{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:11:31Z","timestamp":1787026291319,"version":"build-2736575974"},"reference-count":70,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T00:00:00Z","timestamp":1701129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Neisseria meningitidis<\/jats:italic>\n                      (Nm) is the cause of epidemic meningitis and fulminant meningococcal septicemia. The clinical presentations and outcome of meningococcal septic shock is closely related to the circulating levels of lipopolysaccharides (LPS) and of\n                      <jats:italic>Neisseria meningitidis<\/jats:italic>\n                      DNA (Nm DNA). We have previously explored the distribution of Nm DNA in tissues from large organs of patients dying of meningococcal septic shock and in a porcine meningococcal septic shock model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>1) To explore the feasibility of measuring LPS levels in tissues from the large organs in patients with meningococcal septic shock and in a porcine meningococcal septic shock model. 2) To evaluate the extent of contamination of non-specific LPS during the preparation of tissue samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>\n                      Plasma, serum, and fresh frozen (FF) tissue samples from the large organs of three patients with lethal meningococcal septic shock and two patients with lethal pneumococcal disease. Samples from a porcine meningococcal septic shock model were included. Frozen tissue samples were thawed, homogenized, and prepared for quantification of LPS by Pyrochrome\n                      <jats:sup>\u00ae<\/jats:sup>\n                      Limulus Amoebocyte Lysate (LAL) assay.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:italic>N. meningitidis<\/jats:italic>\n                      DNA and LPS was detected in FF tissue samples from large organs in all patients with meningococcal septic shock. The lungs are the organs with the highest LPS and Nm DNA concentration followed by the heart in two of the three meningococcal shock patients. Nm DNA was not detected in any plasma or tissue sample from patients with lethal pneumococcal infection. LPS was detected at a low level in all FF tissues from the two patients with lethal pneumococcal disease. The experimental porcine meningococcal septic shock model indicates that also in porcinis the highest LPS and Nm DNA concentration are detected in lungs tissue samples. The quantification analysis showed that the highest concentration of both Nm DNA and LPS are in the organs and not in the circulation of patients with lethal meningococcal septic shock. This was also shown in the experimental porcine meningococcal septic shock model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our results suggest that LPS can be quantified in mammalian tissues by using the LAL assay.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2023.1298360","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T03:43:06Z","timestamp":1701142986000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Neisseria meningitidis accumulate in large organs during meningococcal sepsis"],"prefix":"10.3389","volume":"13","author":[{"given":"Berit Sletbakk","family":"Brusletto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernt Christian","family":"Hellerud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reidun","family":"\u00d8vsteb\u00f8","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petter","family":"Brandtzaeg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,11,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/0882-4010(89)90043-0","article-title":"Molecular biology of class 5 outer membrane proteins of Neisseria meningitidis","volume":"7","author":"Aho","year":"1989","journal-title":"Microb. Pathog."},{"key":"B2","doi-asserted-by":"publisher","first-page":"31521","DOI":"10.1074\/jbc.M304749200","article-title":"Detailed structural analysis of the peptidoglycan of the human pathogen Neisseria meningitidis","volume":"278","author":"Antignac","year":"2003","journal-title":"J. Biol. Chem."},{"key":"B3","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1179\/096805103125001559","article-title":"Identification of meningococcal LPS as a major monocyte activator in IL-10 depleted shock plasmas and CSF by blocking the CD14-TLR4 receptor complex","volume":"9","author":"Bjerre","year":"2003","journal-title":"J. Endotoxin Res."},{"key":"B4","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1177\/09680519000060060501","article-title":"Cellular activating properties and morphology of membrane-bound and purified meningococcal lipopolysaccharide","volume":"6","author":"Bjerre","year":"2000","journal-title":"J. Endotoxin Res."},{"key":"B5","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1136\/bmj.288.6415.439","article-title":"Meningococcal septicaemia treated with combined plasmapheresis and leucapheresis or with blood exchange","volume":"288","author":"Bjorvatn","year":"1984","journal-title":"Br. Med. J. (Clin Res. Ed)"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1016\/0140-6736(91)91961-s","article-title":"Effect of outer membrane vesicle vaccine against group B meningococcal disease in Norway","volume":"338","author":"Bjune","year":"1991","journal-title":"Lancet"},{"key":"B7","first-page":"71","article-title":"Pathogenesis of meningococcal infections","volume-title":"Meningococcal disease","author":"Brandtzaeg","year":"1995"},{"key":"B8","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1002\/3527608508.ch21","article-title":"Pathogenesis and pathophysiology of invasive meningococcal disease","volume-title":"Handbook of Meningococcal Disease: Infection Biology, Vaccination, Clinical Management","author":"Brandtzaeg","year":"2006"},{"key":"B9","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1179\/096805101101533016","article-title":"Neisseria meningitidis lipopolysaccharides in human pathology","volume":"7","author":"Brandtzaeg","year":"2001","journal-title":"J. Endotoxin Res."},{"key":"B10","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1172\/jci115660","article-title":"Meningococcal endotoxin in lethal septic shock plasma studied by gas chromatography, mass-spectrometry, ultracentrifugation, and electron microscopy","volume":"89","author":"Brandtzaeg","year":"1992","journal-title":"J. Clin. Invest."},{"key":"B11","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1093\/infdis\/159.2.195","article-title":"Plasma endotoxin as a predictor of multiple organ failure and death in systemic meningococcal disease","volume":"159","author":"Brandtzaeg","year":"1989","journal-title":"J. Infect. Dis."},{"key":"B12","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1084\/jem.184.1.51","article-title":"Net inflammatory capacity of human septic shock plasma evaluated by a monocyte-based target cell assay: identification of interleukin-10 as a major functional deactivator of human monocytes","volume":"184","author":"Brandtzaeg","year":"1996","journal-title":"J. Exp. Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1385\/1-59259-149-3:427","article-title":"Quantitative detection of bacterial lipopolysaccharides in clinical specimens","volume":"67","author":"Brandtzaeg","year":"2001","journal-title":"Methods Mol. Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1093\/infdis\/166.3.650","article-title":"Compartmentalization of lipopolysaccharide production correlates with clinical presentation in meningococcal disease","volume":"166","author":"Brandtzaeg","year":"1992","journal-title":"J. Infect. Dis."},{"key":"B15","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1007\/978-1-61779-346-2_2","article-title":"Classification and pathogenesis of meningococcal infections","volume":"799","author":"Brandtzaeg","year":"2012","journal-title":"Methods Mol. Biol."},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1186\/s12907-017-0049-9","article-title":"Traceability and distribution of Neisseria meningitidis DNA in archived post mortem tissue samples from patients with systemic meningococcal disease","volume":"17","author":"Brusletto","year":"2017","journal-title":"BMC Clin. Pathol."},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.908204","article-title":"Transcriptomic changes in the large organs in lethal meningococcal shock are reflected in a porcine shock model","volume":"12","author":"Brusletto","year":"2022","journal-title":"Front. Cell Infect. Microbiol."},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2020.00042","article-title":"Extensive changes in transcriptomic \"Fingerprints\" and immunological cells in the large organs of patients dying of acute septic shock and multiple organ failure caused by Neisseria meningitidis","volume":"10","author":"Brusletto","year":"2020","journal-title":"Front. Cell Infect. Microbiol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"B64","DOI":"10.1016\/j.vaccine.2009.04.061","article-title":"Meningococcal carriage and disease\u2013population biology and evolution","author":"Caugant","year":"2009","journal-title":"Vaccine"},{"key":"B20","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1086\/596707","article-title":"Severity of meningococcal disease associated with genomic bacterial load","volume":"48","author":"Darton","year":"2009","journal-title":"Clin. Infect. Dis."},{"key":"B21","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1128\/mr.46.2.162-190.1982","article-title":"The meningococcus and mechanisms of pathogenicity","volume":"46","author":"DeVoe","year":"1982","journal-title":"Microbiol. Rev."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1156","DOI":"10.1084\/jem.138.5.1156","article-title":"Release of endotoxin in the form of cell wall blebs during in vitro growth of Neisseria meningitidis","volume":"138","author":"Devoe","year":"1973","journal-title":"J. Exp. Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1128\/jb.136.3.1127-1134.1978","article-title":"Heat-modifiable outer membrane proteins of Neisseria meningitidis and their organization within the membrane","volume":"136","author":"Frasch","year":"1978","journal-title":"J. Bacteriol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1128\/iai.60.3.798-803.1992","article-title":"Conserved outer membrane protein of Neisseria meningitidis involved in capsule expression","volume":"60","author":"Frosch","year":"1992","journal-title":"Infect. Immun."},{"key":"B25","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1097\/SHK.0b013e3182746e52","article-title":"Circulating monocytes are not the major source of plasma cytokines in patients with sepsis","volume":"38","author":"Gille-Johnson","year":"2012","journal-title":"Shock"},{"key":"B26","doi-asserted-by":"publisher","first-page":"4186","DOI":"10.1073\/pnas.0306906101","article-title":"Isolation of an endotoxin-MD-2 complex that produces Toll-like receptor 4-dependent cell activation at picomolar concentrations","volume":"101","author":"Gioannini","year":"2004","journal-title":"Proc. Natl. Acad. Sci. U.S.A."},{"key":"B27","doi-asserted-by":"publisher","first-page":"47818","DOI":"10.1074\/jbc.M206404200","article-title":"An essential role for albumin in the interaction of endotoxin with lipopolysaccharide-binding protein and sCD14 and resultant cell activation*","volume":"277","author":"Gioannini","year":"2002","journal-title":"J. Biol. Chem."},{"key":"B28","doi-asserted-by":"publisher","first-page":"4046","DOI":"10.1128\/iai.00386-12","article-title":"Global effect of interleukin-10 on the transcriptional profile induced by Neisseria meningitidis in human monocytes","volume":"80","author":"Gopinathan","year":"2012","journal-title":"Infect. Immun."},{"key":"B29","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1136\/adc.86.1.44","article-title":"Meningococcal bacterial DNA load at presentation correlates with disease severity","volume":"86","author":"Hackett","year":"2002","journal-title":"Arch. Dis. Child"},{"key":"B30","doi-asserted-by":"publisher","first-page":"5193","DOI":"10.1128\/iai.70.9.5193-5201.2002","article-title":"Analysis of pathogen-host cell interactions in purpura fulminans: expression of capsule, type IV pili, and PorA by Neisseria meningitidis in vivo","volume":"70","author":"Harrison","year":"2002","journal-title":"Infect. Immun."},{"key":"B31","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1007\/bf01641194","article-title":"Quantitation of endotoxin in blood from patients with meningococcal disease using a limulus lysate test in combination with chromogenic substrate","volume":"11","author":"Harthug","year":"1983","journal-title":"Infection"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1467","DOI":"10.1097\/CCM.0b013e3181de8c94","article-title":"Dissecting the effects of lipopolysaccharides from nonlipopolysaccharide molecules in experimental porcine meningococcal sepsis","volume":"38","author":"Hellerud","year":"2010","journal-title":"Crit. Care Med."},{"key":"B33","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1097\/shk.0000000000000441","article-title":"Massive organ inflammation in experimental and in clinical meningococcal septic shock","volume":"44","author":"Hellerud","year":"2015","journal-title":"Shock"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-017-0217-0","article-title":"Combined inhibition of C5 and CD14 efficiently attenuated the inflammatory response in a porcine model of meningococcal sepsis","volume":"5","author":"Hellerud","year":"2017","journal-title":"J. Intensive Care"},{"key":"B35","doi-asserted-by":"publisher","first-page":"4183","DOI":"10.1128\/iai.00195-08","article-title":"Stages of meningococcal sepsis simulated in vitro, with emphasis on complement and Toll-like receptor activation","volume":"76","author":"Hellerud","year":"2008","journal-title":"Infect. Immun."},{"key":"B36","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1128\/jcm.9.2.186-188.1979","article-title":"Serotypes of Neisseria meningitidis isolated from patients in Norway during the first six months of 1978","volume":"9","author":"Holten","year":"1979","journal-title":"J. Clin. Microbiol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1177\/09680519000060050301","article-title":"Differential roles of TLR2 and TLR4 in the host response to Gram-negative bacteria: lessons from a lipopolysaccharide-deficient mutant of Neisseria meningitidis","volume":"6","author":"Ingalls","year":"2000","journal-title":"J. Endotoxin Res."},{"key":"B38","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1080\/10408419891294216","article-title":"Genetic basis for biosynthesis, structure, and function of meningococcal lipooligosaccharide (endotoxin)","volume":"24","author":"Kahler","year":"1998","journal-title":"Crit. Rev. Microbiol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1793","DOI":"10.1128\/jb.174.6.1793-1800.1992","article-title":"Structural characterization of the lipid A component of pathogenic Neisseria meningitidis","volume":"174","author":"Kulshin","year":"1992","journal-title":"J. Bacteriol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1128\/jcm.13.3.478-482.1981","article-title":"Diagnosis of bacteremia in children by quantitative direct plating and a radiometric procedure","volume":"13","author":"La Scolea","year":"1981","journal-title":"J. Clin. Microbiol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1189\/jlb.1105626","article-title":"Live Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis activate the inflammatory response through Toll-like receptors 2, 4, and 9 in species-specific patterns","volume":"80","author":"Mogensen","year":"2006","journal-title":"J. Leukoc. Biol."},{"key":"B42","doi-asserted-by":"publisher","first-page":"413","DOI":"10.2144\/04373st06","article-title":"Detection of bacterial endotoxin in human tissues","volume":"37","author":"Nalepka","year":"2004","journal-title":"Biotechniques"},{"key":"B43","doi-asserted-by":"publisher","first-page":"1741","DOI":"10.1016\/s0140-6736(02)11721-1","article-title":"Fatal meningococcal septicaemia with \"blebbing\" meningococcus","volume":"360","author":"Namork","year":"2002","journal-title":"Lancet"},{"key":"B44","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1097\/SHK.0b013e31819c37be","article-title":"A new dynamic porcine model of meningococcal shock","volume":"32","author":"Nielsen","year":"2009","journal-title":"Shock"},{"key":"B45","doi-asserted-by":"publisher","first-page":"2980","DOI":"10.1128\/jcm.42.7.2980-2987.2004","article-title":"Use of robotized DNA isolation and real-time PCR to quantify and identify close correlation between levels of Neisseria meningitidis DNA and lipopolysaccharides in plasma and cerebrospinal fluid from patients with systemic meningococcal disease","volume":"42","author":"Ovstebo","year":"2004","journal-title":"J. Clin. Microbiol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"2685","DOI":"10.1128\/iai.01625-07","article-title":"Identification of genes particularly sensitive to lipopolysaccharide (LPS) in human monocytes induced by wild-type versus LPS-deficient Neisseria meningitidis strains","volume":"76","author":"Ovsteb\u00f8","year":"2008","journal-title":"Infect. Immun."},{"key":"B47","doi-asserted-by":"publisher","first-page":"e57","DOI":"10.1017\/s0950268823000328","article-title":"Epidemiology of invasive meningococcal disease worldwide from 2010-2019: a literature review","volume":"151","author":"Pardo de Santayana","year":"2023","journal-title":"Epidemiol. Infect."},{"key":"B48","doi-asserted-by":"publisher","first-page":"14146","DOI":"10.1016\/S0021-9258(19)85220-1","article-title":"Structure of the sialylated L3 lipopolysaccharide of Neisseria meningitidis","volume":"268","author":"Pavliak","year":"1993","journal-title":"J. Biol. Chem."},{"key":"B49","doi-asserted-by":"publisher","first-page":"2371","DOI":"10.1128\/jb.01331-10","article-title":"Genome sequence of Neisseria meningitidis serogroup B strain H44\/76","volume":"193","author":"Piet","year":"2011","journal-title":"J. Bacteriol"},{"key":"B50","doi-asserted-by":"publisher","first-page":"38383","DOI":"10.1074\/jbc.M508063200","article-title":"Biochemical and functional characterization of membrane blebs purified from Neisseria meningitidis serogroup B*","volume":"280","author":"Post","year":"2005","journal-title":"J. Biol. Chem."},{"key":"B51","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1086\/317647","article-title":"A lipopolysaccharide-deficient mutant of Neisseria meningitidis elicits attenuated cytokine release by human macrophages and signals via toll-like receptor (TLR) 2 but not via TLR4\/MD2","volume":"183","author":"Pridmore","year":"2001","journal-title":"J. Infect. Dis."},{"key":"B52","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1111\/1469-0691.12647","article-title":"Neisseria meningitidis; clones, carriage, and disease","volume":"20","author":"Read","year":"2014","journal-title":"Clin. Microbiol. Infect."},{"key":"B53","doi-asserted-by":"publisher","first-page":"1378","DOI":"10.1056\/nejm200105033441807","article-title":"Meningococcal disease","volume":"344","author":"Rosenstein","year":"2001","journal-title":"N Engl. J. Med."},{"key":"B54","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/978-1-61779-346-2_1","article-title":"Neisseria meningitidis: biology, microbiology, and epidemiology","volume":"799","author":"Rouphael","year":"2012","journal-title":"Methods Mol. Biol."},{"key":"B55","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1189\/jlb.70.2.283","article-title":"Contributions of Neisseria meningitidis LPS and non-LPS to proinflammatory cytokine response","volume":"70","author":"Sprong","year":"2001","journal-title":"J. Leukoc. Biol."},{"key":"B56","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1038\/33046","article-title":"Meningitis bacterium is viable without endotoxin","volume":"392","author":"Steeghs","year":"1998","journal-title":"Nature"},{"key":"B57","doi-asserted-by":"publisher","first-page":"2196","DOI":"10.1016\/s0140-6736(07)61016-2","article-title":"Epidemic meningitis, meningococcaemia, and Neisseria meningitidis","volume":"369","author":"Stephens","year":"2007","journal-title":"Lancet"},{"key":"B58","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1542\/peds.80.1.63","article-title":"Neisseria meningitidis bacteremia in children: quantitation of bacteremia and spontaneous clinical recovery without antibiotic therapy","volume":"80","author":"Sullivan","year":"1987","journal-title":"Pediatrics"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2017.00256","article-title":"Biological functions of the secretome of Neisseria meningitidis","volume":"7","author":"Tommassen","year":"2017","journal-title":"Front. Cell Infect. Microbiol."},{"key":"B60","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1128\/jb.146.1.69-78.1981","article-title":"Five structural classes of major outer membrane proteins in Neisseria meningitidis","volume":"146","author":"Tsai","year":"1981","journal-title":"J. Bacteriol"},{"key":"B61","doi-asserted-by":"publisher","first-page":"5981","DOI":"10.1128\/iai.69.10.5981-5990.2001","article-title":"Modification of lipid A biosynthesis in Neisseria meningitidis lpxL mutants: influence on lipopolysaccharide structure, toxicity, and adjuvant activity","volume":"69","author":"van der Ley","year":"2001","journal-title":"Infect. Immun."},{"key":"B62","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1128\/CMR.13.1.144","article-title":"Update on meningococcal disease with emphasis on pathogenesis and clinical management","volume":"13","author":"van Deuren","year":"2000","journal-title":"Clin. Microbiol. Rev."},{"key":"B63","doi-asserted-by":"publisher","first-page":"1401","DOI":"10.1086\/517824","article-title":"Posttranscriptional down-regulation of tumor necrosis factor-alpha and interleukin-1beta production in acute meningococcal infections","volume":"177","author":"van Deuren","year":"1998","journal-title":"J. Infect. Dis."},{"key":"B64","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1093\/infdis\/172.2.433","article-title":"Correlation between proinflammatory cytokines and antiinflammatory mediators and the severity of disease in meningococcal infections","volume":"172","author":"van Deuren","year":"1995","journal-title":"J. Infect. Dis."},{"key":"B65","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1136\/bmj.306.6887.1229","article-title":"Rapid diagnosis of acute meningococcal infections by needle aspiration or biopsy of skin lesions","volume":"306","author":"van Deuren","year":"1993","journal-title":"Bmj"},{"key":"B66","doi-asserted-by":"publisher","first-page":"2768","DOI":"10.1016\/j.vaccine.2019.04.020","article-title":"Case fatality rates of invasive meningococcal disease by serogroup and age: A systematic review and meta-analysis","volume":"37","author":"Wang","year":"2019","journal-title":"Vaccine"},{"key":"B67","first-page":"573","article-title":"Ueber die Aetiologie der akuten Meningitis cerebro-spinalis","volume":"5","author":"Weichselbaum","year":"1887","journal-title":"Fortschr. der Med."},{"key":"B68","doi-asserted-by":"publisher","first-page":"16346","DOI":"10.1074\/jbc.M112.343467","article-title":"NMR studies of hexaacylated endotoxin bound to wild-type and F126A mutant MD-2 and MD-2\u00b7TLR4 ectodomain complexes","volume":"287","author":"Yu","year":"2012","journal-title":"J. Biol. Chem."},{"key":"B69","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1128\/iai.72.1.371-380.2004","article-title":"Neisseria meningitidis lipooligosaccharide structure-dependent activation of the macrophage CD14\/Toll-like receptor 4 pathway","volume":"72","author":"Zughaier","year":"2004","journal-title":"Infect. Immun."},{"key":"B70","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1007\/bf02017367","article-title":"Magnitude of bacteremia and complement activation during Neisseria meningitidis infection: study of two co-primary cases with different clinical presentations","volume":"3","author":"Zwahlen","year":"1984","journal-title":"Eur. J. Clin. Microbiol."}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2023.1298360\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T03:43:10Z","timestamp":1701142990000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2023.1298360\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,28]]},"references-count":70,"alternative-id":["10.3389\/fcimb.2023.1298360"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2023.1298360","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,28]]},"article-number":"1298360"}}