Why do you measure hexa-LPS? What is the difference between LPS and hexa-LPS?

LPS (lipopolysaccharide) is an endotoxin found in the outer membrane of Gram-negative bacteria.

Structural difference:

• Penta-acylated LPS (5 fatty acid chains): Less inflammatory, sometimes even immunomodulatory
• Hexa-acylated LPS (6 fatty acid chains): More pro-inflammatory, strongly activates TLR4 receptors

Why it matters: Not all LPS is equally inflammatory. Hexa-LPS is specifically associated with:

• Increased intestinal permeability ("leaky gut")
• Metabolic endotoxemia
• Systemic inflammation
• Insulin resistance and metabolic syndrome

Clinical interpretation:

• High hexa-LPS capacity suggests greater inflammatory potential
• Correlates with the abundance of organisms like E. coli, Klebsiella, Desulfovibrio
• May warrant interventions to reduce Gram-negative overgrowth or strengthen barrier function

Important: This measures genetic capacity to produce hexa-LPS, not actual circulating endotoxin levels (which would require serum LPS testing).