2020
DOI: 10.3390/toxins12060373
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Valid Presumption of Shiga Toxin-Mediated Damage of Developing Erythrocytes in EHEC-Associated Hemolytic Uremic Syndrome

Abstract: The global emergence of clinical diseases caused by enterohemorrhagic Escherichia coli (EHEC) is an issue of great concern. EHEC release Shiga toxins (Stxs) as their key virulence factors, and investigations on the cell-damaging mechanisms toward target cells are inevitable for the development of novel mitigation strategies. Stx-mediated hemolytic uremic syndrome (HUS), characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal injury, is the most severe outcome of an EH… Show more

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Cited by 9 publications
(23 citation statements)
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References 495 publications
(660 reference statements)
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“…Considering the kidney epithelium, the development of 3D-cultures of primary human cortical renal tubular epithelial cells that resemble original human renal proximal tubules is a novel in vitro model to study renal epithelial repair mechanisms upon Stx-mediated injury [ 72 ]. In addition, ex vivo cultivated primary human hematopoietic stem/progenitor cells represent the ideal approach of unravelling the cytotoxic effects of Stxs towards the development of erythrocytes, a process known as erythropoiesis, which normally takes place in vivo in the bone marrow [ 39 , 40 ]. On the other hand, it should not be left unmentioned that primary cells are significantly more demanding than cell lines, as has been discussed in detail in a previous review by Legros and colleagues [ 12 ].…”
Section: Discussionmentioning
confidence: 99%
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“…Considering the kidney epithelium, the development of 3D-cultures of primary human cortical renal tubular epithelial cells that resemble original human renal proximal tubules is a novel in vitro model to study renal epithelial repair mechanisms upon Stx-mediated injury [ 72 ]. In addition, ex vivo cultivated primary human hematopoietic stem/progenitor cells represent the ideal approach of unravelling the cytotoxic effects of Stxs towards the development of erythrocytes, a process known as erythropoiesis, which normally takes place in vivo in the bone marrow [ 39 , 40 ]. On the other hand, it should not be left unmentioned that primary cells are significantly more demanding than cell lines, as has been discussed in detail in a previous review by Legros and colleagues [ 12 ].…”
Section: Discussionmentioning
confidence: 99%
“…It is generally accepted that Stxs target mainly microvascular endothelial cells of the renal glomeruli and the brain in humans [ 1 , 13 , 18 , 37 , 38 ], although evidence has been provided in an ex vivo model using human hematopoietic stem/progenitor cells that erythropoiesis, which takes place in the bone marrow, may be affected by Stx [ 39 , 40 ]. Thus, Stx-mediated toxicity towards erythroblasts during the course of erythropoiesis might contribute to anemia observed during manifestation of STEC-HUS.…”
Section: Introductionmentioning
confidence: 99%
“…The other form of cell-free Stx2a found in patients's sera is particulate toxin (i.e., associated to extracellular vesicles), which is strictly related to the development of eHUS [4]. In this setting, Stx2a can be associated via B chains to Gb3Cer receptors present on the membranes of extracellular vesicles deriving from platelets and monocytes and/or via A chain to TLR4 present on the surface of the same cell-derived vesicles and in those from neutrophils [1,2,19]. The cleaved form of Stx2a present on the surface of extracellular vesicles is detectable only after reduction and release of the A1 fragment from the membrane.…”
Section: Discussionmentioning
confidence: 99%
“…Renal thrombotic microangiopathy is the endpoint of the pathogenesis of Escherichia coli-induced hemolytic uremic syndrome (eHUS) in about 5-10% of children infected with Shiga toxin-producing E. coli strains (STEC) [1][2][3]. Circulating Shiga toxins (Stxs), in particular Stx2 type, are the main bacterial factors among those acting in concert in inducing eHUS [1,2]. During early toxemia and before the onset of eHUS, the toxins have been found free in sera or bound to circulating cells and then released as particulate toxins associated with 1 µm-sized extracellular vesicles [4].…”
Section: Introductionmentioning
confidence: 99%
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