Creydt Virginia Pistone, Nuñez Pablo, Boccoli Javier, Silberstein Claudia, Zotta Elsa, Goldstein Jorge, Ibarra Cristina
Laboratorio de Fisiopatogenia, Departamento de Fisiología, Facultad de Medicina, Universidad de Buenos Aires, Argentina.
Medicina (B Aires). 2006;66 Suppl 3:11-5.
In the last years, infection associated with Shiga toxin-producing Escherichia coli (STEC) and subsequent Hemolitic-Uremic Syndrome (HUS) became relevant as a public health since it was considered as one of the most important emergent patogen present in the food contaminated by cattle feces. STEC infection may be asymptomatic or begins with a watery diarrhea that may or may not progress to bloody diarrhea (hemorrhagic colitis) and HUS. In Argentina, HUS is the most common pediatric cause of acute renal insufficiency and the second cause of chronic renal failure. Up to now, STEC infection lacks of known effective treatment strategies that diminish risk of progression to HUS. The mechanisms by which Shiga toxin (Stx) induce HUS may help to find strategies to prevent or ameliorate HUS. In this article, recent progress that has contributed to understanding the disease pathogenesis of STEC is reviewed. New strategies to prevent further uptake of Shiga from the gut, either during the diarrheal phase or once HUS has developed are discussed.
在过去几年中,与产志贺毒素大肠杆菌(STEC)相关的感染以及随后的溶血尿毒综合征(HUS)成为了一个公共卫生问题,因为它被认为是存在于受牛粪污染食物中的最重要的新兴病原体之一。STEC感染可能无症状,或始于水样腹泻,这种腹泻可能会也可能不会发展为血性腹泻(出血性结肠炎)和HUS。在阿根廷,HUS是急性肾功能不全最常见的儿科病因,也是慢性肾衰竭的第二大病因。到目前为止,STEC感染缺乏已知的有效治疗策略来降低发展为HUS的风险。志贺毒素(Stx)诱发HUS的机制可能有助于找到预防或改善HUS的策略。在本文中,对有助于理解STEC疾病发病机制的最新进展进行了综述。还讨论了在腹泻阶段或HUS发生后防止志贺毒素进一步从肠道吸收的新策略。