Role of Shiga toxins in the pathogenesis of hemolytic uremic syndrome

During the pathogenesis of hemolytic uremic syndrome (HUS), a severe sequela of Shiga toxin (Stx)-producing Escherichia coli (STEC) gastrointestinal infections, before the toxin acts on the target endothelial cells of the kidney and brain, several Stx forms are transported in the bloodstream: free Stx; Stx bound to circulating cells through Gb3Cer and TLR4 receptors; and Stx associated to blood cell-derived microvesicles. The latter form is mainly responsible for the development of life-threatening HUS in 15% of STEC-infected patients. Stx consist of five B subunits non-covalently bound to a single A subunit (uncleaved Stx) which can be cleaved in two fragments (A1 and A2) held by a disulfide bond (cleaved Stx). After reduction, the enzymatically active A1 fragment responsible for toxicity is released. Cleaved and uncleaved Stx are biologically active but functionally different, thus their presence in patients’ blood could affect the onset of HUS. Currently, there are no effective therapies for the treatment of STEC-infected patients and the gold standard strategies available for the diagnosis are very expensive and time-consuming. In this thesis, by exploiting the resolving power of SERS technology (Amplified Raman Spectroscopy on Surfaces), a plasmonic biosensor was developed as effective diagnostic tool for early detection of Stx in patients’ sera. An acellular protein synthesis system for detecting cleaved Stx2a in human serum based on its greater translation inhibition after treatment with reducing agents was developed and used to identify cleaved Stx in STEC-infected patients’ sera. Pathogenic microvesicles from Stx2a-challenged blood from healthy donors were isolated and characterized. The antibiotic NAB815, acting as inhibitor of toxin binding to TLR4 expressed by circulating cells, was found to be effective in impairing the formation of blood cell-derived microvesicles containing Stx2a, also having a protective effect in cellular models. This approach could be proposed as an innovative treatment for HUS prevention.

Advances in methods to detect, isolate and quantify foodborne pathogens

Foodborne diseases impact human health and economies worldwide in terms of health care and productivity loss. Prevention is necessary and methods to detect, isolate and quantify foodborne pathogens play a fundamental role, changing continuously to face microorganisms and food production evolution. Official methods are mainly based on microorganisms growth in different media and their isolation on selective agars followed by confirmation of presumptive colonies through biochemical and serological test. A complete identification requires form 7 to 10 days. Over the last decades, new molecular techniques based on antibodies and nucleic acids allow a more accurate typing and a faster detection and quantification. The present thesis aims to apply molecular techniques to improve official methods performances regarding two pathogens: Shiga-like Toxin-producing Escherichia coli (STEC) and Listeria monocytogenes. In 2011, a new strain of STEC belonging to the serogroup O104 provoked a large outbreak. Therefore, the development of a method to detect and isolate STEC O104 is demanded. The first objective of this work is the detection, isolation and identification of STEC O104 in sprouts artificially contaminated. Multiplex PCR assays and antibodies anti-O104 incorporated in reagents for immunomagnetic separation and latex agglutination were employed. Contamination levels of less than 1 CFU/g were detected. Multiplex PCR assays permitted a rapid screening of enriched food samples and identification of isolated colonies. Immunomagnetic separation and latex agglutination allowed a high sensitivity and rapid identification of O104 antigen, respectively. The development of a rapid method to detect and quantify Listeria monocytogenes, a high-risk pathogen, is the second objective. Detection of 1 CFU/ml and quantification of 10–1,000 CFU/ml in raw milk were achieved by a sample pretreatment step and quantitative PCR in about 3h. L. monocytogenes growth in raw milk was also evaluated.