Endotoxins - The invisible companion in biomaterials research

Ramona Lieder, Pétur Henry Petersen, Ólafur Eysteinn Sigurjónsson*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

47 Citations (Scopus)


Metal implants and polymeric devices for the application in the clinical treatment of orthopedic tissue injuries are increasingly coated with bioactive biomaterials derived from natural substances to induce desirable biological effects. Many metals and polymers used in biomaterials research show high affinity for endotoxins, which are abundant in the environment. Endotoxin contamination is indicated in the pathology of periodontitis and aseptic implant loosening, but may also affect the evaluation of a biomaterial's bioactivity by inducing strong inflammatory reactions. In this review, we discuss the high affinity of three commonly used implant biomaterials for endotoxins and how the contamination can affect the outcome of the orthopedic fixation. The chemical nature of bacterial endotoxins and some of the clinical health implications are described, as this knowledge is critically important to tackle the issues associated with the measurement and removal of endotoxins from medical devices. Commonly used methods for endotoxin testing and removal from natural substances are examined and the lack of standard guidelines for the in vitro evaluation of biomaterials is discussed.

Original languageEnglish
Pages (from-to)391-402
Number of pages12
JournalTissue Engineering - Part B: Reviews
Issue number5
Publication statusPublished - 1 Oct 2013


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