The monocyte activation test (MAT) is another proposed method to test for endotoxins based on monocytes in human blood. It measures the release of cytokines from these due to the presence of pyrogens, basically mirroring the process by which these toxins cause fever in humans (and rabbits, as in the original pyrogen test). A protocol for the MAT test, using cultured cells, is described in the European Pharmacopoeia.
A recent study employing genetically engineered monocytes was able to significantly enhance the sensitivity of monocyte-based detection assays by bringing down the assay-completion time from more than 20 hours to 2–3 hours.