Detection of Serum Antibodies to the Lipopolysaccharide of Escherichia coli O103 in Patients with Hemolyticuremic Syndrome

Luzzi, Ida; Tozzi, Alberto Eugenio; Rizzoni, Gianfranco; Niccolini, A.; Benedetti, Ildo; Minelli, Fabio; Caprioli, Alfredo

doi:10.1093/infdis/171.2.514

Cited by 19 publications

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“…In 1992, STEC O103 strains were identified as causative agents of hemolyticuremic syndrome (HUS) in humans, and it was suggested that EPEC O103 from rabbits and STEC O103 from humans have a common origin but different mechanisms of adaptation to their hosts (39). In the following years, STEC O103 strains were isolated from cattle and sheep and from diseased humans in many countries and on different continents (7,34,43,49,55). STEC O103 represents one of the most frequently identified serovars among STEC types isolated in Germany and other European countries (17,23,46,60).…”

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confidence: 99%

Genetic Analysis of Enteropathogenic and Enterohemorrhagic Escherichia coli Serogroup O103 Strains by Molecular Typing of Virulence and Housekeeping Genes and Pulsed-Field Gel Electrophoresis

et al. 2005

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We investigated the genetic relationships of 54 Escherichia coli O103 strains from humans, animals, and meat by molecular typing of housekeeping and virulence genes and by pulsed-field gel electrophoresis (PFGE). Multilocus sequence typing (MLST) of seven housekeeping genes revealed seven profiles, I through VII. MLST profiles I plus III cover 45 Shiga toxin-producing E. coli (STEC) O103:H2 strains from Australia, Canada, France, Germany, and Northern Ireland that are characterized by the intimin (eae) epsilon gene and carry enterohemorrhagic E. coli (EHEC) virulence plasmids. MLST profile II groups five human and animal enteropathogenic E. coli (EPEC) O103:H2 strains that were positive for intimin (eae) beta. Although strains belonging to MLST groups II and I plus III are closely related to each other (92.6% identity), major differences were found in the housekeeping icdA gene and in the virulence-associated genes eae and escD. E. coli O103 strains with MLST patterns IV to VII are genetically distant from MLST I, II, and III strains, as are the non-O103 E. coli strains EDL933 (O157), MG1655 (K-12), and CFT073 (O6). Comparison of MLST results with those of PFGE and virulence typing demonstrated that E. coli O103 STEC and EPEC have recently acquired different virulence genes and DNA rearrangements, causing alterations in their PFGE patterns. PFGE typing was very useful for identification of genetically closely related subgroups among MLST I strains, such as Stx2-producing STEC O103 strains from patients with hemolytic uremic syndrome. Analysis of virulence genes contributed to grouping of E. coli O103 strains into EPEC and STEC. Novel virulence markers, such as efa (EHEC factor for adherence), paa (porcine adherence factor), and cif (cell cycle-inhibiting factor), were found widely associated with E. coli O103 EPEC and STEC strains.Enteropathogenic Escherichia coli (EPEC) strains of serogroup O103 have been recognized since 1988 as the causative agents of diarrheal disease in rabbits, goats, and chickens (19,44,54). The pathogenic mechanisms of EPEC O103 were investigated, and progress has been made in unraveling the structure of the locus of enterocyte effacement (LEE) of rabbit and bovine EPEC O103:H2 strains (31, 56).A second group of pathogens is Shiga toxin (Stx)-producing E. coli (STEC) O103, whose members were first described as diarrheagenic agents in calves in 1988 (12). In 1992, STEC O103 strains were identified as causative agents of hemolyticuremic syndrome (HUS) in humans, and it was suggested that EPEC O103 from rabbits and STEC O103 from humans have a common origin but different mechanisms of adaptation to their hosts (39). In the following years, STEC O103 strains were isolated from cattle and sheep and from diseased humans in many countries and on different continents (7,34,43,49,55). STEC O103 represents one of the most frequently identified serovars among STEC types isolated in Germany and other European countries (17,23,46,60).It has been suggested that epidemiologically unrelated STEC O103 st...

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Genetic Analysis of Enteropathogenic and Enterohemorrhagic Escherichia coli Serogroup O103 Strains by Molecular Typing of Virulence and Housekeeping Genes and Pulsed-Field Gel Electrophoresis

et al. 2005

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“…The latter assays are available for a number of EHEC serotypes, such as E. coli O157, O26, O55, O103, O111, and O128 [4,5,6,7,8].…”

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confidence: 99%

Antibodies to intimin and Escherichia coli secreted proteins A and B in patients with enterohemorrhagic Escherichia coli infections

Karpman¹,

Békássy²,

Sjögren³

et al. 2002

Pediatr Nephrol

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Enterohemorrhagic Escherichia coli produce an attaching and effacing lesion upon adhering to the intestinal epithelium. Bacterial factors involved in this histopathology include the intimin adhesin and E. coli secreted proteins (Esps) A and B. In this study we investigated the serum antibody responses to recombinant E. coli O157:H7 intimin, EspA, and EspB by immunoblotting. Canadian patients with O157:H7 infection (n=10), Swedish patients with O157:H7 (n=21), non-O157 (n=18), or infection from which the serotype was not available (n=3), and asymptomatic household members (n=25) were studied and compared with Canadian (n=20) and Swedish controls (n=52). In Canadian patients, IgG antibodies to intimin, EspA, and EspB were analyzed, in Swedish patients and their household members IgA, IgG, and IgM antibodies to EspA and EspB were studied. Patients and household members mounted an antibody response to the antigens. Significantly more patients developed an acute response to EspB compared with controls (P<0.01 Canadian patients, P<0.0001 Swedish patients). EspB IgA, IgG, and IgM had a specificity of 100%, 86%, and 86%, positive predictive value of 100%, 83%, and 81%, and sensitivity of 57%, 69%, and 63%, respectively, and appear to be an appropriate assay for the detection of EHEC infection. In cases of hemolytic uremic syndrome or hemorrhagic colitis this assay may be useful when a fecal strain has not been isolated, or in epidemics of non-O157 infection.

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“…However, the immunological response to EHEC infection has not been well characterized. It is known that patients infected with E. coli O157:H7 and other serotypes of EHEC develop an antibody response to O lipopolysaccharide (O LPS), and there is evidence that antibodies to O157 may prevent colonization (3,6,20). There are, however, many serotypes of EHEC that cause HUS, and a monovalent LPS vaccine would not cover them all.…”

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Human Response to Escherichia coli O157:H7 Infection: Antibodies to Secreted Virulence Factors

et al. 2000

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Vaccination has been proposed for the prevention of disease due to enterohemorrhagic Escherichia coli (EHEC), but the immune response following human infection, including the choice of potential antigens, has not been well characterized. To study this, sera were obtained from five pediatric patients with acute diarrhea caused by E. coli O157:H7 0, 8, and 60 days after hospitalization. These sera were used to examine the immune response to four different EHEC virulence factors: Tir (translocated intimin receptor, which is inserted into the host cell membrane), intimin (bacterial outer membrane protein which binds to Tir), EspA (secreted protein which forms filamentous structures on EHEC surface), and EspB (inserted into the host membrane and cytoplasm). The response to O157:H7 lipopolysaccharide was also examined. Sera were assayed against purified recombinant proteins using immunoblot analysis and by enzyme-linked immunosorbent assay to determine the sera's titers to each of the antigens in all patients. We found that there was little reaction to EspA, EspB, and intimin in the acute-phase sera, although there was some reactivity to Tir. By day 8, titers of antibody to all four virulence factors were present in all patients, with a very strong response against Tir (up to a titer of 1:256,000), especially in hemolytic-uremic syndrome patients, and lesser strong responses to the other three antigens. The titer to the antigens 60 days after hospitalization was decreased but was still highest for Tir. These results suggest that there is a strong immune response to Tir, and to a lesser extent to the other three virulence factors, following EHEC disease, indicating that these bacterial molecules are potential vaccine candidates for preventing EHEC disease. They also suggest that bacterial virulence factors that are inserted into host cells during infection by type III secretion systems (Tir or EspB) are still recognized by the host immune response.Enterohemorrhagic Escherichia coli (EHEC) (also called verotoxigenic E. coli) is an important cause of diarrhea. This organism also produces a toxin which plays a role in disease (verotoxin or Shiga-like toxin [SLT]). Most patients with EHEC infection recover uneventfully within a few days, but in about 8% of cases (23) the diarrhea is followed by hemolyticuremic syndrome (HUS), a life-threatening complication with a substantial morbidity in survivors (19,25). HUS appears to be caused by the interaction of SLT with endothelial cells. Worldwide, many serotypes of EHEC have been described, but in North America one type predominates, E. coli O157:H7 (11, 12). Epidemiological evidence shows that EHEC O157:H7 strains are present in the feces of healthy cattle, providing indirect evidence that EHEC O157:H7 can colonize the bovine intestine without causing disease.Because of the potential seriousness of EHEC infection (4), vaccination has been proposed, either to prevent the disease in humans or to reduce colonization in cattle. However, the immunological response to EHEC infection ...

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Detection of Serum Antibodies to the Lipopolysaccharide of Escherichia coli O103 in Patients with Hemolyticuremic Syndrome

Cited by 19 publications

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Genetic Analysis of Enteropathogenic and Enterohemorrhagic Escherichia coli Serogroup O103 Strains by Molecular Typing of Virulence and Housekeeping Genes and Pulsed-Field Gel Electrophoresis

Genetic Analysis of Enteropathogenic and Enterohemorrhagic Escherichia coli Serogroup O103 Strains by Molecular Typing of Virulence and Housekeeping Genes and Pulsed-Field Gel Electrophoresis

Antibodies to intimin and Escherichia coli secreted proteins A and B in patients with enterohemorrhagic Escherichia coli infections

Human Response to Escherichia coli O157:H7 Infection: Antibodies to Secreted Virulence Factors

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