Sacerdoti Flavia, Scalise María Luján, Burdet Juliana, Amaral María Marta, Franchi Ana María, Ibarra Cristina
Laboratorio de Fisiopatogenia, Instituto de Fisiología y Biofísica Bernardo Houssay (IFIBIO Houssay-CONICET), Departamento de Fisiología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, Buenos Aires 1121, Argentina.
Laboratorio de Hematología, Hospital Universitario Austral, Pilar, Buenos Aires 1629, Argentina.
Microorganisms. 2018 Oct 23;6(4):111. doi: 10.3390/microorganisms6040111.
Gastrointestinal infection with Shiga toxin-producing (STEC) causes diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome (HUS), characterized by hemolytic anemia, thrombocytopenia and acute renal failure. The main virulence factor of STEC is Shiga toxin (Stx), which is responsible for HUS development. STEC can produce Stx type 1 and/or 2 (Stx1, Stx2) and their variants, Stx2 being more frequently associated with severe cases of HUS. This pathology occurs in 5⁻15% of cases with STEC infection when Stx gain access to the bloodstream and causes damage in the target organs such as the kidney and brain. STEC infections affect mainly young children, although the large HUS outbreak with a new Stx2-producing STEC O104:H4 in Europe in 2011 involved more adults than children, and women were over-represented. Maternal infections during pregnancy are associated with adverse pregnancy outcomes. Studies in rats showed that Stx2 binds to the utero-placental unit and causes adverse pregnancy outcomes. In this article, we provide a brief overview of Stx2 action on placental tissues and discuss whether they might cause pregnancy loss or preterm birth.
感染产志贺毒素的大肠杆菌（STEC）会引发腹泻、出血性结肠炎和溶血尿毒综合征（HUS），其特征为溶血性贫血、血小板减少和急性肾衰竭。STEC的主要毒力因子是志贺毒素（Stx），它与HUS的发展有关。STEC可产生1型和/或2型志贺毒素（Stx1、Stx2）及其变体，其中Stx2更常与严重的HUS病例相关。当Stx进入血液循环并对肾脏和大脑等靶器官造成损害时，这种病理情况会发生在5%-15%的STEC感染病例中。STEC感染主要影响幼儿，不过2011年在欧洲爆发的由一种新的产Stx2的STEC O104:H4引起的大规模HUS疫情中，成年人的感染人数超过儿童，且女性占比过高。孕期的母体感染与不良妊娠结局有关。对大鼠的研究表明，Stx2与子宫-胎盘单位结合并导致不良妊娠结局。在本文中，我们简要概述了Stx2对胎盘组织的作用，并讨论了它们是否可能导致流产或早产。
