Uchida H, Kiyokawa N, Horie H, Fujimoto J, Takeda T
Department of Infectious Diseases Research, National Children's Medical Research Center, Tokyo, Japan.
Pediatr Res. 1999 Jan;45(1):133-7. doi: 10.1203/00006450-199901000-00022.
Infection of Shiga toxin (Stx)-producing Escherichia coli induces hemolytic uremic syndrome (HUS) in 10 to 15% of cases in infants and young children. Although the endothelial cell damage induced by Stx is widely believed to be a primary event of renal dysfunction in HUS, the precise mechanism remains to be elucidated. We were able to examine the kidney obtained at autopsy of a child who died after HUS associated with Stx-producing Escherichia coli O157:H7 infection, and immunohistochemistry indicated the deposition of Stxl and Stx2 in a portion of the distal tubular epithelia. To our knowledge, this is the first report to show the presence of Stx in human tissue of a patient with HUS, and the results obtained in this study provide evidence that Stx indeed migrates into the kidney and binds to renal tubules during Stx-producing Escherichia coli infection.
产志贺毒素（Stx）的大肠杆菌感染在婴幼儿病例中会导致10%至15%的溶血性尿毒症综合征（HUS）。尽管人们普遍认为Stx诱导的内皮细胞损伤是HUS中肾功能障碍的主要事件，但其确切机制仍有待阐明。我们得以检查了一名在与产Stx的大肠杆菌O157:H7感染相关的HUS后死亡儿童的尸检肾脏，免疫组织化学显示Stx1和Stx2在部分远端肾小管上皮细胞中沉积。据我们所知，这是首次报道在HUS患者的人体组织中发现Stx，本研究获得的结果提供了证据，表明在产Stx的大肠杆菌感染期间，Stx确实会迁移至肾脏并与肾小管结合。
