Particulate Shiga Toxin 2 in Blood is Associated to the Development of Hemolytic Uremic Syndrome in Children
| Autor: | Alfredo Caprioli, Damiano Picicco, Domenica Carnicelli, Maurizio Brigotti, Sara Testa, Pier Luigi Tazzari, Francesca Ricci, Xiaohua He, Gaia Scavia, Fabio Paglialonga, Elisabetta Galassi, Stephanie Patfield, Elisa Porcellini, Gianluigi Ardissino, Stefano Morabito, Valentina Arfilli |
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| Přispěvatelé: | Brigotti M., He X., Carnicelli D., Arfilli V., Porcellini E., Galassi E., Tazzari P.L., Ricci F., Patfield S.A., Testa S., Paglialonga F., Picicco D., Caprioli A., Scavia G., Morabito S., Ardissino G. |
| Rok vydání: | 2019 |
| Předmět: |
Male
0301 basic medicine Neutrophils Escherichia coli Infection 030204 cardiovascular system & hematology urologic and male genital diseases Kidney medicine.disease_cause Shiga Toxin 2 Feces 0302 clinical medicine Shiga toxin-producing Escherichia coli STX2 hemic and lymphatic diseases Child Escherichia coli Infections Shiga-Toxigenic Escherichia coli biology Neutrophil Shiga toxin Hematology medicine.anatomical_structure Child Preschool bloody diarrhea Female Human DNA Bacterial Adolescent Cell Line Microbiology 03 medical and health sciences medicine bacterial toxin Humans Escherichia coli Toxin business.industry Infant Newborn Infant Kidney metabolism Microvesicles 030104 developmental biology Hemolytic-Uremic Syndrome hemolytic uremic syndrome biology.protein Fece Particulate Matter business |
| Zdroj: | Thrombosis and Haemostasis. 120:107-120 |
| ISSN: | 2567-689X 0340-6245 |
| Popis: | Hemolytic uremic syndrome (HUS), the leading cause of acute renal failure in children (< 3 years), is mainly related to Shiga toxins (Stx)-producing Escherichia coli (STEC) infections. STEC are confined to the gut resulting in hemorrhagic colitis, whereas Stx are delivered in blood to target kidney and brain, with unclear mechanisms, triggering HUS in 5 to 15% of infected children. Stx were found on circulating cells, free in sera (soluble Stx) or in blood cell-derived microvesicles (particulate Stx), whereby the relationship between these forms of circulating toxins is unclear. Here, we have examined 2,846 children with bloody diarrhea and found evidence of STEC infection in 5%. Twenty patients were enrolled to study the natural course of STEC infections before the onset of HUS. In patients, Stx were found to be associated to circulating cells and/or free and functionally active in sera. In most children, Stx were bound to neutrophils when high amounts of toxins were found in feces. Time-course analysis showed that Stx increased transiently in patients' sera while the decrease of toxin amount on leukocytes was observed. Notably, patients who recovered (85%) displayed different settings than those who developed HUS (15%). The distinctive feature of the latter group was the presence in blood of particulate Stx2 (Stx2 sedimented at g-forces corresponding to 1 μm microvesicles) the day before diagnosis of HUS, during the release phase of toxins from circulating cells. This observation strongly suggests the involvement of blood cell-derived particulate Stx2 in the transition from hemorrhagic colitis to HUS. |
| Databáze: | OpenAIRE |
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