Inflammatory mediators in Escherichia coli O157:H7 hemorrhagic colitis and hemolytic-uremic syndrome.
BACKGROUND
Recent experimental data suggest that the inflammatory response of the host to verotoxin and/or lipopolysaccharides of Escherichia coli is involved in the pathophysiology of verotoxin-producing E. coli (VTEC) infections.


METHODS
We measured the circulating concentrations of cytokines [TNF-alpha, interleukin (IL)-1-beta, IL-1 receptor antagonist (Ra), IL-6, IL-8, IL-10] and soluble leukocyte adhesion molecules (L-selectin, P-selectin, E-selectin, intracellular cell adhesion molecule-1, vascular cell adhesion molecule-1) by sandwich enzyme-linked immunosorbent assay among (1) normal controls (n = 12), (2) disease controls with hemorrhagic colitis (HC) not associated with VTEC infections (n = 57), (3) patients with uncomplicated HC caused by E. coli O157:H7 (n = 30), and (4) children with hemolytic-uremic syndrome (HUS) (n = 28). Patients with HUS were matched with children who presented an uncomplicated HC caused by E. coli O157:H7 for the time interval elapsed between the onset of HC and that of blood sample collection.


RESULTS
Concentrations of TNF-alpha and IL-1-beta were undetectable. Children with HUS were characterized by increased amounts of IL-6 and IL-8, lower values of soluble L-selectin as well as increased levels of IL-10 and IL-1Ra. The circulating concentrations of IL-1Ra were higher among children with O157:H7 HC who subsequently developed HUS.


CONCLUSIONS
Increased pro- and antiinflammatory cytokine responses are produced by the host during the development of HUS among children with VTEC infections. Further studies are needed to determine their relative contribution to the pathophysiology of classic HUS.
Proulx
F
F
Department of Pediatrics, Sainte-Justine Hospital, University of Montreal, Québec, Canada.
Turgeon
J P
JP
Litalien
C
C
Mariscalco
M M
MM
Robitaille
P
P
Seidman
E
E
D015815:Cell Adhesion Molecules / Q000032:analysis*; D002675:Child, Preschool; D003092:Colitis / Q000276:immunology / Q000382:microbiology*; D016207:Cytokines / Q000032:analysis*; D004797:Enzyme-Linked Immunosorbent Assay; D004927:Escherichia coli Infections / Q000276:immunology*; D019453:Escherichia coli O157; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000276:immunology / Q000382:microbiology; D006463:Hemolytic-Uremic Syndrome / Q000276:immunology / Q000382:microbiology*; D006801:Humans; D007223:Infant; D007378:Interleukins / Q000032:analysis; D008297:Male
D015815:Cell Adhesion Molecules; D016207:Cytokines; D007378:Interleukins