Shiga toxins present in the gut and in the polymorphonuclear leukocytes circulating in the blood of children with hemolytic-uremic syndrome |
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| Authors: | Brigotti Maurizio Caprioli Alfredo Tozzi Alberto E Tazzari Pier Luigi Ricci Francesca Conte Roberto Carnicelli Domenica Procaccino Maria Antonietta Minelli Fabio Ferretti Alfonso V S Paglialonga Fabio Edefonti Alberto Rizzoni Gianfranco |
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| Affiliation: | Dipartimento di Patologia Sperimentale, Via San Giacomo 14, 40126 Bologna, Italy. brigotti@alma.unibo.it |
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| 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. |
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