Serum Shiga toxin 2 values in patients during acute phase of diarrhoea‐associated haemolytic uraemic syndrome

He, Xiaohua; Quiñones, Beatriz; Loo, D. Maroeska W. M. te; Loos, Sebastian; Scavia, Gaia; Brigotti, Maurizio; Levtchenko, Elena; Monnens, L.A.H.

doi:10.1111/apa.13211

Cited by 21 publications

(13 citation statements)

References 23 publications

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“…The question of how VT enters the blood stream following gastrointestinal EHEC infection, is still unclear. VT is difficult to detect in patient blood after EHEC infection but can be detected in the acute phase (He et al, 2015;Yamada et al, 2019). However, these blood concentrations are far lower than needed to cause HUS in the baboon.…”

Section: Vt and Ehusmentioning

confidence: 99%

Verotoxin Receptor-Based Pathology and Therapies

Lingwood

2020

Front. Cell. Infect. Microbiol.

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Section: Vt and Ehusmentioning

confidence: 99%

Verotoxin Receptor-Based Pathology and Therapies

Lingwood

2020

Front. Cell. Infect. Microbiol.

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“…Stx are capable of binding to several blood components, including platelets [ 11 , 12 , 13 ], monocytes [ 14 , 15 ], neutrophils [ 16 , 17 , 18 ], erythrocytes [ 19 ], leukocyte- and platelet-derived microvesicles [ 20 ] and lipoproteins [ 21 ], and these interactions have variable impacts on the pathogenetic mechanisms underlying the onset of HUS. On the other hand, free Stx2 has been detected in sera of STEC-infected patients during the prodromal intestinal phase before the onset of HUS [ 22 ] and in very low amounts in sera of patients with overt HUS [ 23 ]. The detection methods used in these studies relied on very sensitive ELISA [ 22 , 24 ], which correctly identified the toxins without giving any information on their activity.…”

Section: Introductionmentioning

confidence: 99%

A Rapid and Sensitive Method to Measure the Functional Activity of Shiga Toxins in Human Serum

Arfilli

Carnicelli

Ardissino

et al. 2015

Toxins

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Shiga toxins (Stx) have a definite role in the development of hemolytic uremic syndrome in children with hemorrhagic colitis caused by pathogenic Stx-producing Escherichia coli (STEC) strains. The dramatic effects of these toxins on the microvasculature of different organs, particularly of the kidney, are well known, whereas there is no consensus on the mechanism by which Stx reach the endothelia of target organs and/or indirectly injure these body sites. We hereby describe a quick (4 h), radioactive, Raji cell-based method designed for the detection of Stx in human sera. The assay monitors the translation impairment induced by these powerful inhibitors of protein synthesis, which are identified properly by neutralizing their activity with specific monoclonal antibodies. By this method, we detected for the first time the functional activity of Stx in sera of STEC-infected patients during hemorrhagic colitis. Recent research has pointed to a dynamic process of Stx-induced renal intoxication in which concurrent and interactive steps are involved. Our rapid and specific method could be useful for studying the kinetics of Stx during the natural course of STEC infection and the interplay between Stx activity in serum and Stx presence in different blood fractions (neutrophils, monocytes, platelets, leukocyte-platelet aggregates, microvesicles, lipoproteins).

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“…This may be achieved by binding to and injury of intestinal endothelial cells . Free toxin in the bloodstream is minimal , but the toxin binds to neutrophils, monocytes, platelets and red blood cells demonstrated in vivo on platelets and leukocytes, and thus circulates in the bloodstream. Elevated neutrophil counts are associated with a worse prognosis possibly due to the enhanced ability to transfer toxin as well as the destructive properties associated with proteases released by activated neutrophils.…”

Section: Current Understanding Of the Pathophysiology Of Husmentioning

confidence: 99%

Haemolytic uraemic syndrome

et al. 2016

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Abstract. Karpman D, Loos S, Tati R, Arvidsson I (Clinical Sciences Lund, Lund University, Lund, Sweden). Haemolytic uraemic syndrome (Review). J Intern Med 2017; 281: 123-148.Haemolytic uraemic syndrome (HUS) is defined by the simultaneous occurrence of nonimmune haemolytic anaemia, thrombocytopenia and acute renal failure. This leads to the pathological lesion termed thrombotic microangiopathy, which mainly affects the kidney, as well as other organs. HUS is associated with endothelial cell injury and platelet activation, although the underlying cause may differ. Most cases of HUS are associated with gastrointestinal infection with Shiga toxin-producing enterohaemorrhagic Escherichia coli (EHEC) strains. Atypical HUS (aHUS) is associated with complement dysregulation due to mutations or autoantibodies. In this review, we will describe the causes of HUS. In addition, we will review the clinical, pathological, haematological and biochemical features, epidemiology and pathogenetic mechanisms as well as the biochemical, microbiological, immunological and genetic investigations leading to diagnosis. Understanding the underlying mechanisms of the different subtypes of HUS enables tailoring of appropriate treatment and management. To date, there is no specific treatment for EHEC-associated HUS but patients benefit from supportive care, whereas patients with aHUS are effectively treated with anti-C5 antibody to prevent recurrences, both before and after renal transplantation.

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Serum Shiga toxin 2 values in patients during acute phase of diarrhoea‐associated haemolytic uraemic syndrome

Cited by 21 publications

References 23 publications

Verotoxin Receptor-Based Pathology and Therapies

Verotoxin Receptor-Based Pathology and Therapies

A Rapid and Sensitive Method to Measure the Functional Activity of Shiga Toxins in Human Serum

Haemolytic uraemic syndrome

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