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Goldstein J, Nuñez-Goluboay K, Pinto A. Therapeutic Strategies to Protect the Central Nervous System against Shiga Toxin from Enterohemorrhagic Escherichia coli. Curr Neuropharmacol 2021; 19:24-44. [PMID: 32077828 PMCID: PMC7903495 DOI: 10.2174/1570159x18666200220143001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 01/20/2020] [Accepted: 02/19/2020] [Indexed: 11/23/2022] Open
Abstract
Infection with Shiga toxin-producing Escherichia coli (STEC) may cause hemorrhagic colitis, hemolytic uremic syndrome (HUS) and encephalopathy. The mortality rate derived from HUS adds up to 5% of the cases, and up to 40% when the central nervous system (CNS) is involved. In addition to the well-known deleterious effect of Stx, the gram-negative STEC releases lipopolysaccharides (LPS) and may induce a variety of inflammatory responses when released in the gut. Common clinical signs of severe CNS injury include sensorimotor, cognitive, emotional and/or autonomic alterations. In the last few years, a number of drugs have been experimentally employed to establish the pathogenesis of, prevent or treat CNS injury by STEC. The strategies in these approaches focus on: 1) inhibition of Stx production and release by STEC, 2) inhibition of Stx bloodstream transport, 3) inhibition of Stx entry into the CNS parenchyma, 4) blockade of deleterious Stx action in neural cells, and 5) inhibition of immune system activation and CNS inflammation. Fast diagnosis of STEC infection, as well as the establishment of early CNS biomarkers of damage, may be determinants of adequate neuropharmacological treatment in time.
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Affiliation(s)
- Jorge Goldstein
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Fisiología y Biofísica “Houssay” (IFIBIO), Laboratorio de Neurofisiopatología, Facultad de Medicina, Argentina
| | - Krista Nuñez-Goluboay
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Fisiología y Biofísica “Houssay” (IFIBIO), Laboratorio de Neurofisiopatología, Facultad de Medicina, Argentina
| | - Alipio Pinto
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de Fisiología y Biofísica “Houssay” (IFIBIO), Laboratorio de Neurofisiopatología, Facultad de Medicina, Argentina
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Oviedo A, Díaz M, Valenzuela ML, Vidal V, Racca L, Bottai H, Priore G, Peluffo G, Di Bartolomeo S, Cabral G, Toca MDC. Acute Diarrhoea in Children: Determination of Duration Using a Combined Bismuth Hydroxide Gel and Oral Rehydration Solution Therapy vs. Oral Rehydration Solution. CHILDREN (BASEL, SWITZERLAND) 2016; 3:E45. [PMID: 28009823 PMCID: PMC5184820 DOI: 10.3390/children3040045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 12/10/2016] [Accepted: 12/15/2016] [Indexed: 11/27/2022]
Abstract
Oral rehydration salt (ORS) treatment in young children with acute diarrhoea (AD) has contributed to decrease mortality associated with dehydration although effective strategies to reduce morbidity associated with this disease are required. The aim of this study was to evaluate the diarrhoea duration when using combined colloidal bismuth hydroxide gel (CBHG) and oral rehydration salt treatment compared with ORS therapy in children with AD. We designed a double-blind, randomised prospective study with treatment and control groups. Patients aged one to 12 years, with no prior pathology and with AD of less than 48 h were included. The Chi-squared and Mann-Whitney tests were used, as well as the Cox proportional hazards model and the Kaplan-Meier estimator. Patients were randomised into an ORS and CBHG treatment group and a control group for ORS plus placebo. (Average age: 3.2 years). The result of the post-treatment evaluation with respect to the average duration of AD was 25.5 h for the treated group vs. 41.5 h for the control group (p = 0.015). The average number of stools was 4.8 in the treated group and 8.2 in the control group (p = 0.032). We conclude that the use of CBHG plus ORS significantly reduced the duration of AD, the number of stools and the percentage of children with persistent AD after 24 h of treatment compared to the control group. AD remitted almost twice as fast in patients treated with CBHG and ORS compared to those who received ORS plus placebo.
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Affiliation(s)
- Adriana Oviedo
- Sección de Gastroenterología, Servicio de Pediatría, Hospital Nacional Alejandro Posadas, 1684 El Palomar, Buenos Aires, Argentina.
| | - Mirna Díaz
- Sección de Gastroenterología, Servicio de Pediatría, Hospital Nacional Alejandro Posadas, 1684 El Palomar, Buenos Aires, Argentina.
| | - María Laura Valenzuela
- Sección de Gastroenterología, Servicio de Pediatría, Hospital Nacional Alejandro Posadas, 1684 El Palomar, Buenos Aires, Argentina.
| | - Victoria Vidal
- Sección de Gastroenterología, Servicio de Pediatría, Hospital Nacional Alejandro Posadas, 1684 El Palomar, Buenos Aires, Argentina.
| | - Liliana Racca
- Área de Estadística y Procesamiento de Datos, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, 2000 Rosario, Santa Fe, Argentina.
| | - Hebe Bottai
- Área de Estadística y Procesamiento de Datos, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, 2000 Rosario, Santa Fe, Argentina.
| | - Graciela Priore
- Sección de Microbiología, Laboratorio Central, Hospital Nacional Alejandro Posadas, 1684 El Palomar, Buenos Aires, Argentina.
| | - Graciela Peluffo
- Sección de Microbiología, Laboratorio Central, Hospital Nacional Alejandro Posadas, 1684 El Palomar, Buenos Aires, Argentina.
| | - Susana Di Bartolomeo
- Sección de Microbiología, Laboratorio Central, Hospital Nacional Alejandro Posadas, 1684 El Palomar, Buenos Aires, Argentina.
| | - Graciela Cabral
- Sección Virología, Laboratorio Central, Hospital Nacional Alejandro Posadas, 1684 El Palomar, Buenos Aires, Argentina.
| | - María Del Carmen Toca
- Sección de Gastroenterología, Servicio de Pediatría, Hospital Nacional Alejandro Posadas, 1684 El Palomar, Buenos Aires, Argentina.
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Barton LL, Lyle DA, Ritz NL, Granat AS, Khurshid AN, Kherbik N, Hider R, Lin HC. Bismuth(III) deferiprone effectively inhibits growth of Desulfovibrio desulfuricans ATCC 27774. Biometals 2016; 29:311-9. [PMID: 26896170 DOI: 10.1007/s10534-016-9917-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 02/12/2016] [Indexed: 11/28/2022]
Abstract
Sulfate-reducing bacteria have been implicated in inflammatory bowel diseases and ulcerative colitis in humans and there is an interest in inhibiting the growth of these sulfide-producing bacteria. This research explores the use of several chelators of bismuth to determine the most effective chelator to inhibit the growth of sulfate-reducing bacteria. For our studies, Desulfovibrio desulfuricans ATCC 27774 was grown with nitrate as the electron acceptor and chelated bismuth compounds were added to test for inhibition of growth. Varying levels of inhibition were attributed to bismuth chelated with subsalicylate or citrate but the most effective inhibition of growth by D. desulfuricans was with bismuth chelated by deferiprone, 3-hydroxy-1,2-dimethyl-4(1H)-pyridone. Growth of D. desulfuricans was inhibited by 10 μM bismuth as deferiprone:bismuth with either nitrate or sulfate respiration. Our studies indicate deferiprone:bismuth has bacteriostatic activity on D. desulfuricans because the inhibition can be reversed following exposure to 1 mM bismuth for 1 h at 32 °C. We suggest that deferiprone is an appropriate chelator for bismuth to control growth of sulfate-reducing bacteria because deferiprone is relatively nontoxic to animals, including humans, and has been used for many years to bind Fe(III) in the treatment of β-thalassemia.
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Affiliation(s)
- Larry L Barton
- Department of Biology, University of New Mexico, Albuquerque, NM, 87131, USA.
| | - Daniel A Lyle
- Department of Biology, University of New Mexico, Albuquerque, NM, 87131, USA
| | - Nathaniel L Ritz
- Department of Biology, University of New Mexico, Albuquerque, NM, 87131, USA.,Department of Medicine, University of New Mexico and New Mexico VA Health Care System, Albuquerque, NM, 87018, USA
| | - Alex S Granat
- Department of Biology, University of New Mexico, Albuquerque, NM, 87131, USA
| | - Ali N Khurshid
- Department of Biology, University of New Mexico, Albuquerque, NM, 87131, USA
| | - Nada Kherbik
- Department of Biology, University of New Mexico, Albuquerque, NM, 87131, USA
| | - Robert Hider
- Medicinal Chemistry, Institute of Pharmaceutical Science, King's College, London, London, SE1 9NH, UK
| | - Henry C Lin
- Department of Medicine, University of New Mexico and New Mexico VA Health Care System, Albuquerque, NM, 87018, USA
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