| Summary: | <i>Shigella</i> causes moderate to severe diarrhea or dysentery after invading the colon mucosa. Long Pentraxin 3 (PTX3) is recognized as the humoral component of the innate immune response to bacterial pathogens. We examined the interplay between levels of PTX3 and levels of anti-<i>Shigella</i> lipopolysaccharide (LPS) and anti-<i>Shigella</i> type 3 secretion system protein-IpaB antibodies in children during acute shigellosis and after recovery. PTX3 concentrations in serum and stool extracts were determined by sandwich ELISA using commercial anti-PTX3 antibodies. Serum IgG, IgM, and IgA anti-<i>S. sonnei</i> LPS or anti-<i>S. sonnei</i> IpaB were measured using in house ELISA. Children with acute shigellosis (<i>n</i> = 60) had elevated PTX3 levels in serum and stools as compared with recovered subjects (9.6 ng/mL versus 4.7 ng/mL, <i>p</i> < 0.009 in serum and 16.3 ng/g versus 1.1 ng/g in stool, <i>p</i> = 0.011). Very low levels of PTX3 were detected in stools of healthy children (0.3 ng/g). Increased serum levels of PTX3 correlated with high fever accompanied by bloody or numerous diarrheal stools characteristic of more severe shigellosis while short pentraxin; C-Reactive Protein (CRP) did not show such a correlation. PTX3 decreased in convalescence while anti-<i>Shigella</i> antibodies increased, switching the response from innate to adaptive toward the eradication of the invasive organism. These data can inform the development of <i>Shigella</i> vaccines and treatment options.
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