Functional significance of histologic alterations induced by Escherichia coli pig-specific, mouse-negative, heat-stable enterotoxin (STb)

Enterotoxigenic Escherichia coli Heat-Stable Toxin and Ebola Virus Delta Peptide: Similarities and Differences

Enterotoxigenic Escherichia coli (ETEC) STb toxin exhibits striking structural similarity to Ebola virus (EBOV) delta peptide. Both ETEC and EBOV delta peptide are enterotoxins. Comparison of the structural and functional similarities and differences of these two toxins illuminates features that are important in induction of pathogenesis by a bacterial and viral pathogen.

Impact of the Escherichia coli Heat-Stable Enterotoxin b (STb) on Gut Health and Function

Enterotoxigenic Escherichia coli (ETEC) produces the heat-stable enterotoxin b (STb), which is responsible for secretory diarrhea in humans and animals. This toxin is secreted within the intestinal lumen of animals and humans following ETEC colonization, becoming active on enterocytes and altering fluid homeostasis. Several studies have outlined the nature of this toxin and its effects on gut health and the integrity of the intestinal epithelium. This review summarizes the mechanisms of how STb alters the gastrointestinal tract. These include the manipulation of mucosal tight junction protein integrity, the formation of enterocyte cellular pores and toxin internalization and the stimulation of programmed cell death. We conclude with insights into the potential link between STb intoxication and altered gut hormone regulation, and downstream physiology.

Escherichia coli heat-stable toxin b impairs intestinal epithelial barrier function by altering tight junction proteins

Escherichia coli heat-stable toxin b (STb) causes diarrhea in animals. STb binds to sulfatide, its receptor, and is then internalized. In the cytoplasm, through a cascade of events, STb triggers the opening of ion channels, allowing ion secretion and water loss and leading to diarrhea. Tight junctions (TJs) are well known for controlling paracellular traffic of ions and water by forming a physical intercellular barrier in epithelial cells, and some bacterial toxins are known to affect adversely TJs. The present study aimed at determining the effect of STb on TJs. T84 cells were treated for 24 h with purified STb and a nontoxic STb mutant (D30V). Transepithelial resistance (TER), paracellular flux marker, and confocal microscopy were used to analyze the effect of STb on TJs. Purified STb caused a significant reduction of TER parallel to an increase in paracellular permeability compared to the results seen in untreated cells or mutant D30V. The increased paracellular permeability was associated with a marked alteration of F-actin stress fibers. F-actin filament dissolution and condensation were accompanied by redistribution and/or fragmentation of ZO-1, claudin-1, and occludin. These changes were also observed following treatment of T84 cells with an 8-amino-acid peptide found in the STb sequence corresponding to a consensus sequence of Vibrio cholerae Zot toxin. These effects were not observed with a scrambled peptide or mutant D30V. Our findings indicate that STb induces epithelial barrier dysfunction through changes in TJ proteins that could contribute to diarrhea.

Escherichia coli STb toxin and colibacillosis: knowing is half the battle

Expression of both adherence and enterotoxin expression are required for enterotoxigenic Escherichia coli (ETEC) strains to cause colibacillosis. ETEC strains are responsible for diarrhea in humans and animals by production of various enterotoxins. For many years, the role of the heat-stable E. coli enterotoxin STb as a diarrhea-causing toxin in animals, and in particular in swine, has been controversial. In fact, although the presence of STb-positive E. coli strains and diarrhea in animals is frequently observed, the difficulty of reproducing the pathology in an animal model was interpreted as a lack of toxicity. Recently, new light was shed on the activity of STb in intestinal ligated loops and in pigs orally inoculated with STb-positive E. coli strains. This minireview revisits the effects of STb on the intestinal epithelium and enlightens the significance of STb in swine colibacillosis. The interaction of STb toxin with other E. coli enterotoxins and dual ETEC/enteropathogenic E. coli or ETEC/attaching effacing E. coli infections are also discussed.

Trypan blue uptake by chinese hamster ovary cultured epithelial cells: a cellular model to study Escherichia coli STb enterotoxin

The thermostable enterotoxin b (STb) produced by enterotoxigenic Escherichia coli strains is responsible for diarrheal diseases mainly in weaning piglets. For now, the only available assay for biological activity of STb toxin was in the animal host (i.e. piglet) or in an animal model (i.e. rat, mouse). In this study, we developed a cellular model for the study of the biological activity of STb enterotoxin. Using a trypan blue vital stain method, we showed that STb-treated cells of three out of the five cell lines tested absorbed more vital stain than their controls. Of all the cell lines tested, the chinese hamster's ovary derivated cells (CHO) were the most sensitive, absorbing 50% more trypan blue than their control. Maximal stain uptake was observed after 2h. We then evaluated the trypan blue uptake for 16 STb mutants, produced in a previous work, on the CHO cell lines in order to compare it with the in vivo rat loop assay data. Interestingly, we observed a good correlation between the two bioassays. In fact, the biological activity observed in the rat could be correlated with the trypan blue uptake by the CHO cells (R(2)=0.78) for STb toxin and the 16 mutants. Using the variance analysis statistical test, we determined that the correlation between the two bioassays is significant (F(c)> or =F(0.005)). These results suggest that the trypan blue uptake bioassay could represent a new method to evaluate the biological activity and facilitate the elucidation of the mechanism of action of E. coli STb enterotoxin.

Intestinal epithelial damage in sids babies and its similarity to that caused by bacterial toxins in the rabbit

Sections of the duodenum, jejunum, ileum, caecum and large intestine from 14 sudden infant death syndrome (SIDS) babies were examined by scanning (SEM) and transmission electron microscopy (TEM). The type and amount of damage was characterised and quantitated and compared with the presence of Clostridium perfringens, Clostridium difficile, Escherichia coli and Staphylococcus aureus in faecal samples from the babies and toxins from the bacteria in faecal samples and serum from the babies. The data were compared with the damage that these toxins cause to the rabbit intestinal epithelium (see the previous paper in this issue). Damage was present in most of the SIDS samples, varying from 0 to 96%, and most damage occurred when the faecal samples contained the above bacteria and their toxins. Damage varied from removal of microvilli, damage to villus tips, separation of and removal of epithelial cells from the lamina propria, and removal of enterocytes leaving goblet and tuft cells, to damage and breakdown of the lamina propria. The results support the hypothesis that the cause of death in a significant proportion of SIDS babies may result from the absorption of toxins from the intestinal tract initiating a toxic shock reaction.

Regional differences in the effect of cholera toxin and enterotoxigenic Escherichia coli infection on electrolyte and fluid transport in the porcine small intestine

The regional differences in secretory and absorptive responses to cholera toxin (CT) and to infection by enterotoxigenic Escherichia coli (ETEC), producing heat-stable enterotoxins, were studied in the porcine small intestine. Proximal, mid and distal small intestine from newly weaned piglets were used. Na+ and Cl- fluxes and electrical parameters in CT-stimulated and ETEC-infected intestine were measured by the Ussing chamber technique. In addition, CT-induced fluid accumulation in ligated loops was measured. CT induced fluid accumulation, which was highest in the proximal segment and decreased in the aboral direction of the small intestine. In addition, CT induced a net Cl- secretion in the proximal and mid segments, while net Na+ absorption was reduced only in the proximal segment. The ETEC-infected intestine showed a net increase in Cl- secretion in the proximal part and abolished the net Na+ absorption in the distal segment. These results demonstrate segmental differences in the epithelial transport responses to enterotoxin from Vibrio cholerae and to ETEC infection. This needs to be taken into consideration in relation to oral rehydration studies.

Histopathological features in the small intestine of pigs infected with F4ac+ non-enterotoxigenic or enterotoxigenic strains of Escherichia coli

Four porcine strains of Escherichia coli were examined for their effects on the small intestine of 4-week-old weaned pigs infected orogastrically. The strains used experimentally were: strain 1467 (adhesin negative, non-toxigenic); strains 2407 and 1466 (adhesin positive, non-toxigenic), derived by genetical engineering from strain 1467 and containing a wild type plasmid and a recombinant plasmid, respectively, encoding the F4 antigen (adhesin); and strain M1823 (adhesin positive, toxigenic). In addition, 2-week-old pigs that died from natural colibacillosis associated with two strains ("Ihan 1 and 2"; adhesin positive, toxigenic) were examined. Strain M1823 and the Ihan strains produced moderate and marked lesions, respectively. Strain 1467 did not cause mucosal damage or an inflammatory response. Strains 1466 and 2407 caused a mild to moderate leucocyte (mononuclear and polymorphonuclear) infiltration in the jejunal (but not ileal) lamina propria. However, unlike strain 1466, strain 2407 did not cause damage to the small intestinal mucosa and should be further studied as a potential oral vaccine strain for post-weaning E. coli diarrhoea.

Effects of weaning and enterotoxigenic Escherichia coli on net absorption in the small intestine of pigs

The purpose of this study was to measure the net absorption of fluid, sodium, potassium and chloride in the small intestine of weaned pigs and of their unweaned littermates and to correlate these values with villus height and crypt depth. Five pairs of segments of the small intestine were prepared in each of 80 pigs; the cranial segment of each pair was injected with an enterotoxigenic strain of Escherichia coli and the caudal segment with a control solution. Net absorption was measured on the day of weaning and four, seven, 11 and 14 days after weaning. In unweaned pigs the net absorption of fluid, potassium and chloride did not vary with time. In weaned pigs the net absorption of fluid in the control segments was significantly less on days 4, 7 and 14 after weaning and of sodium and chloride on days 4 and 7 than in unweaned littermates. In infected segments of weaned pigs the net absorption of fluid was significantly less than in unweaned littermates on day 11 and 14, of sodium and potassium on day 11 and of chloride on days 4 and 11 after weaning. Net absorption was negatively correlated with villus height but only in the infected segments of weaned pigs; no other correlations were found. It was concluded that after weaning the net absorption of fluid and electrolytes in the small intestine of pigs is temporarily decreased, a condition that may initiate diarrhoea.

Assay for enterotoxigenic Escherichia coli heat-stable toxin b in rats and mice

The Escherichia coli heat-stable enterotoxin STb is the most prevalent toxin associated with diarrheagenic isolates of porcine origin. This report demonstrates that when endogenous protease activity was blocked with soybean trypsin inhibitor, STb evoked a dose-dependent secretory response in infant mice and jejunal loops of rats. Infant mice were much less sensitive to STb than rats were. The response of rat jejunal loops to STb was linearly related to the log of the dose of STb through 10 twofold dilutions. The anterior 25% of the jejunum was less sensitive than was the remainder of the gut. An incubation period of 2.5 h provided a maximal response. The linear response to STb in rats could be used as a bioassay.

Pathophysiology of diarrhoea induced by a combined infection with transmissible gastroenteritis virus and enterotoxigenic Escherichia coli in newly-weaned piglets and the effect of flurbiprofen treatment

In newly-weaned 3-4 week old piglets (n = 29) diarrhoea (100%) and vomiting (65%) were induced by inoculation with transmissible gastroenteritis virus and enterotoxigenic E. coli strains (0(149):K91:K88ac; LT, STa and STb enterotoxin positive). This combined infection resulted in pronounced mortality within 7 days. During this period the piglets had decreases in body weight, arterial pressure and leucocyte count and increases in heart rate and in total plasma protein concentration. The plasma pH and lactic acid concentration decreased, whereas the values for pO2, pCO2 and frequency of respiration did not change significantly. No significant changes in the serum concentrations of potassium, chloride or calcium were observed, whereas sodium concentration revealed a transient increase. In shocked and dying piglets an increase in haematocrit was observed, whereas base excess and bicarbonate concentration decreased. Flurbiprofen, a potent non-steroidal anti-inflammatory drug, administered intramuscularly on 3 successive days following the combined infection at a dosage of 1 mg/kg/12 h was without beneficial effect on diarrhoea or mortality.

Protease degradation of Escherichia coli heat-stable, mouse-negative, pig-positive enterotoxin

Enterotoxigenic Escherichia coli produces three enterotoxins: heat-labile toxin, a mouse-positive heat-stable toxin, and a mouse-negative heat-stable toxin (STb). The only species in which a response to STb has been documented is the pig, and this response is inconsistent. When STb was placed in 60 ligated jejunal segments (loops) in six pigs, a positive response (net secretion) was observed in only 40 loops. In contrast, when the jejunal lumen was pre-rinsed with 50 ml of saline, the same STb preparation induced net secretion in 60 of 60 loops. STb did not induce secretion in rinsed loops when jejunal luminal washings were collected and mixed with STb in vitro. The anti-STb activity of jejunal luminal washings was filterable through 0.45-micron-pore-size filters, was destroyed by heating at 100 degrees C for 15 min, and was blocked by soybean trypsin inhibitor. STb was inactivated when incubated with trypsin in vitro for 60 min at 37 degrees C. It is concluded that STb is susceptible to trypsin degradation and that variable amounts of trypsin-like activity in swine jejuna are responsible for inconsistent responses to STb in jejunal loops of swine. These results also suggest that the concept of species specificity of the STb response should be reexamined.