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Toxins 2017, 9(9), 291;

Shiga Toxin Therapeutics: Beyond Neutralization

Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA 02118, USA
Author to whom correspondence should be addressed.
Academic Editors: Tomas Girbes, Daniel Gillet and Julien Barbier
Received: 25 August 2017 / Revised: 15 September 2017 / Accepted: 15 September 2017 / Published: 19 September 2017
(This article belongs to the Special Issue Ribosome Inactivating Toxins)
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Ribotoxic Shiga toxins are the primary cause of hemolytic uremic syndrome (HUS) in patients infected with Shiga toxin-producing enterohemorrhagic Escherichia coli (STEC), a pathogen class responsible for epidemic outbreaks of gastrointestinal disease around the globe. HUS is a leading cause of pediatric renal failure in otherwise healthy children, resulting in a mortality rate of 10% and a chronic morbidity rate near 25%. There are currently no available therapeutics to prevent or treat HUS in STEC patients despite decades of work elucidating the mechanisms of Shiga toxicity in sensitive cells. The preclinical development of toxin-targeted HUS therapies has been hindered by the sporadic, geographically dispersed nature of STEC outbreaks with HUS cases and the limited financial incentive for the commercial development of therapies for an acute disease with an inconsistent patient population. The following review considers potential therapeutic targeting of the downstream cellular impacts of Shiga toxicity, which include the unfolded protein response (UPR) and the ribotoxic stress response (RSR). Outcomes of the UPR and RSR are relevant to other diseases with large global incidence and prevalence rates, thus reducing barriers to the development of commercial drugs that could improve STEC and HUS patient outcomes. View Full-Text
Keywords: Shiga toxin; Shiga-like toxins; STX1; STX2; Shiga toxin-producing E. coli; STEC; hemolytic uremic syndrome; unfolded protein response; ribotoxic stress response; ribotoxin Shiga toxin; Shiga-like toxins; STX1; STX2; Shiga toxin-producing E. coli; STEC; hemolytic uremic syndrome; unfolded protein response; ribotoxic stress response; ribotoxin

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Hall, G.; Kurosawa, S.; Stearns-Kurosawa, D.J. Shiga Toxin Therapeutics: Beyond Neutralization. Toxins 2017, 9, 291.

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