title: Antibody response to Shiga toxins Stx2 and Stx1 in children with enteropathic hemolytic-uremic syndrome.
abstract: A Western blot (immunoblot) assay (WBA) for the detection of immunoglobulin G antibodies to Shiga toxins Stx2 and Stx1 in sera from 110 patients with enteropathic hemolytic-uremic syndrome (53 culture confirmed to have Shiga toxin-producing Escherichia coli [STEC] infection) and 110 age-matched controls was established by using a chemiluminescence detection system. Thirty-nine (74%) of the 53 culture-confirmed cases were infections with STEC serotype O157, and 14 (26%) were associated with infection by other STEC serotypes. The frequency of an anti-Stx2 response following infection by a Stx2-producing strain (34 of 48 cases; 71%) was higher than that of an anti-Stx1 response following Stx1-producing STEC infection (4 of 10). Furthermore, the frequency of an anti-Stx2 response in 110 control sera (10%) was significantly higher than the frequency of an anti-Stx1 response (1.8%) (P = 0.0325). For STEC O157 culture-confirmed cases WBA for toxin detection had a diagnostic sensitivity of 71% and a specificity of 90%. Because of its high specificity the assay might be a helpful tool for diagnosing suspected STEC infection when tests of stool samples or serological tests against various lipopolysaccharide antigens are negative. Furthermore, the prevalence of anti-Stx antibodies in healthy controls probably reflects the population immunity to systemic Stx-associated disease. It can thus serve as a basis for comparing immunity levels in different populations and for considering future Stx toxoid immunization strategies.
authors.affiliation: Klinik und Poliklinik für Kinder-und Jugendmedizin, Universitäts-Krankenhaus Eppendorf, Martinistr. 52, 20246 Hamburg, Germany. kludwig@uke.uni-hamburg.de
authors.forename: K
authors.initials: K
authors.lastname: Ludwig
authors.forename: M A
authors.initials: MA
authors.lastname: Karmali
authors.forename: V
authors.initials: V
authors.lastname: Sarkim
authors.forename: C
authors.initials: C
authors.lastname: Bobrowski
authors.forename: M
authors.initials: M
authors.lastname: Petric
authors.forename: H
authors.initials: H
authors.lastname: Karch
authors.forename: D E
authors.initials: DE
authors.lastname: Müller-Wiefel
mesh_terms: D000293:Adolescent; D000907:Antibodies, Bacterial / Q000097:blood*; D015153:Blotting, Western; D002648:Child; D002675:Child, Preschool; D004926:Escherichia coli / Q000276:immunology* / Q000378:metabolism; D005243:Feces / Q000382:microbiology; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000276:immunology / Q000382:microbiology*; D006801:Humans; D007223:Infant; D008297:Male; D022622:Shiga Toxin 1 / Q000276:immunology*; D022641:Shiga Toxin 2 / Q000276:immunology*
chemical_list: D000907:Antibodies, Bacterial; D022622:Shiga Toxin 1; D022641:Shiga Toxin 2