Tesh V L, O'Brien A D
Department of Microbiology, Uniformed Services, University of the Health Sciences, Bethesda, Maryland 20814.
Mol Microbiol. 1991 Aug;5(8):1817-22. doi: 10.1111/j.1365-2958.1991.tb00805.x.
It is now well documented that some enteric bacteria which cause diarrhoeal and/or dysenteric disease produce, at high levels, one or more of a family of protein toxins referred to as Shiga toxin and Shiga-like toxins (SLTs; alternatively called verocytotoxins or VTs). Within the past few years, there have been considerable advancements made in our understanding of the biochemistry and molecular biology of Shiga toxin and SLTs. However, the precise role of the toxins in mediating colonic disease, as well as their contribution to the development of extra-intestinal sequelae (e.g. the haemolytic uraemic syndrome and neurological disorders), remain less clear. In this MicroReview, we will briefly summarize recent progress in Shiga toxin- and SLT-related research and present evidence supporting the concept that these toxins contribute to pathogenesis by directly damaging vascular endothelial cells, thereby disrupting the homeostatic properties of these cells. We will also discuss data which suggest that toxin-mediated damage in the kidney may not be limited to glomerular endothelial cells but may include tubular epithelial cells. Thus, the role of the toxins in renal disease may not be limited to the glomeruli, as was initially hypothesized when the association of infection with toxin-producing strains and the development of acute renal failure was established.
现已充分证明，一些引起腹泻和/或痢疾疾病的肠道细菌会大量产生一种或多种被称为志贺毒素和志贺样毒素（SLTs；也称为维罗毒素或VTs）的蛋白质毒素家族。在过去几年中，我们对志贺毒素和志贺样毒素的生物化学和分子生物学的理解有了相当大的进展。然而，这些毒素在介导结肠疾病中的精确作用，以及它们对肠外后遗症（如溶血尿毒综合征和神经系统疾病）发展的贡献，仍不太清楚。在这篇微型综述中，我们将简要总结志贺毒素和志贺样毒素相关研究的最新进展，并提供证据支持这些毒素通过直接损伤血管内皮细胞从而破坏这些细胞的稳态特性来促进发病机制的概念。我们还将讨论一些数据，这些数据表明毒素介导的肾脏损伤可能不限于肾小球内皮细胞，还可能包括肾小管上皮细胞。因此，毒素在肾脏疾病中的作用可能不限于肾小球，这与最初在确定产毒素菌株感染与急性肾衰竭发展之间的关联时所假设的情况不同。
