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Reference Endotoxin is a highly purified preparation of lipopolysaccharide (LPS), typically derived from *Escherichia coli* (such as the EC-6 lot), used as a standardized biological challenge agent in clinical research. Developed and utilized by the National Institutes of Health Clinical Center (CC), it is administered to healthy volunteers via intravenous injection or endobronchial instillation to safely induce a controlled systemic or localized inflammatory response. This response mimics the early pathophysiological features of sepsis and septic shock, including cytokine release and cardiopulmonary changes. By serving as a human model of innate immune activation, Reference Endotoxin allows for the study of sepsis mechanisms and the evaluation of potential therapeutic interventions, such as inhaled nitric oxide, in a highly regulated environment.
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