title: Detection of a vacuolating cytotoxin in stools from children with diarrhea.
abstract: A cytotoxin inducing vacuolation in HEp-2 cells was detected in 19 (3.1%) of 618 stool specimens from children with diarrhea but in none of 135 from control children. Common enteric pathogens were found in only two (10.5%) of the 19 cytotoxin-positive stool specimens. The vacuoles induced by stool filtrates resembled those induced by the vacuolating toxin (VacA) of Helicobacter pylori. The vacuolating toxin was heat-labile and protease-sensitive, and it had an apparent molecular weight of > 100,000 but was not neutralized by an antiserum to H. pylori VacA. Although proper prospective case-control studies are needed to definitely assess the etiologic association between the new vacuolating cytotoxin and diarrhea, the present study suggests that microorganisms of the gastrointestinal tract produce a Helicobacter-like vacuolating toxin and may be responsible for cases of childhood diarrhea whose etiology is currently considered unknown.
authors.affiliation: Laboratorio di Batteriologia e Micologia Medica, Istituto Superiore di Sanità, Rome, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Luzzi
authors.forename: A
authors.initials: A
authors.lastname: Covacci
authors.forename: S
authors.initials: S
authors.lastname: Censini
authors.forename: C
authors.initials: C
authors.lastname: Pezzella
authors.forename: D
authors.initials: D
authors.lastname: Crotti
authors.forename: M
authors.initials: M
authors.lastname: Facchini
authors.forename: A
authors.initials: A
authors.lastname: Giammanco
authors.forename: P
authors.initials: P
authors.lastname: Guglielmetti
authors.forename: C
authors.initials: C
authors.lastname: Piersimoni
authors.forename: M
authors.initials: M
authors.lastname: Bonamico
authors.forename: P
authors.initials: P
authors.lastname: Mariani
authors.forename: R
authors.initials: R
authors.lastname: Rappuoli
authors.forename: A
authors.initials: A
authors.lastname: Caprioli
mesh_terms: D001426:Bacterial Proteins / Q000302:isolation & purification*; D001427:Bacterial Toxins / Q000302:isolation & purification*; D002460:Cell Line; D002648:Child; D002675:Child, Preschool; D003603:Cytotoxins / Q000302:isolation & purification*; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D005243:Feces / Q000737:chemistry* / Q000382:microbiology*; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D016480:Helicobacter pylori / Q000472:pathogenicity; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D014617:Vacuoles / Q000382:microbiology / Q000473:pathology; D014774:Virulence
chemical_list: D001426:Bacterial Proteins; D001427:Bacterial Toxins; D003603:Cytotoxins; C074689:VacA protein, Helicobacter pylori