Valid Presumption of Shiga Toxin-Mediated Damage of Developing Erythrocytes in EHEC-Associated Hemolytic Uremic Syndrome

The global emergence of clinical diseases caused by enterohemorrhagic <i>Escherichia coli</i> (EHEC) is an issue of great concern. EHEC release Shiga toxins (Stxs) as their key virulence factors, and investigations on the cell-damaging mechanisms toward target cells are inevitable for th...

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Main Authors: Johanna Detzner, Gottfried Pohlentz, Johannes Müthing
Format: Article
Language:English
Published: MDPI AG 2020-06-01
Series:Toxins
Subjects:
Online Access:https://www.mdpi.com/2072-6651/12/6/373
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author Johanna Detzner
Gottfried Pohlentz
Johannes Müthing
author_facet Johanna Detzner
Gottfried Pohlentz
Johannes Müthing
author_sort Johanna Detzner
collection DOAJ
description The global emergence of clinical diseases caused by enterohemorrhagic <i>Escherichia coli</i> (EHEC) is an issue of great concern. EHEC release Shiga toxins (Stxs) as their key virulence factors, and investigations on the cell-damaging mechanisms toward target cells are inevitable for the development of novel mitigation strategies. Stx-mediated hemolytic uremic syndrome (HUS), characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal injury, is the most severe outcome of an EHEC infection. Hemolytic anemia during HUS is defined as the loss of erythrocytes by mechanical disruption when passing through narrowed microvessels. The formation of thrombi in the microvasculature is considered an indirect effect of Stx-mediated injury mainly of the renal microvascular endothelial cells, resulting in obstructions of vessels. In this review, we summarize and discuss recent data providing evidence that HUS-associated hemolytic anemia may arise not only from intravascular rupture of erythrocytes, but also from the extravascular impairment of erythropoiesis, the development of red blood cells in the bone marrow, via direct Stx-mediated damage of maturing erythrocytes, leading to “non-hemolytic” anemia.
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spelling doaj.art-ac9daf851b404365973eb3939d00f94a2023-11-20T02:53:26ZengMDPI AGToxins2072-66512020-06-0112637310.3390/toxins12060373Valid Presumption of Shiga Toxin-Mediated Damage of Developing Erythrocytes in EHEC-Associated Hemolytic Uremic SyndromeJohanna Detzner0Gottfried Pohlentz1Johannes Müthing2Institute of Hygiene, University of Münster, 48149 Münster, GermanyInstitute of Hygiene, University of Münster, 48149 Münster, GermanyInstitute of Hygiene, University of Münster, 48149 Münster, GermanyThe global emergence of clinical diseases caused by enterohemorrhagic <i>Escherichia coli</i> (EHEC) is an issue of great concern. EHEC release Shiga toxins (Stxs) as their key virulence factors, and investigations on the cell-damaging mechanisms toward target cells are inevitable for the development of novel mitigation strategies. Stx-mediated hemolytic uremic syndrome (HUS), characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal injury, is the most severe outcome of an EHEC infection. Hemolytic anemia during HUS is defined as the loss of erythrocytes by mechanical disruption when passing through narrowed microvessels. The formation of thrombi in the microvasculature is considered an indirect effect of Stx-mediated injury mainly of the renal microvascular endothelial cells, resulting in obstructions of vessels. In this review, we summarize and discuss recent data providing evidence that HUS-associated hemolytic anemia may arise not only from intravascular rupture of erythrocytes, but also from the extravascular impairment of erythropoiesis, the development of red blood cells in the bone marrow, via direct Stx-mediated damage of maturing erythrocytes, leading to “non-hemolytic” anemia.https://www.mdpi.com/2072-6651/12/6/373AB<sub>5</sub> toxinred blood cellsdeveloping erythrocytesEHECerythropoiesisGb3Cer
spellingShingle Johanna Detzner
Gottfried Pohlentz
Johannes Müthing
Valid Presumption of Shiga Toxin-Mediated Damage of Developing Erythrocytes in EHEC-Associated Hemolytic Uremic Syndrome
Toxins
AB<sub>5</sub> toxin
red blood cells
developing erythrocytes
EHEC
erythropoiesis
Gb3Cer
title Valid Presumption of Shiga Toxin-Mediated Damage of Developing Erythrocytes in EHEC-Associated Hemolytic Uremic Syndrome
title_full Valid Presumption of Shiga Toxin-Mediated Damage of Developing Erythrocytes in EHEC-Associated Hemolytic Uremic Syndrome
title_fullStr Valid Presumption of Shiga Toxin-Mediated Damage of Developing Erythrocytes in EHEC-Associated Hemolytic Uremic Syndrome
title_full_unstemmed Valid Presumption of Shiga Toxin-Mediated Damage of Developing Erythrocytes in EHEC-Associated Hemolytic Uremic Syndrome
title_short Valid Presumption of Shiga Toxin-Mediated Damage of Developing Erythrocytes in EHEC-Associated Hemolytic Uremic Syndrome
title_sort valid presumption of shiga toxin mediated damage of developing erythrocytes in ehec associated hemolytic uremic syndrome
topic AB<sub>5</sub> toxin
red blood cells
developing erythrocytes
EHEC
erythropoiesis
Gb3Cer
url https://www.mdpi.com/2072-6651/12/6/373
work_keys_str_mv AT johannadetzner validpresumptionofshigatoxinmediateddamageofdevelopingerythrocytesinehecassociatedhemolyticuremicsyndrome
AT gottfriedpohlentz validpresumptionofshigatoxinmediateddamageofdevelopingerythrocytesinehecassociatedhemolyticuremicsyndrome
AT johannesmuthing validpresumptionofshigatoxinmediateddamageofdevelopingerythrocytesinehecassociatedhemolyticuremicsyndrome