Increased serum IL-10 and endothelin levels in hemolytic uremic syndrome caused by Escherichia coli O157

Nephron. 2000 Apr;84(4):326-32. doi: 10.1159/000045607.

Abstract

Background: Shiga toxin, produced by Escherichia coli O157:H7, is important for the pathogenicity of the epidemic form of hemolytic uremic syndrome (HUS). This toxin has recently been found to stimulate endothelin-1 synthesis in cultured endothelial cells in vitro.

Methods: We investigated endothelin and cytokine levels in sera during a large outbreak of E. coli O157:H7 infection in Osaka, Japan, in 1996. Eleven patients with HUS and 9 patients with hemorrhagic colitis at the onset of E. coli O157:H7 infection were studied.

Results: Serum IL-6 (p < 0.01), IL-8 (p < 0.05), IL-10 (p < 0.001) and endothelin (p < 0.001) levels were significantly increased in patients with HUS compared to those with colitis only. The serum thrombomodulin level, a molecular marker of endothelial damage, also showed a significant positive correlation with serum IL-6 (p < 0.01), IL-8 (p < 0.01), IL-10 (p < 0.01) and endothelin (p < 0.001) levels. In a HUS patient, the increase in serum IL-10 and endothelin levels reached a plateau prior to the peak of serum creatinine levels.

Conclusion: Increased serum endothelin synthesis by Shiga toxin in vivo was proven in HUS secondary to E. coli O157:H7 infection. Increased serum endothelin and IL-10 levels were speculated to be associated with the development of HUS through vascular endothelial damage caused by E. coli O157:H7 infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • Colitis / blood
  • Colitis / epidemiology
  • Colitis / etiology
  • Creatinine / blood
  • Disease Outbreaks
  • Endothelin-1 / blood*
  • Escherichia coli Infections / blood*
  • Escherichia coli Infections / epidemiology
  • Escherichia coli Infections / etiology*
  • Escherichia coli O157 / pathogenicity*
  • Female
  • Gastrointestinal Hemorrhage / blood
  • Gastrointestinal Hemorrhage / epidemiology
  • Gastrointestinal Hemorrhage / etiology
  • Hemolytic-Uremic Syndrome / blood*
  • Hemolytic-Uremic Syndrome / epidemiology
  • Hemolytic-Uremic Syndrome / etiology*
  • Humans
  • Interleukin-10 / blood*
  • Interleukin-6 / blood
  • Interleukin-8 / blood
  • Japan / epidemiology
  • Male
  • Thrombomodulin / blood
  • Time Factors

Substances

  • Endothelin-1
  • Interleukin-6
  • Interleukin-8
  • Thrombomodulin
  • Interleukin-10
  • Creatinine