Shigatoxin-associated hemolytic uremic syndrome: current molecular mechanisms and future therapies
DRUG DESIGN DEVELOPMENT AND THERAPY, vol.6, pp.195-208, 2012 (SCI-Expanded, Scopus)
- Publication Type: Article / Review
- Volume: 6
- Publication Date: 2012
- Doi Number: 10.2147/dddt.s25757
- Journal Name: DRUG DESIGN DEVELOPMENT AND THERAPY
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Page Numbers: pp.195-208
- Keywords: hemolytic uremic syndrome, shigatoxin, diarrhea, Escherichia coli, complement, alternative pathway, eculizumab
- Dokuz Eylül University Affiliated: No
Abstract
Hemolytic uremic syndrome is the leading cause of acute kidney injury in childhood. Ninety percent of cases are secondary to gastrointestinal infection with shigatoxin-producing bacteria. In this review, we discuss the molecular mechanisms of shigatoxin leading to hemolytic uremic syndrome and the emerging role of the complement system and vascular endothelial growth factor in its pathogenesis. We also review the evidence for treatment options to date, in particular antibiotics, plasma exchange, and immunoadsorption, and link this to the molecular pathology. Finally, we discuss future avenues of treatment, including shigatoxin-binding agents and complement inhibitors, such as eculizumab.