Molecular Decoys: Novel Approaches to the Prevention of Hemolytic Uremic Syndrome

A review of: Kitov PI, Sadowski JM, Mulvey G, et al. 2000 Shiga-like toxins are neutralized by tailored multivalent carbohydrate ligands. Nature 403:669–72. Paton AW, Morona R, Paton JC 2000 A new biological agent for treatment of Shiga toxigenic Escherichia coli infections and dysentery in humans. Nature Medicine 6: 265–72.

Hemolytic uremic syndrome, the most common cause of acute renal failure in children, is almost always a sequela of gasteroenteritis due to shiga toxin-producing E. coli (STEC). Shiga toxins (Stx) bind to glycolipids, bearing a trisaccharide (known as Pk) on the gastrointestinal epithelial cell surface, and are internalized and transported to the cytosol where they inactivate the 28S ribosomal RNA. Protein synthesis is inhibited, the epithelial cell dies and hemorrhagic colitis often ensues.

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