incubation of whole blood and sample extract and analysis of the incubation with ELISA (enzyme linked immunosorbent assay). More specific, some of the issues concerned extraction media, time and shaking intensity for the extraction, blood ratio for the whole blood incubation and cytokines suitable for the method.</p><p>A possible approach for the IPT method, when analysing air samples containing pyrogens, was reached.</p> / <p>Pyrogener kallas ämnen som framkallar feber och de kan exempelvis bestå av hela eller delar av bakterier, virus eller svamp (fungi). En metod som kallas för in vitro pyrogen test (IPT) har utvecklats för att detektera dessa pyrogener. Metoden bygger på att en lösning som misstänks innehålla pyrogener får komma i kontakt med blod från en människa. Efter en inkubering på mellan 4-24 timmar har blodet reagerat på eventuella pyrogener och bildat cytokiner, där mängden cytokiner är proportionell mot mängden pyrogener. De intressanta cytokinerna i den här studien var IL-1<em>β</em> och TNF-<em>α</em>, som båda är involverade i feberprocessen. Det har varit svårigheter med att standardisera metoden, mycket beroende på att det är levande celler som hela metoden bygger på, så syftet med den här studien var att förbättra in vitro pyrogen test. Luftprover tagna i inomhusmiljöer som misstänks innehålla pyrogener har använts i försöken att optimera varje steg i processen. De olika stegen inkluderade extraktion av filter som använts vid luftprovtagningen, inkubering med helblod och provextrakt och analys av inkuberingen med ELISA (enzyme linked immunosorbent assay). Några av de parametrar som undersöktes gällde extraktionsmedium, skaktid och skakintensitet under extraktionen, blodförhållande under helblodsinkuberingen och lämpliga cytokiner för metoden.</p><p>Studien resulterade i att en metodik, för att analysera luftprov innehållande pyrogener med<em> in vitro</em> pyrogen test, kunde tas fram.</p>

Pyrogens are substances that may induce fever in the human body. They can be parts of bacteria, virus or fungi and due to the reaction they may cause in the body, they are routinely looked for in the medical technology industries. A method called in vitro pyrogen test (IPT) has been developed to detect these pyrogens. It is based on the fever reaction in the human body and only requires blood in combination with a solution believed to contain pyrogens. If the result is positive, the production of cytokines is started. The cytokines of interest in the IPT method are those involved in the fever process and two of them are IL-1β and TNF-α, which are the cytokines used as markers of infection in this study. Since the production of cytokines is in proportion to the amount of pyrogens, the inflammation-inducing potential of the sample can be decided. Due to problems in standardizing the method, mainly because it handles with living blood cells, focus is still pointed at improving it. The aim of this study was to optimize parameters within the IPT method by analysing air samples taken in indoor surroundings believed to contain pyrogens. The different parameters included extraction of the filter from the air sampling, incubation of whole blood and sample extract and analysis of the incubation with ELISA (enzyme linked immunosorbent assay). More specific, some of the issues concerned extraction media, time and shaking intensity for the extraction, blood ratio for the whole blood incubation and cytokines suitable for the method. A possible approach for the IPT method, when analysing air samples containing pyrogens, was reached. / Pyrogener kallas ämnen som framkallar feber och de kan exempelvis bestå av hela eller delar av bakterier, virus eller svamp (fungi). En metod som kallas för in vitro pyrogen test (IPT) har utvecklats för att detektera dessa pyrogener. Metoden bygger på att en lösning som misstänks innehålla pyrogener får komma i kontakt med blod från en människa. Efter en inkubering på mellan 4-24 timmar har blodet reagerat på eventuella pyrogener och bildat cytokiner, där mängden cytokiner är proportionell mot mängden pyrogener. De intressanta cytokinerna i den här studien var IL-1β och TNF-α, som båda är involverade i feberprocessen. Det har varit svårigheter med att standardisera metoden, mycket beroende på att det är levande celler som hela metoden bygger på, så syftet med den här studien var att förbättra in vitro pyrogen test. Luftprover tagna i inomhusmiljöer som misstänks innehålla pyrogener har använts i försöken att optimera varje steg i processen. De olika stegen inkluderade extraktion av filter som använts vid luftprovtagningen, inkubering med helblod och provextrakt och analys av inkuberingen med ELISA (enzyme linked immunosorbent assay). Några av de parametrar som undersöktes gällde extraktionsmedium, skaktid och skakintensitet under extraktionen, blodförhållande under helblodsinkuberingen och lämpliga cytokiner för metoden. Studien resulterade i att en metodik, för att analysera luftprov innehållande pyrogener med in vitro pyrogen test, kunde tas fram.

Submitted by Alexandre Sousa (alexandre.sousa@incqs.fiocruz.br) on 2014-08-01T12:58:03Z No. of bitstreams: 1 Dissertação Izabela.pdf: 1302143 bytes, checksum: ab457123bfc94643d499a3062e8b2cc2 (MD5) / Made available in DSpace on 2014-08-01T12:58:03Z (GMT). No. of bitstreams: 1 Dissertação Izabela.pdf: 1302143 bytes, checksum: ab457123bfc94643d499a3062e8b2cc2 (MD5) Previous issue date: 2014 / Fundação Oswaldo Cruz. Instituto Nacional de Controle de Qualidade em Saúde / O teste de detecção de pirogênio é preconizado nas farmacopeias como teste de segurança imprescindível para a avaliação da qualidade de produtos injetáveis. Os métodos alternativos ao teste de pirogênio em coelhos são o Teste de Lisado de Amebócitos de Limulus (LAL) e o Teste de Ativação de Monócitos (MAT). Esses métodos ainda não podem substituir o teste em coelhos por completo, pois no caso do LAL os resultados podem não ser confiáveis quando a análise é realizada na presença de algumas substâncias interferentes com alto teor de lipídios e proteínas (encontrados nos medicamentos biológicos) e glucanas, além disso, o teste só detecta endotoxinas. Em relação ao MAT, já que o teste é sensível para todos os tipos de pirogênios e tem o mesmo mecanismo biológico responsável pela reação de febre em humanos, o Interagency Coordinating Committee on the Validation of Alternative Methods (ICCVAM) recomendou sua utilização desde que fique demonstrada a equivalência de seus resultados ao teste em coelhos, em conformidade com a regulamentação aplicável. Verifica-se assim, que a literatura carece de dados que envolvam a comparação entre a dose limite que causa febre em coelhos e a correspondência para o MAT relacionado ao ácido lipoteicóico (ALT), sendo assim, esse estudo tem como objetivo principal avaliar a utilização do MAT na detecção da contaminação de ALT de S. aureus em Cloreto de Sódio 0,9 % apirogênico artificialmente contaminado, através do estabelecimento de curva dose-resposta de ALT em coelhos; curva concentração-resposta de ALT para o MAT e avaliação em paralelo dos resultados obtidos utilizando ALT no teste em coelhos, LAL cromogênico e MAT. A resposta de febre foi observada a partir de 75.000 ng de ALT/Kg nos coelhos e no MAT para sangue criopreservado/IL-1β foi estabelecida em 50.000 ng/mL de ALT, ou 5,41 UEE/mL. O teste de LAL apresentou resultado falso-reativo a partir de 10.000 ng/mL de ALT. Os resultados apresentados neste estudo fornecem informações importantes sobre a comparação entre o teste de pirogênio em coelhos, MAT e LAL, contribuindo com dados para a validação do MAT, envolvendo outros pirogênios que não a endotoxina, e também para a aceitação deste teste pelos órgãos regulatórios no Brasil visando uma possível substituição do uso de animais, garantindo, assim, a segurança da saúde da população. / The pyrogenic test is preconized in the Pharmacopeias as a safety test indispensable for the quality of evaluation of injectable products. The alternative methods to the rabbit pyrogen test are the Limulus Amebocite Lysate (LAL) Test and the Monocyte Activation Test (MAT). These methods cannot replace the rabbit test completely yet, for in the case of LAL the results may not be reliable when the analysis is carried out in the presence of some interfering substances with high content of lipids and proteins (found in biological medicines) and glucans, moreover, the test only detects endotoxins. Concerning the MAT, since the test is sensitive to all types of pyrogens and has the same biological mechanism responsible for the fever reaction in humans, the Interagency Coordinating Committee on the Validation of Alternative Methods (Comitê de Coordenação Interagências sobre Validação de Métodos Alternativos - ICCVAM) have recommended its utilization provided that the equivalence of its results from the rabbit test, in conformity with the applicable regulation. It can be verified, then, that the literature lacks the data which involves the comparison between the limit dose that causes fever in rabbits and the consequence for the MAT related to the lipoteichoic acid (LTA), that being so, the aim of this study is mainly the utilization of MAT in the detection of the contamination of LTA of S. aureus in apyrogenic 0.9 % Sodium Chloride artificially contaminated, through the establishment of the dose-response curve of LTA in rabbits; concentration-response curve of LTA for the MAT and parallel evaluation of the results obtained by utilizing LTA in the test in rabbits, chromogenic LAL and MAT. The fever response was observed from 75.000 ng of LTA/Kg in rabbits and in MAT and for cryopreserved blood/IL-1β was established in 50.000 ng/mL of LTA, or 5,41 UEE/mL. The LAL test presented a false-positive result from 10.000 ng/mL of ALT. The results presented in this study provide important information on the comparison between the rabbit pyrogen test, MAT and LAL, contributing with data to the evaluation of MAT, involving pyrogens other than endotoxin, and also to the acceptance of this test by the regulatory organs in Brazil aiming at a possible animal substitution, and guaranteeing, then, the health security of the population.