Advances in pathogenesis and therapy of hemolytic uremic syndrome caused by shiga toxin-2

CRISTINA IBARRA; MARÍA MARTA AMARAL; MARINA S. PALERMO

IUBMB LIFE

WIILEY

Lugar: Miami; Año: 2013 vol. 65 p. 827 - 835

1521-6551

Shiga toxin (Stx) producing Escherichia coli (STEC) is responsible to bloody diarrhea (hemorrhagic colitis) and the hemolytic uremic syndrome (HUS). STEC strains carry inducible lambda phages integrated into their genomes that encode Stx and or 2, with several allelic variants each one. O157:H7 is he serotype that was documented in the vast majority of HUS cases although non-O157 serotypes have been increasingly reported to account for HUS cases. However, the outbreak that occurred in central Europe during late spring of 2011 showed that the pathogen was E. coli O104:H4. More than 4,000 persons were infected mainly in Germany, and it pro- duced more than 900 cases of HUS resulting in 54 deaths. E. coli O104:H4 is a hybrid organism that combines some of thevirulence genes of STEC and enteroaggregative E. coli specially  production of Stx2 and the adherence mechanisms tointestinal epithelium. The differences in the epidemiology and presentation of E. coli pathogen meant a challenge for publichealth and scientific research to increase the knowledge of HUS-pathophysiology and to improve available therapies to treat HUS. C 2013 IUBMB Life, 65(10):827?835, 2013