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'''Depyrogenation''' refers to the removal of pyrogens from solution, most commonly from injectable pharmaceuticals.
A [[wikt:pyrogen|pyrogen]] is defined as any substance that can cause a fever. Bacterial pyrogens include [[endotoxins]] and [[exotoxins]], although many pyrogens are endogenous to the host. Endotoxins include [[lipopolysaccharide]] (LPS) molecules found as part of the cell wall of [[Gram-negative]] bacteria (see right), and are released upon bacterial cell [[lysis]]. Endotoxins may become pyrogenic when released into the bloodstream or other tissue where they are not usually found. Although the colon contains Gram-negative bacteria in abundance, they do not cause a pyrogenic effect as the bacteria are not undergoing gross lysis, and the immune system is not exposed to free endotoxin while the colonic wall is intact.
When LPS is released upon bacterial cell lysis, the lipid A component is first bound by serum LPS-Binding Protein (LBP) and then transferred to CD14 (either free CD14 in the serum or bound to the cell surface of macrophages or monocytes). This monomerises the aggregated LPS, as the LPS receptor Toll-like Receptor 4 (TLR4) cannot recognise LPS while aggregated. Monomeric LPS is then transferred to MD-2 pre-complexed with TLR4 on [[macrophages]] and [[monocytes]]. This leads to release of pro-inflammatory cytokines and nitric oxide, which may lead ultimately to septic shock depending on the strength of response. Vascular [[endothelial]] cells also express TLR4 and MD-2 and so respond to LPS directly, as well as via cytokines and nitric oxide. Bronchial epithelial cells and colonic epithelial cells also express TLR4, but as they do not express MD-2 they rely on LPS precomplexed with serum MD-2 in order to signal to LPS.
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