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Varrone E, Carnicelli D, He X, Grasse M, Stampfer K, Huber S, Kellnerová S, Tazzari PL, Ricci F, Paterini P, Ardissino G, Morabito S, Orth-Höller D, Würzner R, Brigotti M. Detection of Cleaved Stx2a in the Blood of STEC-Infected Patients. Toxins (Basel) 2023; 15:690. [PMID: 38133194 PMCID: PMC10747961 DOI: 10.3390/toxins15120690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/24/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Typical hemolytic uremic syndrome (HUS) is mainly caused by Shiga toxin-producing Escherichia coli (STEC) releasing Shiga toxin 2 (Stx2). Two different structures of this AB5 toxin have been described: uncleaved, with intact B and A chains, and cleaved, with intact B and a nicked A chain consisting of two fragments, A1 and A2, connected by a disulfide bond. Despite having the same toxic effect on sensitive cells, the two forms differ in their binding properties for circulating cells, serum components and complement factors, thus contributing to the pathogenesis of HUS differently. The outcome of STEC infections and the development of HUS could be influenced by the relative amounts of uncleaved or cleaved Stx2 circulating in patients' blood. Cleaved Stx2 was identified and quantified for the first time in four out of eight STEC-infected patients' sera by a method based on the inhibition of cell-free translation. Cleaved Stx2 was present in the sera of patients with toxins bound to neutrophils and in two out of three patients developing HUS, suggesting its involvement in HUS pathogenesis, although in association with other bacterial or host factors.
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Affiliation(s)
- Elisa Varrone
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via San Giacomo 14, 40126 Bologna, Italy; (E.V.); (D.C.); (P.P.)
| | - Domenica Carnicelli
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via San Giacomo 14, 40126 Bologna, Italy; (E.V.); (D.C.); (P.P.)
| | - Xiaohua He
- Western Regional Research Center, U.S. Department of Agriculture, Agricultural Research Service, 800 Buchanan Street, Albany, CA 94710, USA;
| | - Marco Grasse
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (K.S.); (S.H.); (S.K.); (R.W.)
| | - Karin Stampfer
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (K.S.); (S.H.); (S.K.); (R.W.)
| | - Silke Huber
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (K.S.); (S.H.); (S.K.); (R.W.)
| | - Sára Kellnerová
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (K.S.); (S.H.); (S.K.); (R.W.)
| | - Pier Luigi Tazzari
- Immunohematology and Transfusion Center, S. Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy; (P.L.T.); (F.R.)
| | - Francesca Ricci
- Immunohematology and Transfusion Center, S. Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy; (P.L.T.); (F.R.)
| | - Paola Paterini
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via San Giacomo 14, 40126 Bologna, Italy; (E.V.); (D.C.); (P.P.)
- Center for Applied Biomedical Research-CRBA, University of Bologna, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Gianluigi Ardissino
- Center for HUS Control, Prevention and Management, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122 Milano, Italy;
| | - Stefano Morabito
- European Reference Laboratory for Escherichia coli, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | | | - Reinhard Würzner
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (M.G.); (K.S.); (S.H.); (S.K.); (R.W.)
| | - Maurizio Brigotti
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Via San Giacomo 14, 40126 Bologna, Italy; (E.V.); (D.C.); (P.P.)
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Kellnerová S, Huber S, Massri M, Fleischer V, Losso K, Sarg B, Kremser L, Talasz H, He X, Varrone E, Brigotti M, Ardissino G, Orth-Höller D, Würzner R. Enzymatic Cleavage of Stx2a in the Gut and Identification of Pancreatic Elastase and Trypsin as Possible Main Cleavers. Microorganisms 2023; 11:2487. [PMID: 37894145 PMCID: PMC10609011 DOI: 10.3390/microorganisms11102487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/15/2023] [Accepted: 10/02/2023] [Indexed: 10/29/2023] Open
Abstract
Shiga toxins (Stxs), especially the Stx2a subtype, are the major virulence factors involved in enterohemorrhagic Escherichia coli (EHEC)-associated hemolytic uremic syndrome (eHUS), a life-threatening disease causing acute kidney injury, especially in children. After oral transmission and colonization in the gut, EHEC release Stx. Intracellular cleavage of the Stx A subunit, when followed by reduction, boosts the enzymatic activity that causes damage to targeted cells. This cleavage was assumed to be mostly mediated by furin during Stx intracellular trafficking. To investigate whether this cleavage could occur in the intestine, even prior to entering target cells, Stx2a A subunit structure (intact or cleaved) was characterized after its exposure to specific host factors present in human stool. The molecular weight of Stx2a A subunit/fragments was determined by immunoblotting after electrophoretic separation under reducing conditions. In this study, it was demonstrated that Stx2a is cleaved by certain human stool components. Trypsin and chymotrypsin-like elastase 3B (CELA3B), two serine proteases, were identified as potential candidates that can trigger the extracellular cleavage of Stx2a A subunit directly after its secretion by EHEC in the gut. Whether the observed cleavage indeed translates to natural infections and plays a role in eHUS pathogenesis has yet to be determined. If so, it seems likely that a host's protease profile could affect disease development by changing the toxin's biological features.
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Affiliation(s)
- Sára Kellnerová
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.K.); (S.H.); (M.M.); (V.F.)
| | - Silke Huber
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.K.); (S.H.); (M.M.); (V.F.)
| | - Mariam Massri
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.K.); (S.H.); (M.M.); (V.F.)
| | - Verena Fleischer
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.K.); (S.H.); (M.M.); (V.F.)
| | - Klemens Losso
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, 6020 Innsbruck, Austria;
- Department of Food Technology and Nutrition, MCI|The Entrepreneurial School, 6020 Innsbruck, Austria
| | - Bettina Sarg
- Protein Core Facility, Institute of Medical Biochemistry, Center of Chemistry and Biomedicine, Medical University of Innsbruck, 6020 Innsbruck, Austria; (B.S.); (L.K.); (H.T.)
| | - Leopold Kremser
- Protein Core Facility, Institute of Medical Biochemistry, Center of Chemistry and Biomedicine, Medical University of Innsbruck, 6020 Innsbruck, Austria; (B.S.); (L.K.); (H.T.)
| | - Heribert Talasz
- Protein Core Facility, Institute of Medical Biochemistry, Center of Chemistry and Biomedicine, Medical University of Innsbruck, 6020 Innsbruck, Austria; (B.S.); (L.K.); (H.T.)
| | - Xiaohua He
- Western Regional Research Center, U.S. Department of Agriculture, Agricultural Research Service, Albany, CA 74710, USA;
| | - Elisa Varrone
- Department of Medical and Surgical Sciences, School of Medicine, University of Bologna, 40126 Bologna, Italy; (E.V.); (M.B.)
| | - Maurizio Brigotti
- Department of Medical and Surgical Sciences, School of Medicine, University of Bologna, 40126 Bologna, Italy; (E.V.); (M.B.)
| | - Gianluigi Ardissino
- Center for HUS Prevention, Control and Management at Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Dorothea Orth-Höller
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.K.); (S.H.); (M.M.); (V.F.)
- MB-LAB–Clinical Microbiology Laboratory, 6020 Innsbruck, Austria
| | - Reinhard Würzner
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (S.K.); (S.H.); (M.M.); (V.F.)
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Rippa M, Sagnelli D, Vestri A, Marchesano V, Munari B, Carnicelli D, Varrone E, Brigotti M, Tozzoli R, Montalbano M, Morabito S, Zhou J, Zyss J, Petti L. Plasmonic Metasurfaces for Specific SERS Detection of Shiga Toxins. ACS Appl Mater Interfaces 2022; 14:4969-4979. [PMID: 35044743 PMCID: PMC8815041 DOI: 10.1021/acsami.1c21553] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The interest in the development of nanoscale plasmonic technologies has dramatically increased in recent years. The photonic properties of plasmonic nanopatterns can be controlled and tuned via their size, shape, or the arrangement of their constituents. In this work, we propose a 2D hybrid metallic polymeric nanostructure based on the octupolar framework with enhanced sensing property. We analyze its plasmonic features both numerically and experimentally, demonstrating the higher values of their relevant figures of merit: we estimated a surface-enhanced Raman spectroscopy (SERS) enhancement factor of 9 × 107 and a SPR bulk sensitivity of 430 nm/RIU. In addition, our nanostructure exhibits a dual resonance in the visible and near-infrared region, enabling our system toward multispectral plasmonic analysis. Finally, we illustrate our design engineering strategy as enabled by electron beam lithography by the outstanding performance of a SERS-based biosensor that targets the Shiga toxin 2a, a clinically relevant bacterial toxin. To the best of our knowledge, this is the first time that a SERS fingerprint of this toxin has been evidenced.
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Affiliation(s)
- M. Rippa
- Institute
of Applied Sciences and Intelligent Systems “E. Caianiello”
of CNR, 80072 Pozzuoli, Italy
| | - D. Sagnelli
- Institute
of Applied Sciences and Intelligent Systems “E. Caianiello”
of CNR, 80072 Pozzuoli, Italy
| | - A. Vestri
- Institute
of Applied Sciences and Intelligent Systems “E. Caianiello”
of CNR, 80072 Pozzuoli, Italy
| | - V. Marchesano
- Institute
of Applied Sciences and Intelligent Systems “E. Caianiello”
of CNR, 80072 Pozzuoli, Italy
| | - B. Munari
- Dipartimento
di Medicina Specialistica, Diagnostica e Sperimentale, Sede di Patologia
Generale, Università di Bologna, 40126 Bologna, Italy
| | - D. Carnicelli
- Dipartimento
di Medicina Specialistica, Diagnostica e Sperimentale, Sede di Patologia
Generale, Università di Bologna, 40126 Bologna, Italy
| | - E. Varrone
- Dipartimento
di Medicina Specialistica, Diagnostica e Sperimentale, Sede di Patologia
Generale, Università di Bologna, 40126 Bologna, Italy
| | - M. Brigotti
- Institute
of Applied Sciences and Intelligent Systems “E. Caianiello”
of CNR, 80072 Pozzuoli, Italy
- Dipartimento
di Medicina Specialistica, Diagnostica e Sperimentale, Sede di Patologia
Generale, Università di Bologna, 40126 Bologna, Italy
| | - R. Tozzoli
- Laboratorio
Nazionale di Riferimento per E. coli, Dipartimento di Sicurezza Alimentare,
Nutrizione e Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - M. Montalbano
- Laboratorio
Nazionale di Riferimento per E. coli, Dipartimento di Sicurezza Alimentare,
Nutrizione e Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - S. Morabito
- Institute
of Applied Sciences and Intelligent Systems “E. Caianiello”
of CNR, 80072 Pozzuoli, Italy
- Laboratorio
Nazionale di Riferimento per E. coli, Dipartimento di Sicurezza Alimentare,
Nutrizione e Sanità Pubblica Veterinaria, Istituto Superiore di Sanità, 00161 Rome, Italy
| | - J. Zhou
- Institute
of Photonics, Faculty of Science, Ningbo
University, 315211 Ningbo, People’s
Republic of China
| | - J. Zyss
- Institute
of Applied Sciences and Intelligent Systems “E. Caianiello”
of CNR, 80072 Pozzuoli, Italy
- Lumière,
Matière et Interfaces (LUMIN) Laboratory, Institut d’Alembert,
Ecole Normale Supérieure Paris-Saclay, Université Paris Saclay, 91190 Gif sur Yvette, France
| | - L. Petti
- Institute
of Applied Sciences and Intelligent Systems “E. Caianiello”
of CNR, 80072 Pozzuoli, Italy
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Varrone E, Carnicelli D, Brigotti M. Extracellular Vesicles and Renal Endothelial Cells: A Fatal Attraction in Hemolytic Uremic Syndrome. Am J Pathol 2021; 191:795-804. [PMID: 33652019 DOI: 10.1016/j.ajpath.2021.02.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/22/2021] [Accepted: 02/10/2021] [Indexed: 12/14/2022]
Abstract
This review focuses on typical hemolytic uremic syndrome (HUS), a life-threatening sequela of human infections caused, particularly in children, by Shiga toxin-producing Escherichia coli strains. Thrombotic microangiopathy of the brain and the kidney is the end point of toxin action, resulting in the hallmarks of HUS (ie, thrombocytopenia, anemia, and acute renal failure). A growing body of evidence points to the role of extracellular vesicles released in the blood of patients by toxin-challenged circulating cells (monocytes, neutrophils, and erythrocytes) and platelets, as a key factor in the pathogenesis of HUS. This review provides i) an updated description of the pathogenesis of Shiga toxin-producing E. coli infections; ii) an analysis of blood cell-derived extracellular vesicles, and of their parent cells, as triggering factors in HUS; and iii) a model explaining why Shiga toxin-containing vesicles dock preferentially to the endothelia of target organs.
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Affiliation(s)
- Elisa Varrone
- Department of Experimental, Diagnostic and Specialty Medicine, School of Medicine, University of Bologna, Bologna, Italy
| | - Domenica Carnicelli
- Department of Experimental, Diagnostic and Specialty Medicine, School of Medicine, University of Bologna, Bologna, Italy
| | - Maurizio Brigotti
- Department of Experimental, Diagnostic and Specialty Medicine, School of Medicine, University of Bologna, Bologna, Italy.
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5
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Rocchetti L, Munari B, Varrone E, Porcellini E, Orth-Höller D, Würzner R, Carnicelli D, Brigotti M. Method for the Detection of the Cleaved Form of Shiga Toxin 2a Added to Normal Human Serum. Toxins (Basel) 2021; 13:toxins13020094. [PMID: 33530614 PMCID: PMC7911550 DOI: 10.3390/toxins13020094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 01/14/2021] [Accepted: 01/21/2021] [Indexed: 11/16/2022] Open
Abstract
The pathogenesis of Escherichia coli-induced hemolytic uremic syndrome (eHUS) caused by infections with pathogenic Shiga toxin (Stx) producing E. coli (STEC) is centered on bacterial (e.g., Stx) and host factors (circulating cells, complement system, serum proteins) whose interaction is crucial for the immediate outcome and for the development of this life-threatening sequela. Stx2a, associated to circulating cells (early toxemia) or extracellular vesicles (late toxemia) in blood, is considered the main pathogenic factor in the development of eHUS. Recently, it was found that the functional properties of Stx2a (binding to circulating cells and complement components) change according to modifications of the structure of the toxin, i.e., after a single cleavage of the A subunit resulting in two fragments, A1 and A2, linked by a disulfide bridge. Herein, we describe a method to be used for the detection of the cleaved form of Stx2a in the serum of STEC-infected or eHUS patients. The method is based on the detection of the boosted inhibitory activity of the cleaved toxin, upon treatment with reducing agents, on a rabbit cell-free translation system reconstituted with human ribosomes. The method overcomes the technical problem caused by the presence of inhibitors of translation in human serum that have been stalled by the addition of RNAase blockers and by treatment with immobilized protein G. This method, allowing the detection of Stx2a at concentrations similar to those found by ELISA in the blood of STEC-infected patients, could be a useful tool to study the contribution of the cleaved form of Stx2a in the pathogenesis of eHUS.
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Affiliation(s)
- Lucrezia Rocchetti
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via San Giacomo 14, 40126 Bologna, Italy; (L.R.); (B.M.); (E.V.); (E.P.); (D.C.)
| | - Beatrice Munari
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via San Giacomo 14, 40126 Bologna, Italy; (L.R.); (B.M.); (E.V.); (E.P.); (D.C.)
| | - Elisa Varrone
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via San Giacomo 14, 40126 Bologna, Italy; (L.R.); (B.M.); (E.V.); (E.P.); (D.C.)
| | - Elisa Porcellini
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via San Giacomo 14, 40126 Bologna, Italy; (L.R.); (B.M.); (E.V.); (E.P.); (D.C.)
| | - Dorothea Orth-Höller
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, A-6020 Innsbruck, Austria; (D.O.-H.); (R.W.)
| | - Reinhard Würzner
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, A-6020 Innsbruck, Austria; (D.O.-H.); (R.W.)
| | - Domenica Carnicelli
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via San Giacomo 14, 40126 Bologna, Italy; (L.R.); (B.M.); (E.V.); (E.P.); (D.C.)
| | - Maurizio Brigotti
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via San Giacomo 14, 40126 Bologna, Italy; (L.R.); (B.M.); (E.V.); (E.P.); (D.C.)
- Correspondence: ; Tel.: +39-051-209-4716
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Varrone E, Albert SN. A stable liquifluor solution for counting 35S in protein-free solution prepared from plasma samples. J Nucl Med 1969; 10:263-4. [PMID: 5785023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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