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Roles of Shiga Toxins in Immunopathology

Environmental Diseases Research Center, Korea Research Institute of Bioscience and Biotechnology, 125 Gwahak-ro, Daejeon 34141, Korea
Department of Biomolecular Science, KRIBB School of Bioscience, Korea University of Science and Technology (UST), 127 Gajeong-ro, Yuseong-gu, Daejeon 34113, Korea
Department of Microbial Pathogenesis and Immunology, Texas A&M University Health Science Center, Bryan, TX 77807, USA
Authors to whom correspondence should be addressed.
Toxins 2019, 11(4), 212;
Received: 28 March 2019 / Revised: 4 April 2019 / Accepted: 5 April 2019 / Published: 9 April 2019
(This article belongs to the Special Issue Toxins and Immunology)
PDF [1928 KB, uploaded 10 April 2019]


Shigella species and Shiga toxin-producing Escherichia coli (STEC) are agents of bloody diarrhea that may progress to potentially lethal complications such as diarrhea-associated hemolytic uremic syndrome (D+HUS) and neurological disorders. The bacteria share the ability to produce virulence factors called Shiga toxins (Stxs). Research over the past two decades has identified Stxs as multifunctional toxins capable of inducing cell stress responses in addition to their canonical ribotoxic function inhibiting protein synthesis. Notably, Stxs are not only potent inducers of cell death, but also activate innate immune responses that may lead to inflammation, and these effects may increase the severity of organ injury in patients infected with Stx-producing bacteria. In the intestines, kidneys, and central nervous system, excessive or uncontrolled host innate and cellular immune responses triggered by Stxs may result in sensitization of cells to toxin mediated damage, leading to immunopathology and increased morbidity and mortality in animal models (including primates) and human patients. Here, we review studies describing Stx-induced innate immune responses that may be associated with tissue damage, inflammation, and complement activation. We speculate on how these processes may contribute to immunopathological responses to the toxins. View Full-Text
Keywords: Shiga toxins; Shiga toxin types 1 and 2; Shiga toxin-producing Escherichia coli; hemolytic uremic syndrome; bacterial toxins; immunopathology Shiga toxins; Shiga toxin types 1 and 2; Shiga toxin-producing Escherichia coli; hemolytic uremic syndrome; bacterial toxins; immunopathology

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Lee, M.-S.; Tesh, V.L. Roles of Shiga Toxins in Immunopathology. Toxins 2019, 11, 212.

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