title: Serum Shiga toxin 2 values in patients during acute phase of diarrhoea-associated haemolytic uraemic syndrome.
abstract: OBJECTIVE
  Shiga toxins are delivered via systemic circulation and are considered to be the cause of diarrhoea-associated haemolytic uraemic syndrome (HUS), as they injure endothelial cells, particularly in the glomeruli. This study measured Shiga toxin 2 (Stx2) in the serum of children affected in by HUS due to Stx2 producing Escherichia coli.
  
  
  METHODS
  The concentration of free Stx2 was measured in the serum of 16 children, collected immediately after admission to the clinic in the acute phase of HUS, using a sandwich enzyme-linked immunosorbent assay. The family members of two children were also investigated, with the relative toxicity of Stx2 assessed by a Vero cell-based fluorescent assay.
  
  
  RESULTS
  Stx2 was found in the serum of eight of the 16 children who were investigated. It was also detected in four of the six family members not showing symptomatic HUS, with an extremely high level in two.
  
  
  CONCLUSIONS
  An absent or rather low concentration of Stx2 was found in the serum of children admitted to the clinic with diarrhoea-associated HUS. The high concentration of Stx2 in family members without HUS, but mostly with watery diarrhoea and raised functional activity, was in line with the concept of early injury by Stx2.
authors.affiliation: US Department of Agriculture, ARS, WRRC, Foodborne Toxin Detection and Prevention Unit, Albany, NY, USA.
authors.forename: Xiaohua
authors.initials: X
authors.lastname: He
authors.affiliation: US Department of Agriculture, ARS, WRRC, Produce Safety and Microbiology Unit, Albany, NY, USA.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Quiñones
authors.affiliation: Department of Pediatrics, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Maroeska Te
authors.initials: MT
authors.lastname: Loo
authors.affiliation: Division of Pediatric Nephrology, Department of Pediatrics, University Medical Center, Hamburg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Loos
authors.affiliation: EU Reference Laboratory for E. coli, Instituto Superiore di Sanita, Rome, Italy.
authors.forename: Gaia
authors.initials: G
authors.lastname: Scavia
authors.affiliation: Dipartimento di Medicina Specialistica Diagnostica e Sperimentale, Sede di Patologia Generale, Universita di Bologna, Bologna, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Brigotti
authors.affiliation: Department of Pediatric Nephrology and Growth and Regeneration, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Elena
authors.initials: E
authors.lastname: Levtchenko
authors.affiliation: Department of Physiology, Radboud University, Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Leo
authors.initials: L
authors.lastname: Monnens
mesh_terms: D000293:Adolescent; D000818:Animals; D001774:Blood Chemical Analysis / Q000379:methods; D002648:Child; D002675:Child, Preschool; D002522:Chlorocebus aethiops; D015331:Cohort Studies; D005260:Female; D006463:Hemolytic-Uremic Syndrome / Q000097:blood*; D006801:Humans; D007223:Infant; D008297:Male; D022641:Shiga Toxin 2 / Q000097:blood*; D014709:Vero Cells
chemical_list: D022641:Shiga Toxin 2
keywords: Foodborne pathogen; Functional assay of Stx-2; Haemolytic uraemic syndrome; Shiga toxin