Shiga Toxins and the Pathophysiology of Hemolytic Uremic Syndrome in Humans and Animals 英文参考文献.docVIP

Toxins 2012, 4, 1261-1287; doi:10.3390/toxins4111261 OPEN ACCESS toxins ISSN 2072-6651 /journal/toxins Review Shiga Toxins and the Pathophysiology of Hemolytic Uremic Syndrome in Humans and Animals Chad L. Mayer ?, Caitlin S. Leibowitz ?, Shinichiro Kurosawa and Deborah J. Stearns-Kurosawa * Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA 02118, USA; E-Mails: cmayer@ (C.L.M.); csleibow@ (C.S.L.); kurosawa@ (S.K.) ? These authors contributed equally to this work. * Author to whom correspondence should be addressed; E-Mail: dstearns@; Tel.: +1-617-414-7092; Fax: +1-617-414-7073. Received: 17 September 2012; in revised form: 1 November 2012 / Accepted: 2 November 2012 / Published: 8 November 2012 Abstract: Food-borne diseases are estimated at 76 million illnesses and 5000 deaths every year in the United States with the greatest burden on young children, the elderly and immunocompromised populations. The impact of efficient food distribution systems and a truly global food supply ensures that outbreaks, previously sporadic and contained locally, are far more widespread and emerging pathogens have far more frequent infection opportunities. Enterohemorrhagic E. coli is an emerging food- and water-borne pathogen family whose Shiga-like toxins induce painful hemorrhagic colitis with potentially lethal complications of hemolytic uremic syndrome (HUS). The clinical manifestations of Shiga toxin-induced HUS overlap with other related syndromes yet molecular mechanisms differ considerably. As discussed herein, understanding these differences and the novel properties of the toxins is imperative for clinical management decisions, design of appropriate animal models, and choices of adjunctive therapeutics. The emergence of new strains with rapidly aggressive virulence makes clinical and research initiatives in this field a high public health priority. Keywords: Entero