HUMORAL IMMUNE RESPONSE TO SHIGA TOXIN 2 (STX2) IN CHILDREN WITH ESCHERICHIOSIS WITH HEMOLYTIC-UREMIC SYNDROME
- Authors: Shkuratova M.A.1, Khlyntseva A.E.1, Kalmantaeva O.V.1, Kartsev N.N.1, Muzurov Alexandr Lvovich A.L.2,3, Firstova V.V.1
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Affiliations:
- STATE RESEARCH CENTER FOR APPLIED MICROBIOLOGY AND BIOTECHNOLOGY
- Moscow Clinical Municipal Children Hospital St. Vladimir
- Russian Medical Academy of Continuous Professional Education Ministry of Healthcare of Russia Federal State Budgetary Educational Institution of Further Professional Education "Russian Medical Academy of Continuous Professional Education" of the Ministry of Healthcare of the Russian Federation
- Section: Joint Immunology Forum 2024
- URL: https://rusimmun.ru/jour/article/view/16859
- DOI: https://doi.org/10.46235/1028-7221-16859-HIR
- ID: 16859
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Abstract
Shiga toxin-producing Escherichia coli (STEC) causes acute intestinal infections and also causes acute renal failure, especially in children. Shiga toxins (Stx) occupy a central place in the pathogenesis of hemolytic uremic syndrome (HUS) in Escherichiosis. The presented work analyzes the effectiveness of laboratory diagnostics of enterohemorrhagic escherichiosis in patients at the stage of manifestation of HUS and/or acute renal failure using microbiological, immunological research methods and PCR analysis. The study used clinical material from 30 patients in the pediatric intensive care unit of the St. Vladimir Children's City Clinical Hospital in Moscow with symptoms of HUS aged from 8 months to 5 years. Blood sera from 20 healthy donors were used as control. As a result of PCR analysis, stx2 DNA was detected in 23.3% of cases. Bacteriological research made it possible to sow a pure culture of Escherichia coli O157:H7 in only 3.3% of cases. Since the development of HUS begins in patients with acute intestinal infection caused by Shiga toxin-producing microorganisms starting from the 5th day of the disease, when antibiotic therapy is already carried out, the bacteria can be completely destroyed, which makes it difficult to identify them by bacteriological methods, as well as to detect genes encoding Shiga toxin in PCR analysis. Typically, patients with HUS are admitted to the intensive care unit 5-7 days after the onset of the disease, when class G immunoglobulins specific to the pathogen are already beginning to circulate in the blood. In this regard, the use of immunological tests can be effective to confirm the diagnosis of STEC infection. In our studies, enzyme immunoassay allowed us to detect antibodies to Stx2A in 63.3%, and to Stx2B in 43.3% of patients. Using immunoblotting, antibodies to Stx2A were detected in all sera obtained from patients, and in 66.7% of cases to Stx2B. Immunoblot analysis was characterized by higher sensitivity for detecting antibodies to Stx2, however, due to the presence of an immunological layer among healthy people, it is preferable to use ELISA analysis. In healthy donors with antibodies to Stx2, the antibody titer was significantly lower than in patients. Thus, laboratory confirmation of the diagnosis of STEC infection is difficult when conducting microbiological and molecular genetic studies, which is confirmed in this work. The effectiveness of laboratory diagnostics can be expanded by performing an ELISA aimed at detecting antibodies to Stx2A.
About the authors
Maria A. Shkuratova
STATE RESEARCH CENTER FOR APPLIED MICROBIOLOGY AND BIOTECHNOLOGY
Author for correspondence.
Email: shkuratova@obolensk.org
ORCID iD: 0000-0001-8021-8453
SPIN-code: 7112-9372
Junior Researcher, Laboratory of Molecular Biology
Russian Federation, SRCAMB Bld. 24, “Quarter A” Territory, 142279, Obolensk, City District Serpukhov, Moscow Region, Russian FederationAnna E. Khlyntseva
STATE RESEARCH CENTER FOR APPLIED MICROBIOLOGY AND BIOTECHNOLOGY
Email: khlyntseva_anna@mail.ru
ORCID iD: 0000-0003-0052-2602
SPIN-code: 3279-6161
PhD (Biological Science), Researcher, Laboratory of Molecular Biology
Russian Federation, SRCAMB Bld. 24, “Quarter A” Territory, 142279, Obolensk, City District Serpukhov, Moscow Region, Russian FederationOlga V. Kalmantaeva
STATE RESEARCH CENTER FOR APPLIED MICROBIOLOGY AND BIOTECHNOLOGY
Email: kalmantaevaov@yandex.ru
ORCID iD: 0000-0002-2838-6879
SPIN-code: 4657-5192
PhD (Biological Science), Researcher, Laboratory of Molecular Biology
Russian Federation, SRCAMB Bld. 24, “Quarter A” Territory, 142279, Obolensk, City District Serpukhov, Moscow Region, Russian FederationNikolay N. Kartsev
STATE RESEARCH CENTER FOR APPLIED MICROBIOLOGY AND BIOTECHNOLOGY
Email: kartsev@obolensk.org
ORCID iD: 0000-0002-2006-9131
SPIN-code: 5463-3016
MD, PhD, Senior Researcher of Antimicrobial Agents Laboratory, Molecular Microbiology Department,
Russian Federation, SRCAMB Bld. 24, “Quarter A” Territory, 142279, Obolensk, City District Serpukhov, Moscow Region, Russian FederationAlexandr L. Muzurov Alexandr Lvovich
Moscow Clinical Municipal Children Hospital St. Vladimir;Russian Medical Academy of Continuous Professional Education Ministry of Healthcare of Russia
Federal State Budgetary Educational Institution of Further Professional Education "Russian Medical Academy of Continuous Professional Education" of the Ministry of Healthcare of the Russian Federation
Email: al_muz@mail.ru
ORCID iD: 0000-0003-4131-9440
SPIN-code: 8489-9991
Ph. D. Med., Head of Department of Center of Gravitational Blood Surgery and Hemodialysis
Associate Professor, Department of Pediatric Anesthesiology, Critical Care Medicine and Toxicology
Russian Federation, 1/3 k1, Rubtsovsko-Dvortsovaya Street, Moscow, Russia, zipcode 107014 2/1, Barrikadnaya st., Moscow, 125993, RussiaVictoria V. Firstova
STATE RESEARCH CENTER FOR APPLIED MICROBIOLOGY AND BIOTECHNOLOGY
Email: firstova@obolensk.org
ORCID iD: 0000-0002-9898-9894
SPIN-code: 9166-9151
PhD, DSc (Biological Science), Chief Researcher, Laboratory of Molecular Biology
Russian Federation, SRCAMB Bld. 24, “Quarter A” Territory, 142279, Obolensk, City District Serpukhov, Moscow Region, Russian FederationReferences
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