SDZ MRL 953, a new synthetic monosaccharidic lipid A, was investigated in vitro and in vivo for immunopharmacological activities. In experimental models of microbial infections, the compound was highly protective when it was administered prophylactically either once or three times to myelosuppressed or immunocompetent mice. The 50% effective doses of SDZ MRL 953 varied with the infectious agents and the route of its administration. In all cases, the 50% effective doses were about 103 times higher than those obtained with endotoxin from Salmonella abortus equi. SDZ MRL 953 was, however, less toxic than lipopolysaccharide by a factor of 104 to >7 x 105 times in galactosamine-sensitized mice. The compound was also an effective inducer of tolerance to endotoxin. Hence, repeated dosing with the compound induced a transient resistance (.1 week) to lethal challenges with endotoxin. In vitro, the compound was devoid of intrinsic antimicrobial activity, but it moderately induced the release of cytokines from monocytes and primed human neutrophils for the enhanced production of reactive oxygen metabolites in response to a soluble stimulus. The results presented here suggest that SDZ MRL 953 may be useful in a clinical setting for enhancing resistance to infections, particularly in patients undergoing myelosuppressive chemotherapy or irradiation, and for the prophylaxis of endotoxin shock.Lipopolysaccharides (LPS) are common constituents of cell walls of gram-negative bacteria. They can cause a whole array of pathophysiological effects and are also the most powerful immunostimulants known. It is generally accepted that the lipid A moiety, the terminal acylated P(1-6)glucosamine disaccharide-1,4'-diphosphates of endotoxin, is responsible for immunopharmacological activity and induction of endotoxicity, such as changes in leukocyte count, disseminated intravascular coagulation, and multiorgan failure leading to irreversible shock and death (5,21,25).Extensive studies have unsuccessfully addressed the possibility of harnessing the immunopharmacological activities of endotoxins by using various detoxifying approaches (17,20). The elucidation of the correct structure of lipid A (8, 26) and the subsequent success in the total synthesis of biologically active lipid A and analogs (9-12, 27) have rekindled interest in the possibility of separating the immunostimulatory and toxic moieties of endotoxin. Efforts to identify beneficial immunostimulatory lipid A derivatives have concentrated on synthetic analogs representing both the nonreducing (10-12) and reducing sugar moieties, such as lipids X and Y (15,27). Synthetic lipid A subunits of the nonreducing sugar moiety such as GLA-27 and GLA-60 were reported to activate B cells and macrophages and to induce release of mediators including gamma interferon and tumor necrosis factor (TNF) at nontoxic doses (for a review, see reference 5). The analogs were also found to be active in enhancing host resistance to microbial and viral infections in normal and myelosuppressed mice (5-7). Synth...