title: Shiga toxins present in the gut and in the polymorphonuclear leukocytes circulating in the blood of children with hemolytic-uremic syndrome.
abstract: Hemolytic-uremic syndrome, the main cause of acute renal failure in early childhood, is caused primarily by intestinal infections from some Escherichia coli strains that produce Shiga toxins. The toxins released in the gut are targeted to renal endothelium after binding to polymorphonuclear leukocytes. The presence of Shiga toxins in the feces and the circulating neutrophils of 20 children with hemolytic uremic syndrome was evaluated by the Vero cell cytotoxicity assay and flow cytometric analysis, respectively. The latter showed the presence of Shiga toxins on the polymorphonuclear leukocytes of 13 patients, 5 of whom had no other microbiologic or serologic evidence of infection by Shiga toxin-producing Escherichia coli. A positive relationship was observed between the amounts of Shiga toxins released in the intestinal lumen and those released in the bloodstream. The toxins were detectable on the neutrophils for a median period of 5 days after they were no longer detectable in stools. This investigation confirms that the immunodetection of Shiga toxins on neutrophils is a valuable tool for laboratory diagnosis of Shiga toxin-producing Escherichia coli infection in hemolytic-uremic syndrome and provides clues for further studies on the role of neutrophils in the pathogenesis of this syndrome.
authors.affiliation: Dipartimento di Patologia Sperimentale, Via San Giacomo 14, 40126 Bologna, Italy. brigotti@alma.unibo.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: Brigotti
authors.forename: Alfredo
authors.initials: A
authors.lastname: Caprioli
authors.forename: Alberto E
authors.initials: AE
authors.lastname: Tozzi
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Tazzari
authors.forename: Francesca
authors.initials: F
authors.lastname: Ricci
authors.forename: Roberto
authors.initials: R
authors.lastname: Conte
authors.forename: Domenica
authors.initials: D
authors.lastname: Carnicelli
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Procaccino
authors.forename: Fabio
authors.initials: F
authors.lastname: Minelli
authors.forename: Alfonso V S
authors.initials: AV
authors.lastname: Ferretti
authors.forename: Fabio
authors.initials: F
authors.lastname: Paglialonga
authors.forename: Alberto
authors.initials: A
authors.lastname: Edefonti
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Rizzoni
mesh_terms: D000818:Animals; D002648:Child; D002675:Child, Preschool; D002522:Chlorocebus aethiops; D004064:Digestive System / Q000378:metabolism*; D004926:Escherichia coli / Q000378:metabolism; D004927:Escherichia coli Infections / Q000175:diagnosis* / Q000378:metabolism; D005243:Feces / Q000382:microbiology; D005260:Female; D005434:Flow Cytometry; D006463:Hemolytic-Uremic Syndrome / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D007223:Infant; D008297:Male; D009504:Neutrophils / Q000378:metabolism*; D022603:Shiga Toxins / Q000378:metabolism* / Q000633:toxicity; D014709:Vero Cells
chemical_list: D022603:Shiga Toxins