Haemolytic-uraemic syndrome

Heyderman, R S; Fitzpatrick, M. J.; Barclay, G. R.; Reymond, D.; Bianchetti, Maria; Burnens, André P.; Lior, H.; Cochran, M.; Coates, Penelope

doi:10.1016/s0140-6736(94)90165-1

Cited by 24 publications

(7 citation statements)

References 8 publications

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“…This indicated systemic release of LPS core antigens during the disease [16]. We know from ongoing studies that speci¢c IgA antibodies to R1, R2, R3, and R4 core LPS of E. coli can be detected in gut lavage £uids from healthy volunteers.…”

Section: Discussionmentioning

confidence: 92%

“…A study of children su¡ering from haemolytic uraemic syndrome showed levels of antibody to rough LPS (by the EndoCAb assay) were signi¢cantly depleted in those with severe disease. This indicated systemic release of LPS core antigens during the disease [16]. We know from ongoing studies that speci¢c IgA antibodies to R1, R2, R3, and R4 core LPS of E. coli can be detected in gut lavage £uids from healthy volunteers.…”

Section: Discussionmentioning

confidence: 92%

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The lipopolysaccharide core type of Escherichia coli O157:H7 and other non-O157 verotoxin-producing E. coli

Currie

1999

FEMS Immunology and Medical Microbiology

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A mouse monoclonal antibody specific for the R3 lipopolysaccharide core type of Escherichia coli was used to determine the core type of E. coli O157:H7 and other non-O157 verotoxin-producing E. coli strains. Lipopolysaccharide extracts from 28 clinical isolates were examined by sodium dodecylsulfate-polyacrylamide gel electrophoresis and immunoblotting and all were found to have the R3 core. None of the core lipopolysaccharide from the strains tested reacted with the control R1 and R2 specific monoclonal antibodies. A common core type between all the verotoxin-producing E. coli strains tested may be significant when considering the immune response to these bacteria, and to the receptor for the VT bacteriophage. z 1999 Federation of European Microbiological Societies. Published by Elsevier Science B.V. All rights reserved.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 92%

The lipopolysaccharide core type of Escherichia coli O157:H7 and other non-O157 verotoxin-producing E. coli

Currie

1999

FEMS Immunology and Medical Microbiology

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“…Dose effects and differences in dietary habits may be sufficient to account for the apparent clustering of cases in younger children; however, alternative possibilities exist, such as the typical pattern of endotoxin antibodies in this age group ( Barclay 1995). Patients with verotoxinaemia are also likely to be endotoxinaemic ( Heyderman, Fitzpatrick & Barclay 1994). From the age of 6 months or so children develop high levels of IgM antiendotoxin antibody, but significant levels of IgG antiendotoxin antibody do not develop until after the age of 3 years.…”

Section: Discussionmentioning

confidence: 99%

Haemolytic uraemic syndrome: prognostic factors

Green

Murphy

Uttley

2000

Clinical &Amp; Laboratory Haematology

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Haemolytic uraemic syndrome (HUS) associated with Escherichia coli O157:H7 is the commonest cause of acute renal failure (ARF) in childhood. Production of verotoxin by the organism is pivotal in the pathogenesis of the disease. Verotoxin binds to a receptor on blood and endothelial cells, expressed as the P1 blood group antigen on red blood cells. A protective effect of the P1 phenotype has been proposed in this disease. This study investigates prognostic factors and the relationship between outcome and P1 phenotype in 27 cases of diarrhoea-associated HUS. A poor outcome as defined by the presence of chronic renal failure (CRF), hypertension or proteinuria on 6 month follow-up was associated with the age of the patient at presentation and with the following clinical markers: maximum WBC and duration of raised WBC, duration of anuria and duration of need for dialysis. None of these outcome measures or prognostic factors, and no extra-renal manifestations of the disease were associated with P1 phenotype.

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“…Evidence that LPS participates in the pathogenesis of D+ HUS includes clinical demonstration of endotoxemia [7, 8] or antibodies to LPS [9, 10] in patients, in vitro observations that LPS treatment enhances endothelial cell apoptosis [11], and that LPS, as well as tumor necrosis factor (TNF) and interleukin-6 upregulate the production of the Stx receptor molecule, globotriaosylceramide (Gb 3 ) [12,13,14]. However, Gb 3 upregulation by LPS has not been demonstrated in vivo, and we report here the results of Stx receptor studies in our model.…”

Section: Introductionmentioning

confidence: 99%

Lipopolysaccharide Upregulates Renal Shiga Toxin Receptors in a Primate Model of Hemolytic Uremic Syndrome

Clayton¹,

Pysher²,

Lou

et al. 2005

Am J Nephrol

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Background: Although Shiga toxin (Stx) mediates classical hemolytic uremic syndrome (HUS), it is not fully understood why only some subjects exposed to Stx-expressing Escherichia coli develop HUS. We have previously shown in a baboon model of Stx-mediated HUS that coadministration of lipopolysaccharide (LPS) results in an augmented host response to otherwise subtoxic Stx1 doses. We used this model to test the hypothesis that LPS upregulates renal Stx receptor (Gb₃) expression. Methods: Juvenile baboons were treated with either Stx1 (100 ng/kg), LPS (1 mg/kg as two divided doses 24 h apart), or a sham injection of saline, and sacrificed and immediately autopsied at 72 h. Renal cortical tissue Gb₃ content was quantitated by lipid extraction and thin-layer chromatography, and Stx1 and Gb₃/CD77 immunostaining was assessed by quantitative immunofluorescent microscopy. Results: Compared to saline-in jected controls, LPS administration resulted in a 2.2-fold increase in renal cortical Gb₃ by chromatography (p < 0.01), a 2.5-fold increase in Stx1 staining (p = 0.003) and a 1.7-fold increase in CD77 immunostaining (p = 0.004). Stx treatment did not significantly alter either Stx or CD77 immunostaining. Conclusion: These observations suggest that LPS primes the host for Stx-mediated renal injury by upregulating renal Gb₃ expression.

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Haemolytic-uraemic syndrome

Cited by 24 publications

References 8 publications

The lipopolysaccharide core type of Escherichia coli O157:H7 and other non-O157 verotoxin-producing E. coli

The lipopolysaccharide core type of Escherichia coli O157:H7 and other non-O157 verotoxin-producing E. coli

Haemolytic uraemic syndrome: prognostic factors

Lipopolysaccharide Upregulates Renal Shiga Toxin Receptors in a Primate Model of Hemolytic Uremic Syndrome

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